Skip to main content
PMC home page
The Canadian Veterinary Journal logoLink to The Canadian Veterinary Journal
. 1990 Aug;31(8):565-567, 570-572.

Cartilage healing: A review with emphasis on the equine model

Marc R Desjardins, Mark B Hurtig
PMCID: PMC1480835  PMID: 17423644

Abstract

Articular cartilage is a remarkably resilient tissue capable of withstanding considerable stress and repeated loading. Since this tissue has no blood vessels, nerve elements, or lymphatics, it is not surprising that it has a limited capacity for repair when damaged. In the horse, cartilage damage occurs as an occupational hazard. Furthermore, developmental defects such as osteochondrosis can lead to osteochondritis dissecans. Resultant cartilage flaps, fissures, and poorly organized subchondral bone produce disruption of joint surfaces.

Veterinarians are often called upon to intervene when damaged cartilage has healed incompletely. Basic understanding of the physiology and repair mechanisms of cartilage is paramount to successfully managing such injuries. This literature review gives a brief overview of recently published clinical and experimental studies on the healing of cartilage. The discussion centers on the equine model.

Full text

PDF
570

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BASSETT C. A., HERRMANN I. Influence of oxygen concentration and mechanical factors on differentiation of connective tissues in vitro. Nature. 1961 Apr 29;190:460–461. doi: 10.1038/190460a0. [DOI] [PubMed] [Google Scholar]
  2. Bentley G. Chondromalacia patellae. J Bone Joint Surg Am. 1970 Mar;52(2):221–232. [PubMed] [Google Scholar]
  3. Bramlage L. R. Surgical diseases of the carpus. Vet Clin North Am Large Anim Pract. 1983 Jul;5(2):261–274. doi: 10.1016/s0196-9846(17)30078-2. [DOI] [PubMed] [Google Scholar]
  4. Brown T. D., Shaw D. T. In vitro contact stress distribution on the femoral condyles. J Orthop Res. 1984;2(2):190–199. doi: 10.1002/jor.1100020210. [DOI] [PubMed] [Google Scholar]
  5. Campbell C. J. The healing of cartilage defects. Clin Orthop Relat Res. 1969 May-Jun;64:45–63. [PubMed] [Google Scholar]
  6. Childers J. C., Jr, Ellwood S. C. Partial chondrectomy and subchondral bone drilling for chondromalacia. Clin Orthop Relat Res. 1979 Oct;(144):114–120. [PubMed] [Google Scholar]
  7. Coletti J. M., Jr, Akeson W. H., Woo S. L. A comparison of the physical behavior of normal articular cartilage and the arthroplasty surface. J Bone Joint Surg Am. 1972 Jan;54(1):147–160. [PubMed] [Google Scholar]
  8. Convery F. R., Akeson W. H., Keown G. H. The repair of large osteochondral defects. An experimental study in horses. Clin Orthop Relat Res. 1972 Jan-Feb;82:253–262. [PubMed] [Google Scholar]
  9. DePalma A. F., McKeever C. D., Subin D. K. Process of repair of articular cartilage demonstrated by histology and autoradiography with tritiated thymidine. Clin Orthop Relat Res. 1966 Sep-Oct;48:229–242. [PubMed] [Google Scholar]
  10. Ficat R. P., Ficat C., Gedeon P., Toussaint J. B. Spongialization: a new treatment for diseased patellae. Clin Orthop Relat Res. 1979 Oct;(144):74–83. [PubMed] [Google Scholar]
  11. Firth E. C., Hartman W. An in vitro study on joint fitting and cartilage thickness in the radiocarpal joint of foals. Res Vet Sci. 1983 May;34(3):320–326. [PubMed] [Google Scholar]
  12. French D. A., Barber S. M., Leach D. H., Doige C. E. The effect of exercise on the healing of articular cartilage defects in the equine carpus. Vet Surg. 1989 Jul-Aug;18(4):312–321. doi: 10.1111/j.1532-950x.1989.tb01091.x. [DOI] [PubMed] [Google Scholar]
  13. Friedman M. J., Berasi C. C., Fox J. M., Del Pizzo W., Snyder S. J., Ferkel R. D. Preliminary results with abrasion arthroplasty in the osteoarthritic knee. Clin Orthop Relat Res. 1984 Jan-Feb;(182):200–205. [PubMed] [Google Scholar]
  14. Fuller J. A., Ghadially F. N. Ultrastructural observations on surgically produced partial-thickness defects in articular cartilage. Clin Orthop Relat Res. 1972 Jul-Aug;86:193–205. doi: 10.1097/00003086-197207000-00031. [DOI] [PubMed] [Google Scholar]
  15. Furukawa T., Eyre D. R., Koide S., Glimcher M. J. Biochemical studies on repair cartilage resurfacing experimental defects in the rabbit knee. J Bone Joint Surg Am. 1980 Jan;62(1):79–89. [PubMed] [Google Scholar]
