Functional Tissue Engineering: The Role of Biomechanics in Articular Cartilage Repair

Homing in on a biological joint replacement

The use of tissue engineering therapies for treating damaged articular cartilage has traditionally focused on cell-based therapies for the repair of focal chondral or osteochondral defects. A recent study by Lee and colleagues in the Lancet shows exciting proof-of-concept that an acellular scaffold containing transforming growth factor beta 3 can induce homing of cells that regenerate a hyaline-like cartilage surface. These findings provide a glimpse into the possibility that tissue engineering may in fact provide the means for regeneration of an entire joint surface, beyond a simple focal defect in the articular cartilage.

Directional fluid flow enhances in vitro periosteal tissue growth and chondrogenesis on poly-epsilon-caprolactone scaffolds

The purpose of this study was to investigate the effect of directional fluid flow on periosteal chondrogenesis. Periosteal explants were harvested from 2-month-old rabbits and sutured onto poly-epsilon-caprolactone (PCL) scaffolds with the cambium layer facing away from the scaffolds. The periosteum/PCL composites were cultured in suspension in spinner flask bioreactors and exposed to various fluid flow velocities: 0, 20, 60, and 150 rpm for 4 h each day for 6 weeks. The application of fluid flow significantly increased percent cartilage yield in periosteal explants from 17% in the static controls to 65-75% under fluid flow (there was no significant difference between 20, 60, or 150 rpm). The size of the neocartilage was also significantly greater in explants exposed to fluid flow compared with static culture. The development of zonal organization within the engineered cartilage was observed predominantly in the tissue exposed to flow conditions. The Young's modulus of the engineered cartilage exposed to 60 rpm was significantly greater than the samples exposed to 150 and 20 rpm. These results demonstrate that application of directional fluid flow to periosteal explants secured onto PCL scaffolds enhances cell proliferation, chondrogenic differentiation, and cell organization and alters the biomechanical properties of the engineered cartilage.

Multifunctional hybrid three-dimensionally woven scaffolds for cartilage tissue engineering

The successful replacement of large-scale cartilage defects or osteoarthritic lesions using tissue-engineering approaches will likely require composite biomaterial scaffolds that have biomimetic mechanical properties and can provide cell-instructive cues to control the growth and differentiation of embedded stem or progenitor cells. This study describes a novel method of constructing multifunctional scaffolds for cartilage tissue engineering that can provide both mechanical support and biological stimulation to seeded progenitor cells. 3-D woven PCL scaffolds were infiltrated with a slurry of homogenized CDM of porcine origin, seeded with human ASCs, and cultured for up to 42 d under standard growth conditions. These constructs were compared to scaffolds derived solely from CDM as well as 3-D woven PCL fabric without CDM. While all scaffolds promoted a chondrogenic phenotype of the ASCs, CDM scaffolds showed low compressive and shear moduli and contracted significantly during culture. Fiber-reinforced CDM scaffolds and 3-D woven PCL scaffolds maintained their mechanical properties throughout the culture period, while supporting the accumulation of a cartilaginous extracellular matrix. These findings show that fiber-reinforced hybrid scaffolds can be produced with biomimetic mechanical properties as well as the ability to promote ASC differentiation and chondrogenesis in vitro.

Chondrogenesis of adult stem cells from adipose tissue and bone marrow: induction by growth factors and cartilage-derived matrix

OBJECTIVES

Adipose-derived stem cells (ASCs) and bone marrow-derived mesenchymal stem cells (MSCs) are multipotent adult stem cells with potential for use in cartilage tissue engineering. We hypothesized that these cells show distinct responses to different chondrogenic culture conditions and extracellular matrices, illustrating important differences between cell types.

METHODS

Human ASCs and MSCs were chondrogenically differentiated in alginate beads or a novel scaffold of reconstituted native cartilage-derived matrix with a range of growth factors, including dexamethasone, transforming growth factor beta3, and bone morphogenetic protein 6. Constructs were analyzed for gene expression and matrix synthesis.

RESULTS

Chondrogenic growth factors induced a chondrocytic phenotype in both ASCs and MSCs in alginate beads or cartilage-derived matrix. MSCs demonstrated enhanced type II collagen gene expression and matrix synthesis as well as a greater propensity for the hypertrophic chondrocyte phenotype. ASCs had higher upregulation of aggrecan gene expression in response to bone morphogenetic protein 6 (857-fold), while MSCs responded more favorably to transforming growth factor beta3 (573-fold increase).

CONCLUSIONS

ASCs and MSCs are distinct cell types as illustrated by their unique responses to growth factor-based chondrogenic induction. This chondrogenic induction is affected by the composition of the scaffold and the presence of serum.

Dynamic mechanical loading enhances functional properties of tissue-engineered cartilage using mature canine chondrocytes

OBJECTIVE

The concept of cartilage functional tissue engineering (FTE) has promoted the use of physiologic loading bioreactor systems to cultivate engineered tissues with load-bearing properties. Prior studies have demonstrated that culturing agarose constructs seeded with primary bovine chondrocytes from immature joints, and subjected to dynamic deformation, produced equilibrium compressive properties and proteoglycan content matching the native tissue. In the process of translating these results to an adult canine animal model, it was found that protocols previously successful with immature bovine primary chondrocytes did not produce the same successful outcome when using adult canine primary chondrocytes. The objective of this study was to assess the efficacy of a modified FTE protocol using adult canine chondrocytes seeded in agarose hydrogel and subjected to dynamic loading.

METHOD

Two modes of dynamic loading were applied to constructs using custom bioreactors: unconfined axial compressive deformational loading (DL; 1 Hz, 10% deformation) or sliding contact loading (Slide; 0.5 Hz, 10% deformation). Loading for 3 h daily was initiated on day 0, 14, or 28 (DL0, DL14, DL28, and Slide14).

RESULTS

Constructs with applied loading (both DL and Slide) exhibited significant increases in Young's modulus compared with free-swelling control as early as day 28 in culture (p < 0.05). However, glycosaminoglycan, collagen, and DNA content were not statistically different among the various groups. The modulus values attained for engineered constructs compare favorably with (and exceed in some cases) those of native canine knee (patella groove and condyle) cartilage.

CONCLUSION

Our findings successfully demonstrate an FTE strategy incorporating clinically relevant, adult chondrocytes and gel scaffold for engineering cartilage replacement tissue. These results, using continuous growth factor supplementation, are in contrast to our previously reported studies with immature chondrocytes where the sequential application of dynamic loading after transient transforming growth factor-beta3 application was found to be a superior culture protocol. Sliding, which simulates aspects of joint articulation, has shown promise in promoting engineered tissue development and provides an alternative option for FTE of cartilage constructs to be further explored.

Mechanics rules cell biology

Cells in the musculoskeletal system are subjected to various mechanical forces in vivo. Years of research have shown that these mechanical forces, including tension and compression, greatly influence various cellular functions such as gene expression, cell proliferation and differentiation, and secretion of matrix proteins. Cells also use mechanotransduction mechanisms to convert mechanical signals into a cascade of cellular and molecular events. This mini-review provides an overview of cell mechanobiology to highlight the notion that mechanics, mainly in the form of mechanical forces, dictates cell behaviors in terms of both cellular mechanobiological responses and mechanotransduction.

