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In this test, acetic acid is added to the synovial fluid specimen. In a normal specimen, this should lead to a congealing of the hyaluronic acid, forming a 'mucin clot.' If inflammation is present, a mucin clot is not formed (the hyaluronic acid is degraded). [21] Lactate is elevated in septic arthritis, usually above 250 mg/dL.
Articular cartilage repair treatment involves the repair of the surface of the articular joint's hyaline cartilage, though these solutions do not perfectly restore the articular cartilage. These treatments have been shown to have positive results for patients who have articular cartilage damage.
A 2011 study reported histologically confirmed hyaline cartilage regrowth in the knee. The successful protocol involved arthroscopic microdrilling/ microfracture surgery followed by postoperative injections of autologous peripheral blood progenitor cells (PBPCs) and hyaluronic acid . [ 15 ]
Hyaline cartilage is the glass-like and translucent cartilage found on many joint surfaces. It is also most commonly found in the ribs , nose, larynx , and trachea . [ 1 ] Hyaline cartilage is pearl-gray in color, with a firm consistency and has a considerable amount of collagen.
They reported a case study in which a full-thickness defect in the articular cartilage of a human knee was successfully repaired. [23] While the use of cultured mesenchymal stem cells has shown promising results, a more recent study using uncultured MSC's has resulted in full-thickness, histologically confirmed hyaline cartilage regrowth.
Histology of a synovial membrane. H&E stain. The synovial membrane is variable but often has two layers: [4] The outer layer, or subintima, can be of almost any type of connective tissue – fibrous (dense collagenous type), adipose (fatty; e.g. in intra-articular fat pads) or areolar (loose collagenous type).
Within finished cartilage, collagen fibers compose 10-20% of the volume, water 65-80%, and the proteoglycan-hyaluronic acid aggregates the remaining portion. Due to the proliferative nature of chondroblasts, cells compose a larger portion of the composition than what is normally found within completed cartilage.
Hyaluronic acid is a polymer of disaccharides, which are composed of D-glucuronic acid and N-acetyl-D-glucosamine, linked via alternating β-(1→4) and β-(1→3) glycosidic bonds. Hyaluronic acid can be 25,000 disaccharide repeats in length. Polymers of hyaluronic acid can range in size from 5,000 to 20,000,000 Da in vivo.