Dr. Joshua John-Ram Schacter explains that bone-on-bone arthritis on X-rays means the joint space is severely narrowed, showing extremely thin or damaged cartilage rather than no cartilage at all. Cartilage doesn't heal on its own because it has poor blood supply, so it needs intervention like regenerative therapy.
That doesn't necessarily mean that there is no cartilage to regenerate or to treat.
If we look at a patient with what we call bone on bone arthritis, when we look at an X ray, we can't see the cartilage itself, but we can see the space it makes. So on an arthritic X ray, you would basically see a significant narrowing of that space to where the bone appears like it's touching on the X ray. And that's what we call bone on bone arthritis. That doesn't necessarily mean that there is no cartilage to regenerate or to treat. It's just that it's extremely thin or extremely damaged. And cartilage itself doesn't have good blood supply. It doesn't have good blood supply, so it doesn't heal itself once the cartilage is damaged. Unless you do an intervention, like a regenerative therapy or something happens, that cartilage is not going to heal by itself.
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