Osteoarthritis (OA) is a major cause of disability and socioeconomic loss worldwide. However, the current pharmacological approaches used to treat OA are largely palliative. Being the hallmark of OA, the cartilage extracellular matrix (ECM) destruction and abnormal homeostasis is gaining more attention as a therapeutic target in cartilage regeneration. Moreover, during the progression of OA, the cartilage ECM shows significant pathological alternations, which can be promising biomarkers in identifying the pathological stages of OA. In this review, we summarize the role of abnormal ECM homeostasis in the joint cartilage during OA. Furthermore, we provide an update on the cartilage ECM derived biomarkers and regenerative medicine therapies targeting cartilage ECM which includes preclinical animal models study and clinical trials.

骨关节炎（OA）是全球范围内致残和社会经济损失的主要原因。但是，当前用于治疗OA的药理学方法在很大程度上是姑息治疗。作为骨关节炎的标志，软骨细胞外基质（ECM）的破坏和异常的动态平衡作为软骨再生的治疗靶点越来越受到重视。此外，在OA的发展过程中，软骨ECM表现出明显的病理变化，这在确定OA的病理学阶段中可能是有希望的生物标志物。在这篇综述中，我们总结了OA期间异常ECM动态平衡在关节软骨中的作用。此外，我们提供了针对软骨ECM的生物标记物和针对软骨ECM的再生药物疗法的更新，其中包括临床前动物模型研究和临床试验。