Functional properties of cell-seeded three-dimensionally woven poly(epsilon-caprolactone) scaffolds for cartilage tissue engineering

Articular cartilage possesses complex mechanical properties that provide healthy joints the ability to bear repeated loads and maintain smooth articulating surfaces over an entire lifetime. In this study, we utilized a fiber-reinforced composite scaffold designed to mimic the anisotropic, nonlinear, and viscoelastic biomechanical characteristics of native cartilage as the basis for developing functional tissue-engineered constructs. Three-dimensionally woven poly(epsilon-caprolactone) (PCL) scaffolds were encapsulated with a fibrin hydrogel, seeded with human adipose-derived stem cells, and cultured for 28 days in chondrogenic culture conditions. Biomechanical testing showed that PCL-based constructs exhibited baseline compressive and shear properties similar to those of native cartilage and maintained these properties throughout the culture period, while supporting the synthesis of a collagen-rich extracellular matrix. Further, constructs displayed an equilibrium coefficient of friction similar to that of native articular cartilage (mu(eq) approximately 0.1-0.3) over the prescribed culture period. Our findings show that three-dimensionally woven PCL-fibrin composite scaffolds can be produced with cartilage-like mechanical properties, and that these engineered properties can be maintained in culture while seeded stem cells regenerate a new, functional tissue construct.

The use of mesenchymal stem cells in collagen-based scaffolds for tissue-engineered repair of tendons

Tendon and ligament injuries are significant contributors to musculoskeletal injuries. Unfortunately, traditional methods of repair are not uniformly successful and can require revision surgery. Our research is focused on identifying appropriate animal injury models and using tissue-engineered constructs (TECs) from bone-marrow-derived mesenchymal stem cells and collagen scaffolds. Critical to this effort has been the development of functional tissue engineering (FTE). We first determine the in vivo mechanical environment acting on the tissue and then precondition the TECs in culture with aspects of these mechanical signals to improve repair outcome significantly. We describe here a detailed protocol for conducting several complete iterations around our FTE 'road map.' The in vitro portion, from bone marrow harvest to TEC collection, takes 54 d. The in vivo portion, from TEC implantation to limb harvest, takes 84 d. One complete loop around the tissue engineering road map, as presented here, takes 138 d to complete.

A subject specific multibody model of the knee with menisci

The menisci of the knee play an important role in joint function and our understanding of knee mechanics and tissue interactions can be enhanced through computational models of the tibio-menisco-femoral structure. Several finite element models of the knee that include meniscus-cartilage contact exist, but these models are typically limited to simplified boundary conditions. Movement simulation and musculoskeletal modeling can predict muscle forces, but are typically performed using the multibody method with simplified representation of joint structures. This study develops a subject specific computational model of the knee with menisci that can be incorporated into neuromusculoskeletal models within a multibody framework. Meniscus geometries from a 78-year-old female right cadaver knee were divided into 61 discrete elements (29 medial and 32 lateral) that were connected through 6x6 stiffness matrices. An optimization and design of experiments approach was used to determine parameters for the 6x6 stiffness matrices such that the force-displacement relationship of the meniscus matched that of a linearly elastic transversely isotropic finite element model for the same cadaver knee. Similarly, parameters for compliant contact models of tibio-menisco-femoral articulations were derived from finite element solutions. As a final step, a multibody knee model was developed and placed within a dynamic knee simulator model and the tibio-femoral and patello-femoral kinematics compared to an identically loaded cadaver knee. RMS errors between finite element displacement and multibody displacement after parameter optimization were 0.017 mm for the lateral meniscus and 0.051 mm for the medial meniscus. RMS errors between model predicted and experimental cadaver kinematics during a walk cycle were less than 11 mm translation and less than 7 degrees orientation. A small improvement in kinematics, compared to experimental measurements, was seen when the menisci were included versus a model without the menisci. With the menisci the predicted tibio-femoral contact force was significantly reduced on the lateral side (937 N peak force versus 633 N peak force), but no significant reduction was seen on the medial side.

Mechanical loading regimes affect the anabolic and catabolic activities by chondrocytes encapsulated in PEG hydrogels

OBJECTIVE

Mechanical loading of cell-laden synthetic hydrogels is one strategy for regenerating functional cartilage. This work tests the hypothesis that type of loading (continuous vs intermittent) and timing when loading is applied (immediate vs delayed) influence anabolic and catabolic activities of chondrocytes when encapsulated in poly(ethylene glycol) (PEG) hydrogels.

METHODS

Primary bovine chondrocytes encapsulated in PEG hydrogels were subjected to unconfined dynamic compressive strains applied continuously or intermittently for 1 week (i.e., immediate) or intermittently for 1 week but after a 1 week free-swelling (FS) period (i.e., delayed). Anabolic activities were assessed by gene expression for collagen II and aggrecan (AGC) and extracellular matrix (ECM) deposition by (immuno)histochemistry. Catabolic activities were assessed by gene expression for matrix metalloproteinases, MMP-1, 3, and 13.

RESULTS

Intermittent loading (IL) upregulated ECM and MMP expressions, e.g., 2-fold, 16-fold and 8-fold for collagen II, MMP-1, MMP-3, respectively. Continuous loading upregulated AGC expression 1.5-fold but down-regulated MMP-1 (3-fold) and -3 (2-fold) expressions. For delayed loading, chondrocytes responded to FS conditions by down-regulating MMP expressions (P<0.01), but were less sensitive to loading when applied during week 2. Spatially, deposition of ECM molecules was dependent on the timing of loading, where immediate loading favored enhanced collagen II deposition.

CONCLUSIONS

The type and timing of dynamic loading dramatically influenced ECM and MMP gene expression and to a lesser degree matrix deposition. Our findings suggest that early applications of IL is necessary to stimulate both anabolic and catabolic activities, which may be important in regenerating and restructuring the engineered tissue long-term.

Chondrogenic differentiation of adipose-derived adult stem cells by a porous scaffold derived from native articular cartilage extracellular matrix

Adipose-derived adult stem cells (ASCs) have the ability to differentiate into a chondrogenic phenotype in response to specific environmental signals such as growth factors or artificial biomaterial scaffolds. In this study, we examined the hypothesis that a porous scaffold derived exclusively from articular cartilage can induce chondrogenesis of ASCs. Human ASCs were seeded on porous scaffolds derived from adult porcine articular cartilage and cultured in standard medium without exogenous growth factors. Chondrogenesis of ASCs seeded within the scaffold was evident by quantitative RT-PCR analysis for cartilage-specific extracellular matrix (ECM) genes. Histological and immunohistochemical examination showed abundant production of cartilage-specific ECM components-particularly, type II collagen-after 4 or 6 weeks of culture. After 6 weeks of culture, the cellular morphology in the ASC-seeded constructs resembled those in native articular cartilage tissue, with rounded cells residing in the glycosaminoglycan-rich regions of the scaffolds. Biphasic mechanical testing showed that the aggregate modulus of the ASC-seeded constructs increased over time, reaching 150 kPa by day 42, more than threefold higher than that of the unseeded controls. These results suggest that a porous scaffold derived from articular cartilage has the ability to induce chondrogenic differentiation of ASCs without exogenous growth factors, with significant synthesis and accumulation of ECM macromolecules, and the development of mechanical properties approaching those of native cartilage. These findings support the potential for a processed cartilage ECM as a biomaterial scaffold for cartilage tissue engineering. Additional in vivo evaluation is necessary to fully recognize the clinical implication of these observations.

