The Cartilage Mystery: Unravelling the Links to Skeletal and Metabolic Comorbidities

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Osteoarthritis (OA) is caused by the degeneration of articular cartilage (AC) in joints, and researchers have been studying these mechanisms for many years, mainly focusing on the anatomical features of AC to identify the roles and functions of its composition in degeneration. However, there has been an increase in OA rates among patients with Type 2 Diabetes Mellitus (T2DM) as a comorbid disease. Since common risk factors such as genetics, aging, and obesity are exhibited in these comorbidities, there is a need to investigate degenerative mechanisms in these conditions. This study aims to investigate the structure of AC in patients with OA/T2DM using various characterization techniques, both qualitatively and quantitatively. The degeneration of AC can be observed as changes in the arrangement of collagen fibrils and proteoglycan networks in different zones of the AC (superficial, middle, deep zones), and these changes can be characterized using various techniques. The qualitative characterizations can be performed using the scanning electron microscope (SEM) and micro computed tomography (micro-CT) by analysing the structural changes in the AC cross sections. Similarly, the quantitative characterization can be performed by Raman spectroscopy and X-ray energy dispersive spectroscopy (EDS) by calculating the losses of proteoglycan changes in the AC zones. These qualitative and quantitative characterizations of the AC can provide insight into the degenerative mechanism in OA/T2DM conditions. Additionally, the bio-tribological properties of AC needto be investigated to understand its friction, wear, and lubrication behaviours at its contact interfaces. These tribological studies will be performed at different contact interfaces (cartilage on glass, cartilage on cartilage) using different lubricants (synovial fluid, hyaluronic acid, lubricin, etc.) to understand their effects on varying the tribological behaviour of AC. The above-mentioned tests will be performed for the AC of bovine samples, as well as on the AC of OA/T2DM patients. These studies will help in developing the tribological characteristics of AC in OA/T2DM comorbidity conditions. The outcomes of these studies will be used in developing a suitable medical treatment by lubricant supplements for the OA/T2DM patients to slow down the AC degeneration reaching the end process of total joint replacements.