  16. Ghadially F. N., Ailsby R. L., Oryschak A. F. Scanning electron microscopy of superficial defects in articular cartilage. Ann Rheum Dis. 1974 Jul;33(4):327–332. doi: 10.1136/ard.33.4.327. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Goodfellow J., Hungerford D. S., Woods C. Patello-femoral joint mechanics and pathology. 2. Chondromalacia patellae. J Bone Joint Surg Br. 1976 Aug;58(3):291–299. doi: 10.1302/0301-620X.58B3.956244. [DOI] [PubMed] [Google Scholar]
  18. Hawkins R. B. Arthroscopic treatment of sports-related anterior osteophytes in the ankle. Foot Ankle. 1988 Oct;9(2):87–90. doi: 10.1177/107110078800900205. [DOI] [PubMed] [Google Scholar]
  19. Hjertquist S. O., Lemperg R. Histological, autoradiographic and microchemical studies of spontaneously healing osteochondral articular defects in adult rabbits. Calcif Tissue Res. 1971;8(1):54–72. doi: 10.1007/BF02010122. [DOI] [PubMed] [Google Scholar]
  20. Hotchkiss R. N., Tew W. P., Hungerford D. S. Cartilaginous debris in the injured human knee. Correlation with arthroscopic findings. Clin Orthop Relat Res. 1982 Aug;(168):144–156. [PubMed] [Google Scholar]
  21. Hurtig M. B., Fretz P. B., Doige C. E., Schnurr D. L. Effects of lesion size and location on equine articular cartilage repair. Can J Vet Res. 1988 Jan;52(1):137–146. [PMC free article] [PubMed] [Google Scholar]
  22. Insall J. The Pridie debridement operation for osteoarthritis of the knee. Clin Orthop Relat Res. 1974 Jun;(101):61–67. [PubMed] [Google Scholar]
  23. Itay S., Abramovici A., Nevo Z. Use of cultured embryonal chick epiphyseal chondrocytes as grafts for defects in chick articular cartilage. Clin Orthop Relat Res. 1987 Jul;(220):284–303. [PubMed] [Google Scholar]
  24. Jeffcott L. B., Kold S. E., Melsen F. Aspects of the pathology of stifle bone cysts in the horse. Equine Vet J. 1983 Oct;15(4):304–311. doi: 10.1111/j.2042-3306.1983.tb01806.x. [DOI] [PubMed] [Google Scholar]
  25. Kimizuka M., Kurosawa H., Fukubayashi T. Load-bearing pattern of the ankle joint. Contact area and pressure distribution. Arch Orthop Trauma Surg. 1980;96(1):45–49. doi: 10.1007/BF01246141. [DOI] [PubMed] [Google Scholar]
  26. Kincaid S. A., Van Sickle D. C. Regional histochemical and thickness variations of adult canine articular cartilage. Am J Vet Res. 1981 Mar;42(3):428–432. [PubMed] [Google Scholar]
  27. Kold S. E., Hickman J., Melsen F. An experimental study of the healing process of equine chondral and osteochondral defects. Equine Vet J. 1986 Jan;18(1):18–24. doi: 10.1111/j.2042-3306.1986.tb03529.x. [DOI] [PubMed] [Google Scholar]
  28. Kozinn S. C., Scott R. D. Surgical treatment of unicompartmental degenerative arthritis of the knee. Rheum Dis Clin North Am. 1988 Dec;14(3):545–564. [PubMed] [Google Scholar]
  29. Mankin H. J. The reaction of articular cartilage to injury and osteoarthritis (second of two parts). N Engl J Med. 1974 Dec 19;291(25):1335–1340. doi: 10.1056/NEJM197412192912507. [DOI] [PubMed] [Google Scholar]
  30. Mankin H. J. The response of articular cartilage to mechanical injury. J Bone Joint Surg Am. 1982 Mar;64(3):460–466. [PubMed] [Google Scholar]
  31. Martin G. S., McIlwraith C. W. Arthroscopic anatomy of the intercarpal and radiocarpal joints of the horse. Equine Vet J. 1985 Sep;17(5):373–376. doi: 10.1111/j.2042-3306.1985.tb02526.x. [DOI] [PubMed] [Google Scholar]
  32. McIlwraith C. W., Yovich J. V., Martin G. S. Arthroscopic surgery for the treatment of osteochondral chip fractures in the equine carpus. J Am Vet Med Assoc. 1987 Sep 1;191(5):531–540. [PubMed] [Google Scholar]
  33. Meachim G., Roberts C. Repair of the joint surface from subarticular tissue in the rabbit knee. J Anat. 1971 Jul;109(Pt 2):317–327. [PMC free article] [PubMed] [Google Scholar]
  34. Milgram J. W. Injury to articular cartilage joint surfaces. I. Chondral injury produced by patellar shaving: a histopathologic study of human tissue specimens. Clin Orthop Relat Res. 1985 Jan-Feb;(192):168–173. [PubMed] [Google Scholar]
  35. Mitchell N., Shepard N. Effect of patellar shaving in the rabbit. J Orthop Res. 1987;5(3):388–392. doi: 10.1002/jor.1100050311. [DOI] [PubMed] [Google Scholar]