Shear stress magnitude and duration modulates matrix composition and tensile mechanical properties in engineered cartilaginous tissue

Cartilage tissue-engineering strategies aim to produce a functional extracellular matrix similar to that of the native tissue. However, none of the myriad approaches taken have successfully generated a construct possessing the structure, composition, and mechanical properties of healthy articular cartilage. One possible approach to modulating the matrix composition and mechanical properties of engineered tissues is through the use of bioreactor-driven mechanical stimulation. In this study, we hypothesized that exposing scaffold-free cartilaginous tissue constructs to 7 days of continuous shear stress at 0.001 or 0.1 Pa would increase collagen deposition and tensile mechanical properties compared to that of static controls. Histologically, type II collagen staining was evident in all construct groups, while a surface layer of type I collagen increased in thickness with increasing shear stress magnitude. The areal fraction of type I collagen was higher in the 0.1-Pa group (25.2 +/- 2.2%) than either the 0.001-Pa (13.6 +/- 3.8%) or the static (7.9 +/- 1.5%) group. Type II collagen content, as assessed by ELISA, was also higher in the 0.1-Pa group (7.5 +/- 2.1%) compared to the 0.001-Pa (3.0 +/- 2.25%) or static groups (3.7 +/- 3.2%). Temporal gene expression analysis showed a flow-induced increase in type I and type II collagen expression within 24 h of exposure. Interestingly, while the 0.1-Pa group showed higher collagen content, this group retained less sulfated glycosaminoglycans in the matrix over time in bioreactor culture. Increases in both tensile Young's modulus and ultimate strength were observed with increasing shear stress, yielding constructs possessing a modulus of nearly 5 MPa and strength of 1.3 MPa. This study demonstrates that shear stress is a potent modulator of both the amount and type of synthesized extracellular matrix constituents in engineered cartilaginous tissue with corresponding effects on mechanical function.

Quasi-steady-state displacement response of whole human cadaveric knees in a MRI scanner

It is important to determine the three-dimensional nonuniform deformation of articular cartilage in its native environment. A new magnetic resonance imaging (MRI)-based technique (cartilage deformation by tag registration (CDTR)) has been developed, which can determine such deformations provided that the compressive load-displacement response of the knee reaches a quasi-steady state during cyclic loading. The objectives of this study were (1) to design and construct an apparatus to cyclically compress human cadaveric knees to physiological loads in a MRI scanner, (2) to determine the number of load cycles required to reach a quasi-steady-state load-displacement response for cyclic loading of human cadaveric knees, and (3) to collect sample MR images of undeformed and deformed states of tibiofemoral cartilage free of artifact while using the apparatus within a MRI scanner. An electropneumatic MRI-compatible apparatus was constructed to fit in a clinical MRI scanner, and a slope criterion was defined to indicate the point at which a quasi-steady-state load-displacement response, which would allow the use of CDTR, occurred during cyclic loading of a human knee. The average number of cycles required to reach a quasi-steady-state load-displacement response according to the slope criterion defined herein for three cadaveric knee joints was 356+/-69. This indicates that human knee joint specimens can be cyclically loaded such that deformation is repeatable according to MRI requirements of CDTR. Sample images of tibiofemoral cartilage were obtained for a single knee joint. These images demonstrate the usefulness of the apparatus in a MRI scanner. Thus the results of this study are a crucial step toward developing a MRI-based method to determine the deformations of articular cartilage in whole human cadaveric knees.

Advanced material strategies for tissue engineering scaffolds

Tissue engineering seeks to restore the function of diseased or damaged tissues through the use of cells and biomaterial scaffolds. It is now apparent that the next generation of functional tissue replacements will require advanced material strategies to achieve many of the important requirements for long-term success. Here we provide representative examples of engineered skeletal and myocardial tissue constructs in which scaffolds were explicitly designed to match native tissue mechanical properties as well as to promote cell alignment. We discuss recent progress in microfluidic devices that can potentially serve as tissue engineering scaffolds, since mass transport via microvascular-like structures will be essential in the development of tissue engineered constructs on the length scale of native tissues. Given the rapid evolution of the field of tissue engineering, it is important to consider the use of advanced materials in light of the emerging role of genetics, growth factors, bioreactors, and other technologies.

Articular cartilage deformation determined in an intact tibiofemoral joint by displacement-encoded imaging

This study demonstrates the in vitro displacement and strain of articular cartilage in a cyclically-compressed and intact joint using displacement-encoded imaging with stimulated echoes (DENSE) and fast spin echo (FSE). Deformation and strain fields exhibited complex and heterogeneous patterns. The displacements in the loading direction ranged from -1688 to -1481 microm in the tibial cartilage and from -1601 to -764 microm in the femoral cartilage. Corresponding strains ranged from -9.8% to 0.7% and from -4.3% to 0.0%. The displacement and strain precision were determined to be 65 microm and less than 0.2%, respectively. Displacement-encoded magnetic resonance imaging is capable of determining the nonuniform displacements and strains in the articular cartilage of an intact joint to a high precision. Knowledge of these nonuniform strains is critical for the in situ characterization of normal and diseased tissue, as well as the comprehensive evaluation of repair constructs designed using regenerative medicine.

Application of an elastic biodegradable poly(L-lactide-co-epsilon-caprolactone) scaffold for cartilage tissue regeneration

In cartilage tissue regeneration, it is important that an implant inserted into a defect site can maintain its mechanical integrity and endure stress loads from the body, in addition to being biocompatible and able to induce tissue growth. These factors are crucial in the design of scaffolds for cartilage tissue engineering. We developed an elastic biodegradable scaffold from poly(L-lactideco-epsilon-caprolactone) (PLCL) for application in cartilage treatment. Biodegradable PLCL co-polymer was synthesized from L-lactide and epsilon-caprolactone in the presence of stannous octoate as a catalyst. A highly elastic PLCL scaffold was fabricated by a gel-pressing method with 80% porosity and 300-500 microm pore size. The tensile mechanical and recovery tests were performed in order to examine mechanical and elastic properties of the PLCL scaffold. They could be easily twisted and bent and exhibited almost complete (over 94%) recoverable extension up to breaking point. For examining cartilaginous tissue formation, rabbit chondrocytes were seeded on scaffolds. They were then cultured in vitro for 5 weeks or implanted in nude mice subcutaneously. From in vitro and in vivo tests, the accumulation of extracellular matrix on the constructs showed that chondrogenic differentiation was sustained onto PLCL scaffolds. Histological analysis showed that cells onto PLCL scaffolds formed mature and well-developed cartilaginous tissue, as evidenced by chondrocytes within lacunae. From these results, we are confident that elastic PLCL scaffolds exhibit biocompatibility and as such would provide an environment where cartilage tissue growth is enhanced and facilitated.

The role of hydrogel structure and dynamic loading on chondrocyte gene expression and matrix formation

Crosslinked poly(ethylene glycol) (PEG) hydrogels are attractive scaffolds for cartilage tissue engineering because of their ability to mimic the aqueous environment and mechanical properties of native cartilage. In this study, hydrogel crosslinking density was varied to study the influence of gel structure and the application of dynamic loading (continuous, 1 Hz, 15% amplitude strain) on chondrocyte gene expression over approximately 1 week culture. Gene expression was quantified using real-time RT-PCR for collagen II and aggrecan, the major cartilage extracellular matrix (ECM) components, and collagen I, an indicator of chondrocyte de-differentiation. When chondrocytes were encapsulated in PEG gels with low or high crosslinking, a high collagen II expression compared to collagen I expression (1000 or 100,000:1, respectively) indicated the native chondrocyte phenotype was retained. In the absence of loading, relative gene expression for collagen II and aggrecan was significantly higher (e.g., 2-fold and 4-fold, respectively, day 7) in the low crosslinked gels compared to gels with higher crosslinking. Dynamic loading, however, showed little effect on ECM gene expression in both crosslinked systems. To better understand the cellular environment, ECM production was qualitatively assessed using an in situ immunofluorescent technique and standard histology. A pericellular matrix (PCM) was observed as early as day 3 post-encapsulation and the degree of formation was dependent on gel crosslinking. These results suggest the PCM may protect the cells from sensing the applied loads. This study demonstrates that gel structure has a profound effect on chondrocyte gene expression, while dynamic loading has much less of an effect at early culture times.

