Cartilaginous intra-articular bodies float freely within the synovial fluid, which they require for nutrition and growth. Progressive enlargement and ossification occur with time. If they remain free, they continue to grow larger and more calcified. In severe cases, they may occupy the entire joint space or penetrate to adjacent tissues. Alternately, they can deposit in the synovial lining, reestablish a blood supply, and become replaced by bone. On occasion, synovial reattachment can lead to complete reabsorption of the cartilage fragment.
Both aging cartilage and osteoarthritic cartilage share the common change of decreased proteoglycan content as shown in Illustration A. The review article by Martin et al states that OA is not an inevitable consequence of aging but rather, aging increases the risk of OA because of a decrease in the ability of chondrocytes to maintain and repair the tissue. Increased water content and chondroitin sulfate concentration are seen with osteoarthritis but not aging. Decreased collagen content, modulus of elasticity, and keratin sulfate concentration are also seen with osteoarthritis but not aging.
SUPARTZ is indicated for treatment of pain in osteoarthritis (OA) of the knee in patients who have failed to respond adequately to conservative non-pharmacologic therapy and simple analgesics, ., acetaminophen. You should not use SUPARTZ if you have infections or skin diseases at the injection site or allergies to poultry products. SUPARTZ is not approved for pregnant or nursing women, or children. Risks can include general knee pain, warmth and redness or pain at the injection site. Full prescribing information can be found here or by contacting customer service at 800-396-4325.