Cartilage. Biomedical Aspects

354 Pages·1983·8.186 MB·English

by  Brian K. Hall (Eds.)

CONTRIBUTORS
James A. Albright
William A. Beresford
M. Michael Cohen, Jr.
Michael W. Elves
Paul F. Goetinck
Richard J. Goss
Brian K. Hall
C. W. McCutchen
R. P. Misra
Leon Sokoloff
Bruce A. Wright
Cartilage
V O L U ME 3
Biomédical Aspects
Edited by
BRIAN K. HALL
Department of Biology
Dalhousie University
Halifax, Nova Scotia
Canada
1983
ACADEMIC PRESS
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COPYRIGHT © 1983, BY ACADEMIC PRESS, INC.
ALL RIGHTS RESERVED.
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United Kingdom Edition published by
ACADEMIC PRESS, INC. (LONDON) LTD.
24/28 Oval Road, London NW1 7DX
Library of Congress Cataloging in Publication Data
Main entry under title:
Cart iläge.
Includes bibliographical references and index.
Contents: v. 1. Structure, function, and biochemistry-
v. 3- Biomédical aspects.
1. Cartilage. I. Hall, Brian Keith, Date
QP88.2.C37 1982 59ΚΓ852 82-20566
ISBN O-I2-319503-9 (v. 3)
PRINTED IN THE UNITED STATES OF AMERICA
83 84 85 86 9 8 7 6 5 4 3 2 1
Contributors
Numbers in parentheses indicate the pages on which the authors' contributions begin.
James A. Albright (49), Department of Orthopaedic Surgery, School of
Medicine, Louisiana State University Medical Center, Shreveport,
Louisiana 71103
William A. Beresford (1), Department of Anatomy, West Virginia University,
Morgantown, West Virginia 26506
M. Michael Cohen, Jr. (143, 191), Faculties of Dentistry and Medicine,
Dalhousie University, Halifax, Nova Scotia B3H 4J1, Canada
Michael W. Elves (229), Glaxo Group Research Ltd., Greenford, Middlesex
UB6 OHE, England
Paul F. Goetinck (165), Department of Animal Genetics, and Genetics and
Cell Biology Section of the Biological Sciences Group, The University
of Connecticut, Storrs, Connecticut 06268
Richard J. Goss (267), Division of Biology and Medicine, Brown University,
Providence, Rhode Island 02912
Brian K. Hall (309), Department of Biology, Dalhousie University, Halifax,
Nova Scotia B3H 4J1, Canada
C. W. McCutchen (87), National Institutes of Health, Bethesda, Maryland
20205
R. P. Misra (49), Department of Pathology, School of Medicine, Louisiana
State University Medical Center, Shreveport, Louisiana 71103
Leon Sokolojf (109), Department of Pathology, State University of New York
at Stony Brook, Stony Brook, New York 11794
Bruce A. Wright (143), Faculty of Dentistry, Dalhousie University, Halifax,
Nova Scotia B3H 4J1, Canada
IX
Preface
This is the third in a series of three volumes devoted to cartilage. Volume 1 dealt
with the structure, function, and biochemistry of cartilage; Volume 2 dealt with
cartilage's development, differentiation, and growth. This volume covers what I
have termed the biomédical aspects of cartilage. Although the topics covered in
Volumes 1 and 2 all impinge on the study of cartilage in the human body, the
chapters in this volume are more directly related to the inevitable deterioration of
cartilage that accompanies aging, disease, or genetic mutations. The introductory
chapter discusses the formation of cartilage outside the confines of the
skeleton—the so-called ectopic cartilages. It highlights the important but little
understood neoplastic and metaplastic processes that produce ectopic cartilage.
For a comprehensive overview of mechanisms of cartilage differentiation, this
chapter should be read in conjunction with the opening chapter in Volume 2.
Several chapters highlight aspects of age-related changes in cartilage: résorp-
tion and remodeling in Chapter 2, lubrication in Chapter 3, and degenerative
diseases in Chapter 4. These chapters summarize current theories of how carti-
lage is maintained under conditions that would be expected to lead to perpetual
remodeling, résorption, and functional diminution. Cartilage normally resists
invasion by tumors; this is discussed in Volume 1, Chapter 11. Chapter 5 dis-
cusses those tumors that do manage to invade cartilage. Two chapters then deal
with mutations that affect cartilage. Chapter 6 concentrates on those affecting
limb cartilages and highlights the molecular and biochemical bases of some
well-studied mutations. Chapter 7 concentrates on mutations that affect cranio-
facial cartilages and that lead to craniofacial anomalies and growth deficiencies.
Here the emphasis is more clinical. Taken together, these two chapters provide a
balanced overview of those mutations that affect cartilage and how they might
act.
Immunological properties of cartilage, both in situ and when used as a graft to
stimulate repair, are extensively discussed in Chapter 8, a chapter that empha-
sizes the need for combined basic and clinical approaches to this important topic.
