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You are watching: A major characteristic of fibrocartilage is its unique amount of flexibility and elasticity.

StatPearls . Endowment Island (FL): StatPearls Publishing; 2021 Jan-.


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Introduction

Cartilage has plenty of functions, consisting of the ability to withstand compressive forces, enhance bone resilience, and carry out support on bony locations where over there is a need for flexibility. The major cell that makes cartilage is the chondrocyte, which stays within the lacunae. The matrix of cartilage consists that fibrous tissue and also various combinations of proteoglycans and also glycosaminoglycans. Cartilage, once synthesized, lacks lymphatic or blood supply and also the movement of waste and nutrition is chiefly via diffusion to and also from surrounding tissues. Cartilage, like bone, is surrounded by a perichondrium-like fibrous membrane. This layer is not efficient in ~ regenerating cartilage. Hence, its recovery is slow-moving after injury. The lack of energetic blood circulation is the significant reason any type of injury to cartilage bring away a lengthy time come heal. Cartilage has actually no nerve innervation, and also hence over there is no sensation when it is injured or damaged. Once there is calcification of cartilage, the chondrocytes die. This is adhered to by the instead of of cartilage with bone-like tissue. Uneven bone, cartilage walk not have actually calcium in the matrix. Instead, it includes high amounts of chondroitin, which is the product that offers elasticity and also flexibility.


Structure and also Function

Several species of cartilage are found in the person body, and also their structure and relevant role depend on this variation. 

Hyaline Cartilage

Hyaline cartilage is the many copious type the cartilage in the human body.<1> It has a pale blue-white color and also is smooth to the touch. It is primarily composed of form II collagen and also proteoglycans. The surface ar is generally moist, however with age, the cartilage i do not care dry, thinner, and more yellow. Hyaline cartilage is usually found in the trachea, nose, epiphyseal expansion plate, sternum, and ventral segments of the ribs. Hyaline cartilage to produce a long lasting surface with minimal friction. It additionally has fantastic ability to withstand compressive forces at website of bone articulation.<2>

Elastic Cartilage

This cartilage appears a dull yellow and is most generally found in the larynx, ear, epiglottis, and eustachian tube. A perichondrium-like layer additionally surrounds it. It provides flexibility and is sturdy to pressure.<3>

Fibrocartilage

This is abundant in kind 1 collagen and contains significantly less proteoglycan than hyaline cartilage. It have the right to resist high degrees of tension and also compression. That is commonly found in tendons, ligaments, intervertebral discs, articular surfaces of some bones, and also in menisci. Unlike various other cartilage, it has actually no perichondrium.<4>


Embryology

Cartilage is created from the mesoderm germ layer by the process known together chondrogenesis.<5> Mesenchyme differentiates right into chondroblasts, which are the cells that secrete the significant components the the extracellular matrix—the most crucial of these components for cartilage development being aggrecan and form II collagen. When initial chondrification occurs, the immature cartilage grows mostly by developing into a an ext mature state since it cannot grow by mitosis. Over there is minimal cell department in cartilage; therefore, the size and mass that cartilage perform not change significantly after originally chondrification.


Blood Supply and also Lymphatics

Cartilage is avascular. This characteristic of cartilage is paramount during the discussion and management of illness affecting cartilage. Since there is no straight blood supply, chondrocytes obtain nourishment via diffusion indigenous the neighboring environment. The compressive pressures that frequently act top top cartilage likewise increase the diffusion of nutrients. This indirect procedure of receiving nutrients is a major factor in the sluggish turnover that the extracellular matrix and also lack the repair checked out in cartilage.


Nerves

Cartilage does not contain nerves; it is aneural.<6> If any pain is linked with a pathology entailing cartilage, that is most frequently due to irritation of bordering structures, such together inflammation that the joint and bone in osteoarthritis.


Muscles

Fibrocartilage is a major component of entheses, defined as the connective tissue between muscle tendon or ligament and bone. The fibrocartilaginous enthesis is composed of 4 transition zones together it progresses native tendon come bone.<7> These change zones are provided in bespeak of progression from muscle come bone. 


Longitudinal fibroblasts and a parallel arrangement of collagen fibers are uncovered in the tendinous area
A fibrocartilaginous region where the main type of cells current transitions from fibroblast come chondrocytes
A an ar called the "blue line" or "tide mark" because of an abrupt shift from cartilaginous to calcified fibrocartilage
Bone

Clinical Significance

An immense range of clinical pathology exists entailing cartilage, such as osteoarthritis, spinal bowl herniation, traumatic rupture/detachment, achondroplasia, costochondritis, and also neoplasm, and also many others. These an outcome from a variety of degenerative, inflammatory, and also congenital causes.

Osteoarthritis is a condition affecting the totality joint; however, the articular cartilage (a subset the hyaline cartilage) within the share is the most influenced tissue. Osteoarthritis is well-known as a "wear and tear" phenomenon due to it greatly affecting joints under higher amounts of stress. It results as result of articular cartilage gift thinned and wearing away. This at some point results in a decreased variety of motion, "bone versus bone" call within the joint, and also pain. The early stage clinical therapy is with anti-inflammatories and corticosteroid injections intraarticularly. Both therapies duty to minimize the inflammation reaction brought about by the degenerative cartilage"s relax of cytokines. Patients may also show development by shedding weight, exercising, and also efforts to decrease joint anxiety with remainder and using a cane. Eventually, however, countless patients will construct pain and symptoms that interfere with everyday life. In ~ this point, joint instead of or resurfacing might be recommended. Arthroscopic surgical procedure is no longer recommended together it go not boost outcomes in knee osteoarthritis and can cause harm.

Another usual degenerative disease of cartilage is spinal bowl herniation. It is due to degenerative changes of the outer ring that the intervertebral disc, called the annulus fibrosus. The annulus fibrosus is written of fibrocartilage. Trauma, straining, and also lifting injuries are likewise implicated in the weakening the the annulus fibrosis predisposing come disc herniation. Once there is structural damages to the annulus fibrosus, the cell nucleus pulposus had within the disc might herniate into the spinal canal, leading to impingement of 1 or many nerves as well together induce inflammatory alters due come the damaged fibrocartilage.<9> Diagnosis is made by history, symptoms, and physical examination. At some suggest in the evaluation, imaging studies are usually conducted to preeminence out other reasons such as tumors, spondylolisthesis, and space-occupying lesions. Although some patients warrant surgery because of the severity the symptoms, most situations do not need surgical intervention as they solve with conservative procedures such as anti-inflammatories and also lifestyle transforms for the patient.

In comparison to the degenerative diseases of cartilage, Achondroplasia is a genetic disorder that cartilage formation and is the many common reason of dwarfism. The pathology checked out is as result of a mutation on chromosome 4 influence the fibroblast development factor receptor 3 (FGFR3) gene, i m sorry normally functions as a negative regulator of bone and also cartilage growth. The mutation in achondroplasia results in a truncated dysfunctional protein that is constitutively active. These dysfunctional protein impede cartilage expansion and advancement by suppressing chondrocyte proliferation and calcification.

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<10> The diagnosis of achondroplasia is usually throughout pregnancy via prenatal ultrasound. Over there is currently no recognized cure for achondroplasia as it is not impacted by a hormone pathway that deserve to be pharmacologically manipulated, and also corrective surgical treatment is controversial.<11>