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Phases of Acute Joint Injury and Biologic Response
| Early phase: Cell death and inflammation |
| Necrosis |
| Apoptosis |
| Matrix degradation |
| Elevated caspase, proinflammatory cytokines, nitric oxide, reactive oxygen species, basic fibroblast growth factor, matrix metalloproteinases, aggrecanases, release of matrix fragments |
| Intermediate phase: Balance of catabolic and anabolic phases |
| Late phase: Matrix formation |
| Initial anabolic response |
| Matrix synthesis |
| Elevated anabolic growth factors |
