Osteoarthritis of the ankle: bridging concepts in basic science with clinical care.

Trends in science are beginning to suggest that cartilage degeneration may be related to a chronic imbalance in extracellular matrix metabolism. In cartilage, a combination of biomechanical, biochemical, and matrix-related signaling pathways regulates the equilibrium between cartilage anabolism and catabolism. A potential limitation of many current treatments of osteoarthritis is that they may not comprehensively restore regulation of a balance between cartilage anabolism and catabolism.