Mechanical stimulation of tendon tissue engineered constructs: effects on construct stiffness, repair biomechanics, and their correlation

The objective of this study was to determine how in vitro mechanical stimulation of tissue engineered constructs affects their stiffness and modulus in culture and tendon repair biomechanics 12 weeks after surgical implantation. Using six female adult New Zealand White rabbits, autogenous tissue engineered constructs were created by seeding mesenchymal stem cells (0.1 x 10(6) cells/ml) in collagen gel (2.6 mg/ml) and combining both with a collagen sponge. Employing a novel experimental design strategy, four constructs from each animal were mechanically stimulated (one 1 Hz cycle every 5 min to 2.4% peak strain for 8 h/day for 2 weeks) while the other four remained unstretched during the 2 week culture period. At the end of incubation, three of the mechanically stimulated (S) and three of the nonstimulated (NS) constructs from each animal were assigned for in vitro mechanical testing while the other two autogenous constructs were implanted into bilateral full-thickness, full-length defects created in the central third of rabbit patellar tendons (PTs). No significant differences were found in the in vitro linear stiffnesses between the S (0.15+/-0.1 N/mm) and NS constructs (0.08+/-0.02 N/mm; mean+/-SD). However, in vitro mechanical stimulation significantly increased the structural and material properties of the repair tissue, including a 14% increase in maximum force (p=0.01), a 50% increase in linear stiffness (p=0.001), and 23-41% increases in maximum stress and modulus (p=0.01). The S repairs achieved 65%, 80%, 60%, and 40% of normal central PT maximum force, linear stiffness, maximum stress, and linear modulus, respectively. The results for the S constructs exceed values obtained previously by our group using the same animal and defect model, and to our knowledge, this is the first study to show the benefits of in vitro mechanical stimulation on tendon repair biomechanics. In addition, the linear stiffnesses for the construct and repair were positively correlated (r=0.56) as were their linear moduli (r=0.68). Such in vitro predictors of in vivo outcome hold the potential to speed the development of tissue engineered products by reducing the time and costs of in vivo studies.

Cartilage reshaping via in vitro mechanical loading

Shaped cartilage grafts can be used in the restoration of injured joints and the reconstruction of deformities of the head and neck. This study describes a novel method for altering cartilage shape, based on the hypothesis that mechanical loading coupled with in vitro tissue growth and remodeling facilitates tissue reshaping. Static bending deformations were imposed on strips of immature articular cartilage, and retention of the imposed shape and structural and biochemical measures of growth were assessed after 2, 4, and 6 days of incubation. The results show that mechanical reshaping of tissue is feasible, because shape retention was greater than 86% after 6 days of culture. The imposed mechanical deformations had little effect on measures of tissue viability or growth within the 6-day culture period. The addition of cycloheximide to the culture medium only slightly reduced the ability to reshape these tissues, but cycloheximide plus a lower culture temperature of 4 degrees C markedly inhibited the reshaping response. These results suggest a limited role for chondrocyte biosynthesis but a potentially important role for metabolic reactions in the cartilage matrix in the reshaping process. The ability to modulate cartilage shape in vitro may prove useful for tissue engineering of shaped cartilage grafts.

Mechanotransduction of bovine articular cartilage superficial zone protein by transforming growth factor beta signaling

OBJECTIVE

Mechanical signals are key determinants in tissue morphogenesis, maintenance, and restoration strategies in regenerative medicine, although molecular mechanisms of mechanotransduction remain to be elucidated. This study was undertaken to investigate the mechanotransduction process of expression of superficial zone protein (SZP), a critical joint lubricant.

METHODS

Regional expression of SZP was first quantified in cartilage obtained from the femoral condyles of immature bovines, using immunoblotting, and visualized by immunohistochemistry. Contact pressure mapping in whole joints was accomplished using pressure-sensitive film and a load application system for joint testing. Friction measurements on cartilage plugs were acquired under boundary lubrication conditions using a pin-on-disk tribometer modified for reciprocating sliding. Direct mechanical stimulation by shear loading of articular cartilage explants was performed with and without inhibition of transforming growth factor beta (TGFbeta) signaling, and SZP content in media was quantified by enzyme-linked immunosorbent assay.

RESULTS

An unexpected pattern of SZP localization in knee cartilage was initially identified, with anterior regions exhibiting high levels of SZP expression. Regional SZP patterns were regulated by mechanical signals and correlated with tribological behavior. Direct relationships were demonstrated between high levels of SZP expression, maximum contact pressures, and low friction coefficients. Levels of SZP expression and accumulation were increased by applying shear stress, depending on location within the knee, and were decreased to control levels with the use of a specific inhibitor of TGFbeta receptor type I kinase and subsequent phospho-Smad2/3 activity.

CONCLUSION

These findings indicate a new role for TGFbeta signaling in the mechanism of cellular mechanotransduction that is especially significant for joint lubrication.

The beneficial effect of delayed compressive loading on tissue-engineered cartilage constructs cultured with TGF-beta3

OBJECTIVE

To determine whether the functional properties of tissue-engineered constructs cultured in a chemically-defined medium supplemented briefly with TGF-beta3 can be enhanced with the application of dynamic deformational loading.

METHODS

Primary immature bovine cells (2-3 months old) were encapsulated in agarose hydrogel (2%, 30 x 10(6)cells/ml) and cultured in chemically-defined medium supplemented for the first 2 weeks with transforming growth factor beta 3 (TGF-beta3) (10 microg/ml). Physiologic deformational loading (1 Hz, 3 h/day, 10% unconfined deformation initially and tapering to 2% peak-to-peak deformation by day 42) was applied either concurrent with or after the period of TGF-beta3 supplementation. Mechanical and biochemical properties were evaluated up to day 56.

RESULTS

Dynamic deformational loading applied concurrently with TGF-beta3 supplementation yielded significantly lower (-90%) overall mechanical properties when compared to free-swelling controls. In contrast, the same loading protocol applied after the discontinuation of the growth factor resulted in significantly increased (+10%) overall mechanical properties relative to free-swelling controls. Equilibrium modulus values reach 1306+/-79 kPa and glycosaminoglycan levels reach 8.7+/-1.6% w.w. during this 8-week period and are similar to host cartilage properties (994+/-280 kPa, 6.3+/-0.9% w.w.).

CONCLUSIONS

An optimal strategy for the functional tissue engineering of articular cartilage, particularly to accelerate construct development, may incorporate sequential application of different growth factors and applied deformational loading.

