Osteoarthritis (OA) is the most common degenerative joint disease and a growing health problem affecting more than half of the population over the age of 65. It is characterized by inflammation in the cartilage and synovium, resulting in the loss of joint structure and progressive damage to the cartilage. Many pro-inflammatory mediators are elevated in OA, including reactive oxygen species (ROS) such as nitric oxide (NO) and hydrogen peroxide (HO). Damaged articular cartilage remains a challenge to treat due to the limited self-healing capacity of the tissue and unsuccessful biological interventions. This highlights the need for better therapeutic strategies to heal damaged articular cartilage. Ozone (O) therapy has been shown to have positive results in the treatment of OA; however the use of O therapy as a therapeutic agent is controversial. There is a perception that O is always toxic, whereas evidence indicates that when it is applied following a specified method, O can be effective in the treatment of degenerative diseases. The mechanism of action of O therapy in OA is not fully understood and this review summarizes the use of O therapy in the treatment of damaged articular cartilage in OA.

In response to the recent alarming prevalence of cancer, osteoarthritis and other inflammatory disorders, the study of anti-inflammatory and anticancer crude medicinal plant extracts has gained considerable attention. Eucomis autumnalis is a native flora of South Africa with medicinal value. It has been found to have anti-inflammatory, anti-bacterial, anti-tumor/cancer, anti-oxidative and antihistaminic characteristics and produces bulb that have therapeutic value in South African traditional medicine. Despite the widely acclaimed therapeutic values of Eucomis autumnalis, its proper identification and proper knowledge, morphogenetic factors are yet to be efficiently evaluated. Similar to other plants with the same characteristics, E. autumnalis extract may stimulate bone formation and cartilage regeneration by virtue of its anti-inflammatory properties. This review provides data presented in the literature and tries to evaluate the three subspecies of E. autumnalis, highlighting their geographical location in South African provinces, their toxicity effects, as well as their phytochemistry and anti-inflammatory properties. Biologically active components, pharmacological importance and some environmental factors that can affect E. autumnalis are presented. The review also discussed the novel potential roles of E. autumnalis in regenerative medicine. Proper knowledge of the E. autumnalis plant and its possible role in bone and cartilage regeneration will help in addressing and clarifying its use in the production of drugs and for other therapeutic purposes, especially in the treatment of inflammatory diseases and cancer.

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Any trauma to a joint such as sports injury can lead to osteoarthritis especially injuries that include torn cartilage, dislocated joints and ligaments. In sports injury specifically, most of the ointments in the market are only applied after physical activity. Repair of the bone and cartilage continues to be a challenge. Autologous and allografts are the gold standard for the treatment of the bone and cartilage. They have an invasive, open surgical procedure that requires the tissue to be harvested from an alternative site within the patient. South Africa is rich in native flora that is currently tapped as medicine by traditional healers. However, little is known about the natural products of our native flora and their potential to serve as a remedy for sports injuries, fracture healing and osteoarthritis. The grand purpose of the project is to explore medicinal plants of South Africa as a potential source for bone and tissue engineering of articular cartilage.

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