Osteoarthritis (OA) is a common form of arthritis, which is characterized by progressive degradation of joint cartilage resulting in pain, joint stiffness, deformity and disability that is also recently related to an increased incidence of mortality. Inhibition of the extracellular matrix (ECM) production by chondrocytes and accumulation of catabolic mediators associated with matrix degradation are the cause of OA. Nonsurgical treatments for OA can be characterised as symptom-modifying or disease-modifying approaches. It's estimated that 10% of the world population older than 60 years demonstrated symptoms of OA (Messier SP, Callahan LF, Beavers DP et al., BMC Musculoskelet Disord 18(1):91, 2017). A virtue of chondrocytes has a limited proliferation capability; nonsurgical OA therapies mostly include native cartilage extracellular component injections like hyaluronic acid, anti-inflammatory effected autologous cell implantations, platelet rich plasma injections and medicals like corticosteroids. Stem cells are searched to cure OA recently. Also nowadays we can develop injectable release systems, biocompatible hydrogels and micro/nano sized carriers to make these medicals more effective. In this review we cover injectable alternatives to modify the natural course of OA that gives a window for patients between conventional treatment methods and joint replacement surgery.
Keywords: Cartilage; Chondrocytes; Chondroitin sulfate; Glycosaminoglycan; Hyaluronan; Osteoarthritis.