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By K A Athanasiou; Eric M Darling; Jerry C Hu

ISBN-10: 1598298763

ISBN-13: 9781598298765

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The increased synthesis of COMP by chondrocytes and synoviocytes has also been associated with OA, as its production can be stimulated by TGF-β1 [270]. 3 COSTS OF ARTHRITIS OA causes significant pain and suffering to individual patients, and the economic burden of this disease for society is great [271]. For example, in the US alone OA related costs exceed $65 billion per year (both medical costs and lost wages) [218]. Conservatively, it is estimated that 1 in 8 American adults over the age of 25 have clinically manifested OA [220, 272], making it one of the leading causes of disability in the United States [225].

Little League began to implement a pilot pitch-count program only in 2005 [277], though its initially set standards were quickly relaxed. While elbow and shoulder injuries are common in baseball, a global survey of adolescent knee injuries put the incidence rate at greater than 25% in sports participants [278], particularly in basketball [279,280]. In terms of articular cartilage defects, young patients with knee injuries show 75% superficial (grade I–II) and 25% deep lesions (grade III– IV) [229].

The differentiation is additionally mediated by epithelial-mesenchymal interactions by TGF-β [107, 108]. TGF-β participates in condensation by regulating fibronectin [109], which in turn regulates N-CAM [110], which was initially thought to be required in maintaining condensation along with the adhesion molecule N-cadherin [111–113]. Note that N-CAM is not required in initiating condensation [110], but instead in its maintenance. Also, recent data obtained using organ culture have shown that Ncadherin-deficient limb buds were capable of mesenchymal condensation and chondrogenesis [114], indicating that N-CAM is not necessary in chondrogenesis, albeit an important player within normal cartilage development.

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Articular cartilage tissue engineering by K A Athanasiou; Eric M Darling; Jerry C Hu


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