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Structure and function: joints and connective tissue 

Structure and function: joints and connective tissue

Chapter:
Structure and function: joints and connective tissue
Author(s):

Tim E. Cawston

DOI:
10.1093/med/9780199204854.003.1901
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date: 25 March 2017

The joint is a discrete unit that consists of cartilage, bone, tendon, and ligaments. Tendon consists of a matrix mainly made of collagen; bone consists of a mineralized collagen matrix; and cartilage is made up of collagens, proteoglycans, and specialized glycoproteins. Many studies have focused on single tissues of the joint, rather than regarding the joint as an organ made up of cartilage, bone, tendon, and muscle: future studies would benefit from an integrated approach.

All of the tissues in a joint are actively synthesized and degraded by the resident connective-tissue cells, such that there is a balance between matrix synthesis and degradation in adult tissues. Different classes of proteinase play a part in connective tissue turnover: active proteinases can cleave matrix protein during resorption, but the proteinase that predominates varies between different tissues and diseases. The matrix metalloproteinases (MMPs) are potent enzymes that degrade connective tissue and are inhibited by tissue inhibitors of metalloproteinases (TIMPs), the balance between active MMPs and TIMPs determining the extent of degradation in many tissues. Cysteine proteinases are responsible for the breakdown of collagen in bone. Various cytokines and growth factors, alone or in combination, can promote or inhibit matrix synthesis and stimulate proteinase production and matrix destruction. Growth factor combinations can be used in conjunction with artificial matrices to promote the repair of cartilage defects in large joints in some circumstances.

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