  36. Mitchell N., Shepard N. Healing of articular cartilage in intra-articular fractures in rabbits. J Bone Joint Surg Am. 1980;62(4):628–634. [PubMed] [Google Scholar]
  37. Mitchell N., Shepard N. The resurfacing of adult rabbit articular cartilage by multiple perforations through the subchondral bone. J Bone Joint Surg Am. 1976 Mar;58(2):230–233. [PubMed] [Google Scholar]
  38. Nelson B. H., Anderson D. D., Brand R. A., Brown T. D. Effect of osteochondral defects on articular cartilage. Contact pressures studied in dog knees. Acta Orthop Scand. 1988 Oct;59(5):574–579. doi: 10.3109/17453678809148788. [DOI] [PubMed] [Google Scholar]
  39. Palmer S. E. Prevalence of carpal fractures in thoroughbred and standardbred racehorses. J Am Vet Med Assoc. 1986 May 15;188(10):1171–1173. [PubMed] [Google Scholar]
  40. Radin E. L., Paul I. L. A consolidated concept of joint lubrication. J Bone Joint Surg Am. 1972 Apr;54(3):607–613. [PubMed] [Google Scholar]
  41. Richardson D. W., Clark C. C. Biochemical changes in articular cartilage opposing full- and partial-thickness cartilage lesions in horses. Am J Vet Res. 1990 Jan;51(1):118–122. [PubMed] [Google Scholar]
  42. Riddle W. E., Jr Healing of articular cartilage in the horse. J Am Vet Med Assoc. 1970 Dec 1;157(11):1471–1479. [PubMed] [Google Scholar]
  43. Salter R. B., Hamilton H. W., Wedge J. H., Tile M., Torode I. P., O'Driscoll S. W., Murnaghan J. J., Saringer J. H. Clinical application of basic research on continuous passive motion for disorders and injuries of synovial joints: a preliminary report of a feasibility study. J Orthop Res. 1984;1(3):325–342. doi: 10.1002/jor.1100010313. [DOI] [PubMed] [Google Scholar]
  44. Salter R. B., Simmonds D. F., Malcolm B. W., Rumble E. J., MacMichael D., Clements N. D. The biological effect of continuous passive motion on the healing of full-thickness defects in articular cartilage. An experimental investigation in the rabbit. J Bone Joint Surg Am. 1980 Dec;62(8):1232–1251. [PubMed] [Google Scholar]
  45. Salter R. B. The biologic concept of continuous passive motion of synovial joints. The first 18 years of basic research and its clinical application. Clin Orthop Relat Res. 1989 May;(242):12–25. [PubMed] [Google Scholar]
  46. Shamis L. D., Bramlage L. R., Gabel A. A., Weisbrode S. Effect of subchondral drilling on repair of partial-thickness cartilage defects of third carpal bones in horses. Am J Vet Res. 1989 Feb;50(2):290–295. [PubMed] [Google Scholar]
  47. Shimizu T., Videman T., Shimazaki K., Mooney V. Experimental study on the repair of full thickness articular cartilage defects: effects of varying periods of continuous passive motion, cage activity, and immobilization. J Orthop Res. 1987;5(2):187–197. doi: 10.1002/jor.1100050205. [DOI] [PubMed] [Google Scholar]
  48. Strömberg B., Rejnö S. Osteochondrosis in the horse. I. A clinical and radiologic investigation of osteochondritis dissecans of the knee and hock joint. Acta Radiol Suppl. 1978;358:139–152. [PubMed] [Google Scholar]
  49. Suzuki Y. Studies on the repair tissue of injured articular cartilage--biochemical and biomechanical properties. Nihon Seikeigeka Gakkai Zasshi. 1983 Jul;57(7):741–752. [PubMed] [Google Scholar]
  50. Trotter G. W., Yovich J. V., McIlwraith C. W., Norrdin R. W. Effects of intramuscular polysulfated glycosaminoglycan on chemical and physical defects in equine articular cartilage. Can J Vet Res. 1989 Apr;53(2):224–230. [PMC free article] [PubMed] [Google Scholar]
  51. Vachon A., Bramlage L. R., Gabel A. A., Weisbrode S. Evaluation of the repair process of cartilage defects of the equine third carpal bone with and without subchondral bone perforation. Am J Vet Res. 1986 Dec;47(12):2637–2645. [PubMed] [Google Scholar]
  52. WILES P., ANDREWS P. S., DEVAS M. B. Chondromalacia of the patella. J Bone Joint Surg Br. 1956 Feb;38-B(1):95–113. doi: 10.1302/0301-620X.38B1.95. [DOI] [PubMed] [Google Scholar]
  53. Wyburn R. S. A degenerative joint disease in the horse. N Z Vet J. 1977 Nov;25(11):321-2, 335. doi: 10.1080/00480169.1977.34445. [DOI] [PubMed] [Google Scholar]

Articles from The Canadian Veterinary Journal are provided here courtesy of Canadian Veterinary Medical Association

RESOURCES