Sensate scaffolds can reliably detect joint loading

Treatment of cartilage defects is essential to the prevention of osteoarthritis. Scaffold-based cartilage tissue engineering shows promise as a viable technique to treat focal defects. Added functionality can be achieved by incorporating strain gauges into scaffolds, thereby providing a real-time diagnostic measurement of joint loading. Strain-gauged scaffolds were placed into the medial femoral condyles of 14 adult canine knees and benchtop tested. Loads between 75 and 130 N were applied to the stifle joints at 30 degrees, 50 degrees, and 70 degrees of flexion. Strain-gauged scaffolds were able to reliably assess joint loading at all applied flexion angles and loads. Pressure sensitive films were used to determine joint surface pressures during loading and to assess the effect of scaffold placement on joint pressures. A comparison of peak pressures in control knees and joints with implanted scaffolds, as well as a comparison of pressures before and after scaffold placement, showed that strain-gauged scaffold implantation did not significantly alter joint pressures. Future studies could possibly use strain-gauged scaffolds to clinically establish normal joint loads and to determine loads that are damaging to both healthy and tissue-engineered cartilage. Strain-gauged scaffolds may significantly aid the development of a functional engineered cartilage tissue substitute as well as provide insight into the native environment of cartilage.

A biomimetic three-dimensional woven composite scaffold for functional tissue engineering of cartilage

Tissue engineering seeks to repair or regenerate tissues through combinations of implanted cells, biomaterial scaffolds and biologically active molecules. The rapid restoration of tissue biomechanical function remains an important challenge, emphasizing the need to replicate structural and mechanical properties using novel scaffold designs. Here we present a microscale 3D weaving technique to generate anisotropic 3D woven structures as the basis for novel composite scaffolds that are consolidated with a chondrocyte-hydrogel mixture into cartilage tissue constructs. Composite scaffolds show mechanical properties of the same order of magnitude as values for native articular cartilage, as measured by compressive, tensile and shear testing. Moreover, our findings showed that porous composite scaffolds could be engineered with initial properties that reproduce the anisotropy, viscoelasticity and tension-compression nonlinearity of native articular cartilage. Such scaffolds uniquely combine the potential for load-bearing immediately after implantation in vivo with biological support for cell-based tissue regeneration without requiring cultivation in vitro.

Encapsulated chondrocyte response in a pulsatile flow bioreactor

We have developed a bioreactor-based millifluidic technique that allows for dynamic culture conditions and measurement of the fluid flow impinging upon a three-dimensional tissue engineering scaffold. Chondrocytes in scaffolds have been shown to require mechanical stimulation to produce an extracellular matrix that resembles native cartilage. This study investigates the effect of pulsatile flow on chondrocyte response in a model poly(ethylene glycol) dimethacrylate hydrogel. Bovine chondrocytes were encapsulated in the hydrogel and cultured for 7, 14 and 21 days at pulsatile flow frequencies of 0.5 Hz (15ml/min) and 1.5Hz (17ml/min). The scaffolds cultured under dynamic conditions were compared to those cultured under static (non-flow) conditions. Quantitative real-time reverse transcription polymerase chain reaction was used to quantify collagen type I, collagen type II and aggrecan gene copy numbers as markers for chondrocyte phenotypic expression. Histological sections stained with hematoxylin & eosin, and Alcian blue confirmed chondrocyte morphology and matrix formation. Interestingly, regulation of the collagen type II gene was particularly sensitive to the flow conditions. The understanding of the cell response to encapsulation and flow could be used to identify the appropriate culture conditions necessary to design and develop hydrogel carriers to promote the formation of extracellular matrix as well as to further our knowledge of chondrocyte mechanobiology.

Quantitative Analysis of Temporal and Spatial Variations of Chondrocyte Behavior in Engineered Cartilage during Long-Term Culture

In this work, we present the fact that chondrocyte activity differs in relation to their position in an engineered cartilage construct. Chondrocytes from porcine articular cartilage were cultured in a monolayer. Then the cell/extracellular matrix (ECM) membrane was peeled off and centrifuged into a three-dimensional (3D) pellet-type construct. Cultivated in a static condition, the constructs were harvested at specific time intervals (1, 2, 3, and 5 weeks) and manually cored using a biopsy punch to separate the core from the remaining construct. The resultant parts, core and peripheral remnant were thus obtained and subjected to analysis individually. Cell density (10(6 )cells/cm(3)) of the core was significantly higher at 1 week than that of the periphery but this trend was reversed at later time points. Cell viability was remarkably better in the peripheral tissue. Alcian blue staining of glycosaminoglycan (GAG) revealed an intense blue staining from the periphery, exhibiting a steep gradient in distribution of GAG concentration. The gene expression ratio of collagen type II to I appeared to be more altered in the periphery, possibly suggesting cell dedifferentiation, especially at later time points (>2 weeks). The mRNA levels of matrix metalloproteinase-1 (MMP-1) and MMP-13 remained in the normal range, whereas collagen type X expression was more significantly upregulated at the periphery. This study showed that chondrocyte behavior could be highly variable in the extent of their proliferation, differentiation and dedifferentiation, depending on their physical location within 3D engineered cartilage construct.

Advanced Tools for Tissue Engineering: Scaffolds, Bioreactors, and Signaling

This article contains the collective views expressed at the second session of the workshop "Tissue Engineering--The Next Generation,'' which was devoted to the tools of tissue engineering: scaffolds, bioreactors, and molecular and physical signaling. Lisa E. Freed and Farshid Guilak discussed the integrated use of scaffolds and bioreactors as tools to accelerate and control tissue regeneration, in the context of engineering mechanically functional cartilage and cardiac muscle. Edward Guo focused on the opportunities that tissue engineering generates for studies of mechanobiology and on the need for tissue engineers to learn about mechanical forces during tissue and organ genesis. Martha L. Gray focused on the potential of biomedical imaging for noninvasive monitoring of engineered tissues and on the opportunities biomedical imaging can generate for the development of new markers. Robert Tranquillo reviewed the approach to tissue engineering of a spectrum of avascular habitually loaded tissues- blood vessels, heart valves, ligaments, tendons, cartilage, and skin. Jeffrey W. Holmes offered the perspective of a "reverse paradigm''--the use of tissue constructs in quantitative studies of cell-matrix interactions, cell mechanics, matrix mechanics, and mechanobiology. Milica Radisic discussed biomimetic design of tissue-engineering systems, on the example of synchronously contractile cardiac muscle. Michael V. Sefton proposed a new, simple approach to the vascularization of engineered tissues. This session stressed the need for advanced scaffolds, bioreactors, and imaging technologies and offered many enlightening examples on how these advanced tools can be utilized for functional tissue engineering and basic research in medicine and biology.

Prediction of collagen orientation in articular cartilage by a collagen remodeling algorithm

OBJECTIVE

Tissue engineering is a promising method to treat damaged cartilage. So far it has not been possible to create tissue-engineered cartilage with an appropriate structural organization. It is envisaged that cartilage tissue engineering will significantly benefit from knowledge of how the collagen fiber orientation is directed by mechanical conditions. The goal of the present study is to evaluate whether a collagen remodeling algorithm based on mechanical loading can be corroborated by the collagen orientation in healthy cartilage.

METHODS

According to the remodeling algorithm, collagen fibrils align with a preferred fibril direction, situated between the positive principal strain directions. The remodeling algorithm was implemented in an axisymmetric finite element model of the knee joint. Loading as a result of typical daily activities was represented in three different phases: rest, standing and gait.

RESULTS

In the center of the tibial plateau the collagen fibrils run perpendicular to the subchondral bone. Just below the articular surface they bend over to merge with the articular surface. Halfway between the center and the periphery, the collagen fibrils bend over earlier, resulting in a thicker superficial and transitional zones. Near the periphery fibrils in the deep zone run perpendicular to the articular surface and slowly bend over to angles of -45 degrees and +45 degrees with the articular surface.

CONCLUSION

The collagen structure as predicted with the collagen remodeling algorithm corresponds very well with the collagen structure in healthy knee joints. This remodeling algorithm is therefore considered to be a valuable tool for developing loading protocols for tissue engineering of articular cartilage.

