What Is Osteoarthritis?
5. Disease Progression
The progression of osteoarthritis can be divided into three stages. At stage 1, the cartilage matrix goes through proteolytic breakdown. Stage 2 involves the erosion and fibrillation of the cartilage surface. This causes the release of collagen fragments and proteoglycan into the synovial fluid.
By stage 3, cartilage breakdown products cause a chronic inflammatory response which then causes further cartilage breakdown. Although there are several systems that are used to grade focal cartilage change, simple descriptions (such as surface, partial or full thickness, subchondral bone change) are usually sufficient and help prevent confusion. Erosive osteoarthritis has been found to have the worst prognosis and causes the most disability with time.
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