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The onset of cartilage destruction is due to mechanical stress, which either directly damages chondrocytes or activates them to produce abnormal levels of MMPs and reactive oxygen species (ROS) responsible for cartilage breakdown and the release of microcrystals, osteochondral fragments, and products of ECM degradation into the joint cavity

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By improving oxygen unloading, ITPP reduces tissue hypoxia and tempers the overactivation of hypoxia-sensitive signaling