Articular cartilage: What it is, why it fails in osteoarthritis, and what can be done about it

Articular cartilage covers the ends of long bones and together with synovial fluid is responsible for the remarkably efficient mechanical properties of synovial joints. In osteoarthritis (OA) joint articular cartilage fails. While the etiology of cartilage failure in OA is still controversial, some of the mechanisms responsible for loss of proteoglycans from these tissues have been identified and offer insights for potential avenues of therapeutic control. Many non‐steroidal antiinflammatory drugs (NSAIDs), although effective at suppressing the symptoms of OA, do little to support the attempts by chondrocytes to replenish proteoglycan loss from the extracellular matrix. However, evidence is now accumulating, largely from studies using animal models, that not all antiarthritic agents are deleterious to cartilage. Some may even promote those anabolic processes necessary for its repair and restoration of function. These recent developments offer a more optimistic approach for the therapeutic management of the osteoarthritic patient in the future.