Nanoindentation differentiates tissue-scale functional properties of native articular cartilage

Cartilage mechanical properties are typically tested at the macroscale. To demonstrate the ability of nanoindentation to characterize in situ articular cartilage properties at the tissue scale, we investigated the local structure-property relationships of intact articular cartilage of a normal rabbit metacarpophalangeal joint. We calculated the mechanical parameters of stiffness, S, resistance to penetration, R, and volumetric creep strain, dV/V, from nanoindentation of the articular surface at specific regions of interest. We measured morphological parameters of superficial zone thickness, middle zone thickness, total uncalcified thickness, and cell density from corresponding regions with light and polarized light microscopy. Mechanical parameters were compared to morphological parameters. There were significant positive correlations (r = 0.98, p < 0.05) between superficial zone thickness and both S and R. However, we found no significant correlation between dV/V and the zone sizes. There were moderate, negative correlations between cell density and both S and R, suggesting an effect of cell volume on cartilage behavior at the tissue scale. We opine that the superficial zone plays important role in load support, as evidenced by correlations between zone size and intact cartilage mechanical properties.

Tailoring secretion of proteoglycan 4 (PRG4) in tissue-engineered cartilage

Articular cartilage provides a low-friction surface for joint articulation, with boundary lubrication facilitated by proteoglycan 4 (PRG4), which is secreted by chondrocytes of the superficial zone. Chondrocytes from different zones are phenotypically distinct, and their phenotypes in vitro are influenced by the system in which they are cultured. We hypothesized that culturing cells from the superficial (S) zone in two-dimensional monolayer or three-dimensional alginate would affect their synthesis of PRG4, and that subsequently seeding them atop alginate-recovered cells from the middle/ deep (M) zone in various proportions would result in tissue-engineered constructs with varying levels of PRG4 secretion and matrix accumulation. During monolayer culture, S cells retained their PRG4-secreting phenotype, whereas in alginate culture the percentage of cells secreting PRG4 decreased with time. Constructs formed with increasing percentages of S cells decreased in thickness and matrix accumulation, depending on both the culture conditions before construct formation and the S-cell density. PRG4-secreting cells were localized to the S-cell seeded construct surface, with secretion rates of 0.1-4 pg/cell/day or 0.1-1 pg/cell/day for constructs formed with monolayer-recovered or alginate-recovered S cells, respectively. Tailoring secretion of PRG4 in cartilage constructs may be useful for enhancing low-friction properties at the articular surface, while maintaining other surfaces free of PRG4 for enhancing integration with surrounding tissues.

Effects of cell seeding density and collagen concentration on contraction kinetics of mesenchymal stem cell-seeded collagen constructs

Our group has been engineering cell-scaffold constructs to improve tendon repair by contracting mesenchymal stem cells (MSCs) in collagen gels and then evaluating their repair potential in wound sites in rabbits. Because the construct's initial conditions may influence the ultimate repair outcome, this two-part study sought to distinguish which factors most influence contraction kinetics in culture. (1)We optically determined if varying cell-to-collagen ratio significantly affected construct contraction. Temporal changes in construct area were monitored up to 168 h for 4 cell-to-collagen ratios (HK = 0.04, LK = 0.08, HM = 0.4, and LM = 0.8, where H, L = 2.6, 1.3 mg/mL collagen and K,M = 0.1, 1 million cells/mL, respectively).A mathematical model was created with terms that represent the different combinations of cell densities and collagen concentrations in order to predict the contraction kinetics as a function of time. Highly significant differences in construct areas were found among all 4 ratios after 8 h of contraction with the exception of the LK (0.08) vs. HM(0.4) conditions. This similar pattern raised the question of whether cell density or collagen concentration more influenced these events. (2) To isolate these effects, the contraction kinetics of the HM construct were compared to those of a new construct (L5K) with equivalent cell-to-collagen ratio (0.4) but half the cell density (500 K MSCs/mL) and half the collagen concentration (1.3 mg/mL). The L5K construct contracted significantly faster and more completely than the HM construct but no differently than the LM construct. These results indicate that above a threshold value of cell density, percentage reductions in collagen concentration influence contraction kinetics more than equivalent percentage increases in cell seeding density. The fact that our model successfully predicted intermediate time points of contraction suggests its utility for examining other cell and collagen densities. Controlling scaffold as well as cellular initial conditions will be critical in achieving our goal of functional tissue engineering (FTE) a successful tendon repair.

The Chondrocyte: Biology and Clinical Application

Chondrocyte is a unique cell type in articular cartilage tissue and is essential for cartilage formation and functionality. It arises from mesenchymal stem cells (MSCs) and is regulated by a series of cytokine and transcription factor interactions, including the transforming growth factor-beta super family, fibroblast growth factors, and insulin-like growth factor-1. To understand the biomechanisms of the chondrocyte differentiation process, various cellular model systems have been employed, such as primary chondrocyte culture, clonal normal cell lines (HCS-2/8, Ch-1, ATDC5, CFK-2, and RCJ3.1C5.18), and transformed clonal cell lines (T/C-28a2, T/C-28a4, C-28/I2, tsT/AC62, and HPV-16 E6/E7). Additionally, cell culture methods, including conventional monolayer culture, three-dimensional scaffold culture, bioreactor culture, pellet culture, and organ culture, have been established to create stable environments for the expansion, phenotypic maintenance, and subsequent biological study of chondrocytes for clinical application. Knowledge gained through these study systems has allowed for the use of chondrocytes in orthopedics for the treatment of cartilage injury and epiphyseal growth plate defects using tissue-engineering approaches. Furthermore, the potential of chondrocyte implantation for facial reconstruction, the treatment of long segmental tracheal defects, and urinary incontinence and vesicoureteral reflux are being investigated. This review summarizes the present study of chondrocyte biology and the potential uses of this cell in orthopedics and other disciplines.

Fluid flow increases type II collagen deposition and tensile mechanical properties in bioreactor-grown tissue-engineered cartilage

A novel parallel-plate bioreactor has been designed to apply a consistent level of fluid flow-induced shear stress to tissue-engineered articular cartilage in order to improve the matrix composition and mechanical properties and more nearly approximate to that of native tissue. Primary bovine articular chondrocytes were seeded into the bioreactor at high densities (1.7 x 10(6) cell/cm2) without a scaffold and cultured for two weeks under static, no-flow conditions. A mean fluid flow-induced shear stress of 1 dyne/cm2 was then applied continuously for 3 days. The application of flow produced constructs with significantly (p < 0.05) higher amounts of total collagen (via hydroxyproline) and specifically type II collagen (via ELISA) (25.3 +/- 2.5% and 22.1 +/- 4.7% of native tissue, respectively) compared to static controls (22.4 +/- 1.7% and 9.5 +/- 2.3%, respectively). Concurrently, the tensile Young's modulus and ultimate strength were significantly increased in flow samples (2.28 +/- 0.19 MPa and 0.81 +/- 0.07 MPa, respectively) compared to static controls (1.55 +/- 0.10 MPa and 0.62 +/- 0.05 MPa, respectively). This study suggests that flow-induced shear stresses and/or enhanced mass transport associated with the hydrodynamic environment of our novel bioreactor may be an effective functional tissue-engineering strategy for improving matrix composition and mechanical properties in vitro.

