Articular cartilage is the shiny white 'gristle' covering the ends of joint bones, where they articulate.
Page updated June 2024 by Dr Sheila Strover (Clinical Editor)
Normal articular cartilage (joint cartilage) of femur (below) and patella (above) in the knee joint. Grade 0 on the Outerbridge scale
What is articular cartilage composed of?
The white articular cartilage has a very special internal structure, with the cartilage cells or chondrocytes suspended in pockets within a background matrix supported by collagen fibres.
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Quote from peer-reviewed paper:
"....Articular cartilage is devoid of blood vessels, lymphatics, and nerves and is subject to a harsh biomechanical environment....The superficial layer....is in contact with synovial fluid and is responsible for most of the tensile properties of cartilage...."
Citation: Sophia Fox AJ, Bedi A, Rodeo SA. The basic science of articular cartilage: structure, composition, and function. Sports Health. 2009 Nov;1(6):461-8. doi: 10.1177/1941738109350438. PMID: 23015907; PMCID: PMC3445147.
Grading of articular cartilage damage
Surgeons will grade the damage they see through the arthroscope according to the 'Outerbridge' scale.
This allows other surgeons to easily understand the situation, and also provides a measure that can be compared with later findings if the cartilage deteriorates or improves.
Articular cartilage damage and arthritis
Articular cartilage is also called joint cartilage or hyaline cartilage. It is damage to the articular cartilage which is called 'arthritis'
In the knee all efforts are geared towards preventing any damage or breakdown of this all-essential joint surface, as it has a poor blood supply and does not heal well if damaged.
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Quote from peer-reviewed paper:
"Once articular cartilage is damaged, full recovery of its structure, function and biomechanical property is hardly expected in most cases....stimulation of articular cartilage repair and regeneration of articular cartilage are strong demands [from patients]...."
Citation: Iwamoto M, Ohta Y, Larmour C, Enomoto-Iwamoto M. Toward regeneration of articular cartilage. Birth Defects Res C Embryo Today. 2013 Sep;99(3):192-202. doi: 10.1002/bdrc.21042. PMID: 24078496; PMCID: PMC4089504.
Forum discussions
- “Seeking Advice on Returning to Sports After Severe Knee Cartilage Damage”
Previous Olympic gymnast seeks advice about articular cartilage damage.
Cartilage disorders -
Classification -
Cartilage repair -
2008 - Articular cartilage repair - by Dr Karen Hambly (Physiotherapist)
eBook - Clearing up confusion about knee cartilage
eBook authored by Dr Sheila Strover (Clinical Editor), explaining the difference between articular cartilage and meniscus cartilage. Free to download.