“…It is well known that diseased chondrocytes synthesize less ECM than normal chondrocytes contributing to the net loss of ECM. 2,3 Matrix metalloproteinase-2, -9, and -13 (MMP2, MMP9, and MMP13), a disintegrin and metalloproteinase with thrombospondin motifs-4 and -5 (ADAMTS-4 and ADAMTS-5), inducible nitric oxide synthase (iNOS), and both cyclooxygenases and prostaglandin E synthases (PGES) are increased in the OA joint facilitating ECM degradation or inhibit the synthesis of a new ECM. 4 Inflammation is believed to play a key role in this matrix imbalance 5 with the nuclear factor kB (NFkB) playing a pivotal role in transcriptionally regulating the expression of MMPs, proinflammatory cytokines, and transcription factors and their regulators.…”