Chondrogenic differentiation and functional maturation of bovine mesenchymal stem cells in long-term agarose culture

BACKGROUND

The developmental history of the chondrocyte results in a cell whose biosynthetic activities are optimized to maintain the concentration and organization of a mechanically functional cartilaginous extracellular matrix. While useful for cartilage tissue engineering studies, the limited supply of healthy autologous chondrocytes may preclude their clinical use. Consequently, multipotential mesenchymal stem cells (MSCs) have been proposed as an alternative cell source.

OBJECTIVE

While MSCs undergo chondrogenesis, few studies have assessed the mechanical integrity of their forming matrix. Furthermore, efficiency of matrix formation must be determined in comparison to healthy chondrocytes from the same donor. Given the scarcity of healthy human tissue, this study determined the feasibility of isolating bovine chondrocytes and MSCs, and examined their long-term maturation in three-dimensional agarose culture.

EXPERIMENTAL DESIGN

Bovine MSCs were seeded in agarose and induced to undergo chondrogenesis. Mechanical and biochemical properties of MSC-laden constructs were monitored over a 10-week period and compared to those of chondrocytes derived from the same group of animals maintained similarly.

RESULTS

Our results show that while chondrogenesis does occur in MSC-laden hydrogels, the amount of the forming matrix and measures of its mechanical properties are lower than that produced by chondrocytes under the same conditions. Furthermore, some important properties, particularly glycosaminoglycan content and equilibrium modulus, plateau with time in MSC-laden constructs, suggesting that diminished capacity is not the result of delayed differentiation.

CONCLUSIONS

These findings suggest that while MSCs do generate constructs with substantial cartilaginous properties, further optimization must be done to achieve levels similar to those produced by chondrocytes.

Chondrocytic differentiation of human adipose-derived adult stem cells in elastin-like polypeptide

Human adipose derived adult stem (hADAS) cells have the ability to differentiate into a chondrogenic phenotype in three-dimensional culture and media containing dexamethasone and TGF-beta. The current study examined the potential of a genetically engineered elastin-like polypeptide (ELP) to promote the chondrocytic differentiation of hADAS cells without exogenous chondrogenic supplements. hADAS cells were cultured in ELP hydrogels in either chondrogenic or standard medium at 5% O2 for up to 2 weeks. By day 14, constructs cultured in either medium exhibited significant increases in sulfated glycosaminoglycan (up to 100%) and collagen contents (up to 420%). Immunolabeling confirmed that the matrix formed consisted mainly of type II and not type I collagen. The composition of the constructs cultured in either medium did not differ significantly. To assess the effect of oxygen tension on the differentiation of the above constructs, samples were cultured in standard medium at either 5% or 20% O2 for 7 days and their gene expression profile was evaluated using real time RT-PCR. In both cases, the hADAS-ELP constructs upregulated SOX9 and type II collagen gene expression, while type I collagen was downregulated. However, constructs cultured in 20% O2 highly upregulated type X collagen, which was not detected in the 5% O2 cultures. The study suggests that ELP can promote chondrogenesis for hADAS cells in the absence of exogenous TGF-beta1 and dexamethasone, especially under low oxygen tension conditions.

Polymer scaffolds fabricated with pore-size gradients as a model for studying the zonal organization within tissue-engineered cartilage constructs

The zonal organization of cells and extracellular matrix (ECM) constituents within articular cartilage is important for its biomechanical function in diarthroidal joints. Tissue-engineering strategies adopting porous three-dimensional (3D) scaffolds offer significant promise for the repair of articular cartilage defects, yet few approaches have accounted for the zonal structural organization as in native articular cartilage. In this study, the ability of anisotropic pore architectures to influence the zonal organization of chondrocytes and ECM components was investigated. Using a novel 3D fiber deposition (3DF) technique, we designed and produced 100% interconnecting scaffolds containing either homogeneously spaced pores (fiber spacing, 1 mm; pore size, about 680 microm in diameter) or pore-size gradients (fiber spacing, 0.5-2.0 mm; pore size range, about 200-1650 microm in diameter), but with similar overall porosity (about 80%) and volume fraction available for cell attachment and ECM formation. In vitro cell seeding showed that pore-size gradients promoted anisotropic cell distribution like that in the superficial, middle, and lower zones of immature bovine articular cartilage, irrespective of dynamic or static seeding methods. There was a direct correlation between zonal scaffold volume fraction and both DNA and glycosaminoglycan (GAG) content. Prolonged tissue culture in vitro showed similar inhomogeneous distributions of zonal GAG and collagen type II accumulation but not of GAG:DNA content, and levels were an order of magnitude less than in native cartilage. In this model system, we illustrated how scaffold design and novel processing techniques can be used to develop anisotropic pore architectures for instructing zonal cell and tissue distribution in tissue-engineered cartilage constructs.

Heterogeneous three-dimensional strain fields during unconfined cyclic compression in bovine articular cartilage explants

Articular cartilage provides critical load-bearing and tribological properties to the normal function of diarthrodial joints. The unique properties of cartilage, as well as heterogeneous deformations during mechanical compression, are due to the nonuniform microstructural organization of tissue components such as collagens and proteoglycans. A new cartilage deformation by tag registration (CDTR) technique has been developed by the authors to determine heterogeneous deformations in articular cartilage explants. The technique uses a combination of specialized MRI methods, a custom cyclic loading apparatus, and image processing software. The objective of this study was to use the CDTR technique to document strain patterns throughout the volume of normal bovine articular cartilage explants during cyclic unconfined compression at two physiologically-relevant applied normal stress levels (1.29 and 2.57 MPa). Despite simple uniaxial cyclic compressive loading with a flat, nonporous indenter, strain patterns were heterogeneous. Strains in the thickness direction (E(yy)) were compressive, varied nonlinearly with depth from the articular surface from a maximum magnitude of 11% at the articular surface, and were comparable despite a 2-fold increase in applied normal stress. Strains perpendicular to the thickness direction (E(xx) and E(zz)) were tensile, decreased linearly with depth from the articular surface from a maximum of 7%, and increased in magnitude 2.5-fold with a 2-fold increase in applied normal stress. Shear strains in the transverse plane (E(xz)) were approximately zero while shear strains in the other two planes were much larger and increased in magnitude with depth from the articular surface, reaching maximum magnitudes of 2% at the articular cartilage-subchondral bone interface. In general, strain patterns indicated that cartilage osteochondral explants exhibited depth-dependent nonisotropic behavior during uniaxial cyclic loading. These results are useful in verifying constitutive formulations of articular cartilage during cyclic unconfined compression and in characterizing the micromechanical environment likely experienced by individual chondrocytes throughout the tissue volume.

Cell density alters matrix accumulation in two distinct fractions and the mechanical integrity of alginate-chondrocyte constructs

Chondrocyte density in articular cartilage is known to change with the development and growth of the tissue and may play an important role in the formation of a functional extracellular matrix (ECM). The objective of this study was to determine how initial chondrocyte density in an alginate hydrogel affects the matrix composition, its distribution between the cell-associated (CM) and further removed matrix (FRM) fractions, and the tensile mechanical properties of the developing engineered cartilage. Alginate constructs containing primary bovine chondrocytes at densities of 0, 4, 16, and 64 million cells/ml were fabricated and cultured for 1 or 2 weeks, at which time structural, biochemical, and mechanical properties were analyzed. Both matrix content and distribution varied with the initial cell density. Increasing cell density resulted in an increasing content of collagen and sulfated-glycosaminoglycan (GAG) and an increasing proportion of these molecules localized in the CM. While the equilibrium tensile modulus of cell-free alginate did not change with time in culture, the constructs with highest cell density were 116% stiffer than cell-free controls after 2 weeks of culture. The equilibrium tensile modulus was positively correlated with total collagen (r2=0.47, p<0.001) and GAG content (r2=0.68, p<0.001), and these relationships were enhanced when analyzing only those matrix molecules in the CM fraction (r2=0.60 and 0.72 for collagen and GAG, respectively, each p<0.001). Overall, the results of this study indicate that initial cell density has a considerable effect on the developing composition, structure, and function of alginate-chondrocyte constructs.