Chapter 9 provides an overview of the role of cartilage in situations involving
regeneration and repair of skeletal tissues, and Chapter 10 discusses bioelectrical
properties of cartilage and the response of cartilage to bioelectrical stimulation,
both in vivo and in vitro.
xi
Xll Preface
Once again it is a pleasure to thank all of the contributors for their willingness
to take time from very busy schedules to review their specialized fields within the
framework of biomédical aspects of cartilage. It is my hope that this volume, and
indeed the three volumes, will serve to emphasize the need for collaborative and
coordinated basic and clinical research on cartilage while summarizing current
knowledge and pointing toward approaches for the future. Although much has
already been done, much remains to be done.
CONTENTS OF OTHER VOLUMES
Volume 1: Structure, Function, and Biochemistry
1. Vertebrate Cartilages 7. Collagens of Cartilage
Melvin L. Moss and Letty Moss-Salentijn Richard Mayne and Klaus von der Mark
2. Invertebrate Cartilages 8. Glycosaminoglycans of Cartilage
Philip Person James W. Lash and N. S. Vasan
9. Metabolism of Cartilage
3. The Chondroblast and the Chondrocyte
R. A. Stockwell
Robert A. Kosher
10. Vascularity of Cartilage
4. Transmission Electron Microscopy of Klaus E. Kuettner and Bendicht U.
Cartilage Pauli
Huntington Sheldon 11. Biomechanics of Cartilage and Its
5. Scanning Electron Microscopy of Response to Biomechanical Stimuli
Cartilage Elizabeth R. Myers and Van C. Mow
Alan Boy de and Sheila J. Jones 12. Calcification of Cartilage
6. Cell Kinetics of Cartilage S. YousufAli
N. F. Kember Index
Volume 2: Development, Differentiation, and Growth
1. The Origin of Cartilage: Investigations in 6. Morphogenesis of Cartilage
Quest of Chondrogenic DNA Peter Thorogood
Marshall R. Urist
7. Growth of Cartilage
2. Control of Cartilage Differentiation
J. R. Hinchliffe and D. R. Johnson
Susan J. Hunter and Arnold I. Caplan
3. Cell-Cell Interactions and 8. Vitamins and Cartilage
Chondrogenesis Asher Ornoy and Igor Zusman
Michael Solursh 9. Hormones and Cartilage
4. Cellular Condensations and Michael Silbermann
Chondrogenesis
10. Growth Factors and Cartilage
D. A. Ede
William A. Elmer
5. Tissue Interactions and Chondrogenesis
Brian K. Hall Index
Xlll
I
Ectopic Cartilage, Neoplasia,
and Metaplasia
William A. Beresford
I. Introduction 1
II. Extraskeletal versus Ectopic Cartilage 2
III. Specious Ectopic Cartilages 4
IV. Tumors and Tumor-Like Conditions with Ectopic Cartilage 5
A. Osseous Tumors 8
B. Benign ExtraosseousTumors 8
C. Malignant Extraosseous Tumors 11
D. Composite Extraosseous Tumors 14
E. Miscellaneous Extraosseous Tumors 19
F. Tumor-Like Conditions 20
G. Cartilage in Malformations 23
H. Veterinary Examples of Ectopic Cartilage 24
V. Experimental Ectopic Cartilage 24
A. Embryonic Cartilage 24
B. Extraosseous Cartilage in "Maturity" 26
VI. Discussion and Summary 31
A. Matrix Synthesis and Variety 31
B. Precursor Cells 31
C. Stimuli 33
References 34
I. INTRODUCTION
To pronounce a tissue of an individual as out of its rightful place requires a
thorough knowledge of anatomy and its variations. Thus, cartilage is ex-
pected in the tongue of a dog, but not in that of a human. Cartilages occur-
ring separately from the principal skeleton, ear, and airway, and as a normal
part in a particular species, will here be called extraskeletal, in distinction to
ectopic (EC) cartilage, which is not usually found at the site in any member
of that species. This convention is necessary here, but contradicts (7) the
common practice of clinicians to use extraskeletal in the sense of ectopic and
(2) the skeletal role of the extraskeletal cartilages in the heart, tongue, eye,
and elsewhere. Cartilage also arises on or within the skeleton and will be
named osseous ectopic. For the EC cartilage of soft tissues, extraosseous will
1
Cartilage, Volume 3 Copyright © 1983 by Academic Press, Inc.
Biomédical Aspects All rights of reproduction in any form reserved.
ISBN 0-12-319503-9
2 William A. Beresford
be used. Difficulties and points of interest between the extraskeletal and ec-
topic categories will be explored.
How easy is it to claim a material in a soft-tissue or bony site as cartilage?
Chondroid, pseudocartilage, myxoid, chondroosteoid, and other entities
have been hard to distinguish from cartilage, and in some instances the terms
may have been misnomers for proper cartilage (see Volume 1, Chapters 1
and 2). True cartilage, of course, has a wide range of forms. How well the ec-
topic instances meet the morphological and histochemical criteria for car-
tilage, and the better criteria becoming available will be discussed.
