The reaction patterns of chondrocytes in osteoarthritis can be summarized in five categories:​ (1) proliferation and cell death (apoptosis);​ changes in (2) synthetic activity and (3) degradation;​ (4) phenotypic modulation of the articular chondrocytes;​ and (5) formation of osteophytes. In osteoarthritis, the primary responses are reinitiation of synthesis of cartilage macromolecules, the initiation of synthesis of types IIA and III procollagens as markers of a more primitive phenotype, and synthesis of active proteolytic enzymes. Reversion to a fibroblast-like phenotype, known as 'dedifferentiation', does not appear to be an important component. Proliferation plays a role in forming characteristic chondrocyte clusters near the surface, while apoptosis probably occurs primarily in the calcified cartilage.