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Biomecanica Del Cartilago Articular
Biomecanica Del Cartilago Articular
Biomecanica Del Cartilago Articular
Osteoartrosis
Asesor: Dr. Med. Eduardo
lvarez
Toms Alejandro Ramos
Snchez R3
Cartlago Articular
Tejido elstico avascular, aneural y
alinftico que recubre las articulaciones
diartrodiales del esqueleto
Cartlago Articular
Funcin
Facilita el deslizamiento y lubricacin
articular
Disminuye la friccin y ayuda a la
movilidad sin dolor
Absorbe los traumatismos mecnicos
Distribuye las cargas sobre el hueso
subyacente
Cartlago Articular
Chapte
Condrocitos
Matriz extracelular
Colgeno
Proteoglicanos
Protenas no colagenicas
Figure 6 A, Electron micrograph sho wing the articular cartilage m
8-month-old rabbit. Arro w heads indicate pericellular matrix, * indicate
electron micrograph sho wing the same matrix compartments and the re
matrix. Bar = 1 nm. Notice the short-cell processes that extend through
Hunziker EB, Rosenberg LC, et al: Articular cartilage: Composition and str
the M usculoskeletal So f t Tissues. Park Ridge, IL, A merican Academy of Or
Condrocitos
sponsible for the maintenance and structural competence amounts of macromolecules and assembling them into a
highly ordered macromolecular framework. To accom-
plish these activities, the cells must sense changes in the
matrix composition caused by degradation of macromol-
ecules and the mechanical demands placed on the articu-
lar surface, and then respond by synthesizing appropriate
madre pluripotenciales del mesnquima
proteoglycans, their proliferative capacity, and their re-
sponse to anabolic stimuli (including growth factors) de-
creases. These changes may limit the ability of the cells to
Representan el 1% del volumen total.
maintain and restore the tissue and thereby contribute to
the development and progression of articular cartilage de-
generation.
La concentracin varia de
vides the tensile acuerdo
stiffness a la
and strength of articular cartilage
and contributes to the cohesiveness of the tissue by me-
com
mo
articulacin, edad, dao articular y
chanically entrapping the large proteoglycans. The princi-
pal articular cartilage collagen, type II, accounts for 90%
cro
the
enfermedad.
to 95% of the cartilage collagen and forms the primary mo
typ
int
Glucosaminoglicanos: disacridos ing
bin
repetidos
lag
pe
Dermatan sulfato
Pr
Pro
.
cos
cha
Proteoglicanos
2 tipos principales
Molculas de cadena Larga 90%
Agrecanos
Molculas Cortas 10%
Decorinas
Biglycano
Fibromodulina
Colgeno tipo IX
Protenas no colgenicas y
glucocoprotenas
Protenas, monosacridos u
oligosacridos
Zonas
Superficial o tangencial
Zona media o radial
ziker EB, Rosenberg LC, et al: Articular cartilage: Composition
and structure, in W oo SL, Buck w alter JA (eds): Injury and Repair
o f the M usculoskeletal So f t Tissues. Park Ridge, IL, A merican
Academy of Orthopaedic Surgeons, 1988, pp 405-425.)
Zona Transicional
plish these activities, the cells must sense changes in the
matrix composition caused by degradation of macromol-
ecules and the mechanical demands placed on the articu-
lar surface, and then respond by synthesizing appropriate
Mayor espesor que la zona superficial
types and amounts of macromolecules.
Aging profoundly alters chondrocyte function. With
aging, the capacity of the cells to synthesize some types of
Condrocitos esferoidales
proteoglycans, their proliferative capacity, and their re-
sponse to anabolic stimuli (including growth factors) de-
Fibras colgeno
creases. These changes may limit the ability of the cells to
maintain and restore the tissue and thereby contribute to
the development and progression of articular cartilage de-
Mayor dimetro
generation.
No organizadas y oblicuas
Figure 1
a la superficie
Extracellular M atrix
Articular cartilage from the medial f emoral condyle
o f an 8-month-old rabbit. The tissue is organized into f our lay-
The articular cartilage matrix consists of two compo-
ers or zones: the superficial zone (S), the transitional zone (T),
nents: the tissue fluid and the framework of structural
Mayor contenido de proteoglicanos
the middle (radial or deep) zone (M), and the calcified cartilage
zone (C). Bar = 50 nm. (Reproduced from Buck w alter JA, Hun-
ziker EB, Rosenberg LC, et al: Articular cartilage: Composition
macromolecules that give the tissue its form and stability.
