Objective. The physiologic interstitial tonicity of healthy articular cartilage (350-480 mOsm) is lowered to 280-350 mOsm in osteoarthritis (OA). This results in loss of tissue prestress, altered compressive behavior, and, thus, inferior tissue properties. This study was undertaken to determine whether physiologic tonicity in combination with the inhibition of calcineurin (Cn) activity by FK-506 has synergistic effects on human articular chondrocytes and explants in vitro.Methods. OA chondrocytes and explants and non-OA chondrocytes were cultured in cytokine-free medium of 280 mOsm or 380 mOsm with or without Cn inhibition by FK-506. Chondrogenic, hypertrophic, and catabolic marker expression was evaluated at the messenger RNA (mRNA), protein, and activity levels.Results. Compared to OA chondrocytes cultured at 280 mOsm, those cultured at 380 mOsm had increased expression of mRNA for chondrogenic markers (e.g., ϳ13 fold for COL2; P < 0.001), and decreased COL1 expression (ϳ0.5 fold, P < 0.01). Inhibiting Cn activity under physiologic tonicity further enhanced the expression of anabolic markers at the mRNA level (ϳ50 fold for COL2; P < 0.001, ϳ2 fold for AGC1; P < 0.001, and ϳ3.5 fold for SOX9; P < 0.001) and at the protein level (ϳ6 fold for type II collagen; P < 0.001). Cn inhibition suppressed relevant collagenases as well as hypertropic and mineralization markers at the mRNA and activity levels. Expression of aggrecanase 1 and aggrecanase 2 was not influenced by tonicity or FK-506 alone, but the combination suppressed both, by ϳ50% (P < 0.05) and ϳ40% (P < 0.001), respectively. Generally, similar anabolic and antihypertrophic effects were observed in ex vivo cartilage explant cultures and non-OA chondrocytes.Conclusion. Our findings indicate that Cn at physiologic tonicity exerts a superior effect compared to physiologic tonicity or FK-506 alone, increasing anabolic markers while suppressing hypertrophic and catabolic markers. Our data may aid in the development of improved cell-based chondral repair and OA treatment strategies.Articular cartilage has unique properties related to the structure and composition of its extracellular matrix (ECM), which is mainly composed of proteoglycans (PGs), such as aggrecan, entangled in a network of collagen fibers, such as type II collagen, and large amounts of water (1). Water and inorganic salts represent the bulk mass portion, while collagens, PGs, and other glycoproteins and proteins constitute only 20% of the wet weight of the tissue. Collagens represent 50-60% of the dry weight of cartilage, while PGs, the second largest solid-phase portion, account for 5-10%.In normal cartilage there is a balance between matrix synthesis and degradation. Depletion of aggrecan from articular cartilage by matrix metalloproteinase (MMP) and aggrecanase (ADAMTS) action is an essential early pathophysiologic event in osteoarthritis (OA) (2-4). This decrease in PG content can result in reduced viscoelastic properties and increased deformation of