Osteoarthritis: What You Need to Know (Cleveland Clinic)

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What is osteoarthritis?
Arthritis, which means "joint inflammation," causes joint pain and swelling. There are many types of arthritis, but osteoarthritis is the most common type. Also known as degenerative joint disease or age-related arthritis, osteoarthritis is more likely to develop as people age. Inflammation and injury to the joint cause a breaking down of cartilage tissues, resulting in pain, swelling and deformity. The changes in osteoarthritis usually occur slowly over many years, though there are occasional exceptions.

There are two main types of osteoarthritis:

  • primary: more generalized osteoarthritis that affects the fingers, thumbs, spine, hips, and knees
  • secondary: osteoarthritis that occurs after injury or inflammation in a joint

What is cartilage?
Cartilage is a firm, rubbery material covering the ends of bones in normal joints (see figure 1). It is primarily composed of water and proteins whose primary function is to reduce friction in the joints and serve as a "shock absorber." The shock-absorbing quality of normal cartilage comes from its ability to change shape when compressed, because of its high water content. Although cartilage may undergo some repair when damaged, the body does not regenerate new cartilage after injury.

Cartilage is made up of two main elements: a gel-like substance called matrix composed primarily of water and two types of proteins – collagen and proteoglycans - and cells known as chondrocytes that are contained within the matrix.

  • Collagen is a structural protein found in many tissues such as skin, tendons and bone, and is a key structural component of cartilage. Collagen provides cartilage with its strength and creates a framework for the other components of cartilage.
  • Proteoglycans are complex molecules composed of protein and sugar combinations that are interwoven in the matrix of cartilage. Their function is to trap large amounts of water in cartilage, which allows it to change shape when compressed and thus act as shock absorber.
  • Water makes up a large part of healthy cartilage. Water helps to form a "gel-like" matrix with the other components outlined, allowing it to function as the "shock absorber" for the joint. In diseases like osteoarthritis, cartilage loses a lot of its water content. This water loss diminishes protection of the joint.
  • Chondrocytes are highly complex multifunctional cartilage cells. Functions include production of collagen, proteoglycans, and enzymes involved in the maintenance of healthy cartilage. As cartilage forms, these cells migrate through the different layers of cartilage, changing as they do so by mechanisms that are not fully understood.

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Last Updated: 4/20/2010

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