Pathogenesis of degenerative joint disease.

Proteoglycan degradation is central to the development of degenerative joint disease. Proteoglycans may be degraded by lysosomal enzymes from chondrocytes, synoviocytes or leucocytes. Collagen and matrix degradation occurs either by direct damage or due to degrading enzymes released into synovial fluid. Once the pathological sequence has begun it continues in a cyclic manner unless arrested by the ability of chondrocytes to synthesise sufficient matrix components. Treatment should ideally be directed to this end.