Zou, S., Shimizu, T., Shimizu, S., Higashi, Y., Nakamura, K., Ono, H
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For leaner individuals, the subcutaneous layer may only be 5-8mm, which means a 45-degree angle and skin pinching become essential to avoid hitting the muscle
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Cartilage faces even greater obstacles given avascular nature (no blood vessels penetrating tissue), low cell density (chondrocytes sparse within extensive extracellular matrix), minimal metabolic activity (slow turnover and repair), and mechanical loading challenges (constant stress impeding healing)