Most EC cartilage falls into Schaffer's (1930) class of secondary cartilage,
appearing after the establishment of the primary cartilaginous skeleton, and
frequently much later in life. The formation of EC cartilage in an already
formed and functioning soft connective tissue implies the conversion of one
differentiated tissue into another, that is, a metaplasia (Virchow, 1884;
Willis, 1962). Metaplasia might also happen, were EC cartilage to experience
a direct conversion to bone, as is sometimes claimed. In its unexpected late
development, the cartilage is a new growth, but when it is normal cartilage,
limited in its growth, it is scarcely a neoplasm. However, many cartilage-
bearing soft-tissue lesions are without question neoplastic in the modern
sense. Consideration will be given to the fit of the concepts of metaplasia and
neoplasia to pathological and experimental EC cartilage.
II. EXTRASKELETAL VERSUS ECTOPIC CARTILAGE
Schaf fer (1930), Willis (1962), and Beresford (1981) list the many sites of ex-
traskeletal cartilage in various species. Examples are still cofning to light,
thus the fibrocartilaginous reinforcements in the urethral process of the
goat's penis (Ghoshal and Bal, 1976) and the submandibular ventral pouch
of rorqual whales (Pivorunas, 1977). The latter cartilage is closely bound to
the mylohyoid muscle. A similarly intimate relation to muscle exists for a
previously undescribed anterior element of the hyoid skeleton of the finch,
Passer: the preglossale (Bock and Morony, 1978). This forms late via car-
tilage, articulates with another bone, and is definitely skeletal. The interest
in the preglossale with regard to EC cartilage lies in its absence in all other
birds and their possible reptilian ancestors, making it a skeletal neomorph.
Bock and Morony suggest that it might have originated phylogenetically as
an ectopic splint for its muscle, which developed a joint with the paraglossale
and somehow became a constant skeletal element.
This hypothesis of a skeletal element being a genetically incorporated
manifestation of an earlier EC cartilage contrasts with the more common,
but ill-founded, view of EC mammalian abdominal-wound and scierai car-
1. Ectopic Cartilage, Neoplasia, and Metaplasia 3
tilages as atavistic expressions of crocodilian abdominal ribs and reptilian
scierai cartilage. But atavism cannot be cast out altogether. The human os
paracuneiforme, accessory to the tarsus, presumably forms in a cartilage,
which by its sporadic presence might (but should not) be considered ectopic.
Conroy (1978) argues that this element is the vestigial homolog of the
primate prehallux.
Returning to the hyoid apparatus, Gentscheff (1934) saw small islands of
hyaline cartilage in around 30% of human tongues (including those of
newborns) near the tip where the genioglossal muscle inserts into the septum.
The position of the cartilage matches that of the carnivores' lyssa, which led
Gentscheff to conclude that both instances constitute a relic of the rod in
ancestral reptilian tongues. This inconstant extraskeletal cartilage has not
confused the categorization of other lingual nodules in man as ectopic (see
Section IV,B,1), because its existence is virtually unknown, and the chon-
dromas are off the midline and not so anterior.
Misconceptions have arisen because of ignorance of the partly car-
tilaginous nature of the cardiac skeleton in many species (Benninghoff,
1930). For dog and human, clinical reports of EC cartilage (James and
Drake, 1968; Ferris and Aherne, 1971) ignored fibrocartilage as a normal
component of these hearts (Balogh, 1971; Sandusky et ai, 1979). The
hyaline cartilage in the aortic ring of the rat, although not thought to be ec-
topic, was construed as an aspect of cardiac aging, until Hollander (1968)
showed its presence from the second week of life. On the other hand, truly
EC cartilage develops in healing infarcts in the rat's ventricular wall and in
the diseased human aortic valve.
The inconstant occurrence of certain cartilage bones might seem to blur
the distinction between EC and extraskeletal cartilages, but rarity is not ec-
topia. The number and form of sesamoids in the hands and feet show how
great the anatomical variation can be (Jacobs, 1974; Scranton and Rutkow-
ski, 1980). When the frequency of the accessory bone drops very low,
calling it and its cartilaginous precursor extraskeletal recognizes a weak
genetic commitment to chondrogenesis at that site that the term ectopic
denies.
Constraints are transmitted to an offspring along with the genetic endow-
ment to cells of the ability to respond to proliferative and other stimuli. Ec-
topic chondrogenesis reflects the persistent responsiveness of fibroblasts and
perhaps other cells, and the slackening of controls hitherto keeping them
fibroblastic. Extraskeletal cartilages occupy consistent positions because of
the constraints. Beyond this simple view is the complex interplay between
genome, cells, tissues, and stimuli in the individual and over generations,
resulting in the variable presence of some bones and cartilages, the forma-
tion of EC cartilage in response to stimuli that are ineffective in other in-