The interaction of the tissue fluid and the macromolecu-
lar framework give the tissue its mechanical propertiesChap
Menos concentracin de agua
and structure, in W oo SL, Buck w alter JA (eds): Injury and Repair of
o f the M usculoskeletal So f t Tissues. Park Ridge, IL, A merican
Academy of Orthopaedic Surgeons, 1988, pp 405-425.)
stiffness and resilience. Water contributes up to 80% of
amounts of macromolecules and assembling them into a
highly ordered macromolecular framework. To accom-
plish these activities, the cells must sense changes in the
la superficie
maintain and restore the tissue and thereby contribute to
the development and progression of articular cartilage de-
generation.
Fibras
Extracellular M atrixde colgeno de mayor dimetro
The articular cartilage matrix consists of two compo-
Figure 1 Articular cartilage from the medial f emoral condyle Extracellular M atrix
subcondral
ziker EB, Rosenberg LC, et al: Articular cartilage: Composition
and structure, in W oo SL, Buck w alter JA (eds): Injury and Repair
o f the M usculoskeletal So f t Tissues. Park Ridge, IL, A merican
The interaction of the tissue fluid and the macro
lar framework give the tissue its mechanical prop
stiffness and resilience. Water contributes up to
Academy of Orthopaedic Surgeons, 1988, pp 405-425.)
Figure 2 Electron micrographs sho w ing the superficial zone (A), transitional zone (B), middle (radial or deep) zone (C),
fied cartilage zone (D) o f mature articular cartilage chondrocytes from the medial f emoral condyle o f a rabbit. N = n u
Interaccin Matriz -
Condrocito
En respuesta a diferentes estmulos
Autocrino o paracrino
Interleucina 1
Metaloproteasas
Degradan macromolculas
Interfieren en la sntesis te proteoglicanos
Caderas
Pie
Columna
Manos
Osteoartritis
Sntomas y signos
Dolor
Limitacin de la movilidad
Crepitacin
Inflamacin
Deformidad
Osteoartrosis
Tejidos involucrados
Tejido sinovial
Cartilago articular
Hueso subcondral y metafisiario
Ligamentos
Capsula articular
Msculos
Cambio Primario
Perdida del cartilago articular, remodelacin de
hueso subcondral y formacin de osteofitos.
Osteoartrosis
Microscpicos + tempranos
Deshilachamiento o desfibrilacin de la zona
superficial hasta transicional del cartlago
articular.
Inflamacin Articular
Disminucin en la rigidez
de la matriz extracelular
Osteoartrosis
2 Fase
Condrocitos detectan dao en los tejidos o
alteracin en la osmolaridad, densidad o
estructura y liberan mediadores que
estimulan la respuesta celular
Osteoartritis
2 Fase. Respuesta
Actividad anablica y catablica
Respuesta Anablica
Proliferacin de condrocitica
Sntesis de matriz extracelular
Respuesta Catablica
Produccin de Oxido Ntrico
Produccin de Interleucina 1
Condrocitos
Liberacin en
respuesta a un estrs
Oxido
ntrico
Interleucina
1
Metaloproteas
as
Degradacin de
las molculas de
la matriz
(fibronectina)
Interleucina
1
Osteoartritis
3 Fase
Falla en estabilizar o restaurar el tejido.
Dao progresivo el cartlago articular
Disminucin en la respuesta anablica de los
condrocitos
Osteoartrosis
Osteoartritis
Alteraciones del hueso subcondral
Incremento en la densidad del hueso
subcondral o esclerosis subcondral
(Primer signo de enf. articular degenerativa en hueso
subcondral)
Formacin de cavidades seas en forma de
quiste con tejido mixoide, fibroso o
cartilaginoso
Apariencia de cartilago regenerativo en o
sobre el hueso subcondral. OSTEOFITOS
Osteoartritis
Acortamiento
Deformidad
Inestabilidad
Tratamiento
Objetivos
Alivio de sintomas
Mantener/mejorar funcin
Limitar incapacidad fsica
Evitar toxicidad medicamentosa