Spatial and temporal development of chondrocyte-seeded agarose constructs in free-swelling and dynamically loaded cultures

Dynamic deformational loading has been shown to significantly increase the development of material properties of chondrocyte-seeded agarose hydrogels, however little is known about the spatial development of the material properties within these constructs. In this study, a technique that combines video microscopy and optimized digital image correlation, was applied to assess the spatial development of material properties in tissue-engineered cartilage constructs cultured in free-swelling and dynamically-loaded conditions (3h/day, 5 days/week, and maintained in free-swelling conditions when not being loaded) over a 6-week period. Although homogeneous at day 0, both free-swelling and dynamically loaded samples progressively developed stiffer outer edges and a softer central region. The distribution of GAGs and collagens were shown to mimic this profile. These results indicate that although dynamic loading augments the development of bulk properties in these samples, possibly by overcoming some of the diffusion limitation and nutrient transport issues, the overall profile of construct properties in the axial direction remains qualitatively the same as in free-swelling culture conditions. Poisson's ratio of these constructs increased over time in culture with increased fixed charged density contributed by the GAGs, but this increase was significantly less in dynamically loaded samples by day 42. Polarized light microscopy of Picrosirius Red labeled samples, at an angle perpendicular to the direction of loading, suggests that these differences in Poisson's ratio may be due to improved organization of collagen network in the dynamically loaded samples.

Multibody dynamic simulation of knee contact mechanics

Multibody dynamic musculoskeletal models capable of predicting muscle forces and joint contact pressures simultaneously would be valuable for studying clinical issues related to knee joint degeneration and restoration. Current three-dimensional multibody knee models are either quasi-static with deformable contact or dynamic with rigid contact. This study proposes a computationally efficient methodology for combining multibody dynamic simulation methods with a deformable contact knee model. The methodology requires preparation of the articular surface geometry, development of efficient methods to calculate distances between contact surfaces, implementation of an efficient contact solver that accounts for the unique characteristics of human joints, and specification of an application programming interface for integration with any multibody dynamic simulation environment. The current implementation accommodates natural or artificial tibiofemoral joint models, small or large strain contact models, and linear or nonlinear material models. Applications are presented for static analysis (via dynamic simulation) of a natural knee model created from MRI and CT data and dynamic simulation of an artificial knee model produced from manufacturer's CAD data. Small and large strain natural knee static analyses required 1 min of CPU time and predicted similar contact conditions except for peak pressure, which was higher for the large strain model. Linear and nonlinear artificial knee dynamic simulations required 10 min of CPU time and predicted similar contact force and torque but different contact pressures, which were lower for the nonlinear model due to increased contact area. This methodology provides an important step toward the realization of dynamic musculoskeletal models that can predict in vivo knee joint motion and loading simultaneously.

Adjacent tissues (cartilage, bone) affect the functional integration of engineered calf cartilage in vitro

OBJECTIVE

An in vitro model was used to test the hypothesis that culture time and adjacent tissue structure and composition affected chondrogenesis and integrative repair in engineered cartilage.

METHOD

Engineered constructs made of bovine calf chondrocytes and hyaluronan benzyl ester non-woven mesh were press-fitted into adjacent tissue rings made of articular cartilage (AC), devitalized bone (DB), or vital bone (VB) and cultured in rotating bioreactors for up to 8 weeks. Structure (light and electron microscopy), biomechanical properties (interfacial adhesive strength, construct compressive modulus), biochemical composition (construct glycosaminoglycans (GAG), collagen, and cells), and adjacent tissue diffusivity were assessed.

RESULTS

Engineered constructs were comprised predominately of hyaline cartilage, and appeared either closely apposed to adjacent cartilage or functionally interdigitated with adjacent bone due to interfacial deposition of extracellular matrix. An increase in culture time significantly improved construct adhesive strength (P<0.001), modulus (P=0.02), GAG (P=0.04) and cellularity (P<0.001). The type of adjacent tissue significantly affected construct adhesion (P<0.001), modulus (P<0.001), GAG (P<0.001) and collagen (P<0.001). For constructs cultured in rings of cartilage, negative correlations were observed between ring GAG content (log transformed) and construct adhesion (R2=0.66, P<0.005), modulus (R2=0.49, P<0.05) and GAG (R2=0.44, P<0.05). Integrative repair was better for constructs cultured adjacent to bone than cartilage, in association with its solid architectural structure and high GAG content, and best for constructs cultured adjacent to DB, in association with its high diffusivity.

CONCLUSIONS

Chondrogenesis and integrative repair in engineered cartilage improved with time and depended on adjacent tissue architecture, composition, and transport properties.

A layered agarose approach to fabricate depth-dependent inhomogeneity in chondrocyte-seeded constructs

Inspired by the depth-dependent inhomogeneity of articular cartilage, it was hypothesized that a novel layered agarose technique, using a 2% (wt/vol) top and a 3% (wt/vol) bottom layer, would create an inhomogenous tissue construct with distinct material properties in conjoined regions. The biochemical and mechanical development of these constructs was observed alongside uniform 2% and 3% constructs. Initially, uniform 3% agarose disks had the highest bulk Young's modulus (E(Y) approximately 28 kPa) of all groups. After 28 days of culture in 20% FBS-containing media, however, uniform 2% chondrocyte-seeded constructs achieved the highest Young's modulus compared to bilayered and 3% agarose disks. Though all three groups contained similar GAG content ( approximately 1.5% ww), uniform 2% agarose disks on day 28 possessed the highest collagen content ( approximately 1% ww). Unlike in either homogeneous construct type, microscopic analysis of axial strain fields in bilayered constructs in response to applied static compression revealed two mechanically disparate regions on day 0: a softer 2% layer and a stiffer 3% layer. With time in culture, this inhomogeneity became less distinct, as indicated by increased continuity in both the local displacement field and local E(Y), and depended on the level of FBS supplementation of the feed media, with lower FBS concentrations (10%) more closely maintaining the original distinction of material properties. These results shed positive light on a layered agarose technique for the production of inhomogeneous bilayered chondrocyte-seeded agarose constructs with applications for investigations of chondrocyte mechanotransduction and for possible use in the tissue engineering of inhomogeneous articular cartilage constructs.

Characterization of in vivo Achilles tendon forces in rabbits during treadmill locomotion at varying speeds and inclinations

The objective of this study was to test the hypothesis that increasing the speed and inclination of the treadmill increases the peak Achilles tendon forces and their rates of rise and fall in force. Implantable force transducers (IFT) were inserted in the confluence of the medial and lateral heads of the left gastrocnemius tendon in 11 rabbits. IFT voltages were successfully recorded in 8 animals as the animals hopped on a treadmill at each of two speeds (0.1 and 0.3 mph) and inclinations (0 degrees and 12 degrees). Instrumented tendons were isolated shortly after sacrifice and calibrated. Contralateral unoperated tendons were failed in uniaxial tension to determine maximum or failure force, from which safety factor (ratio of maximum force to peak in vivo force) was calculated for each activity. Peak force and the rates of rise and fall in force significantly increased with increasing treadmill inclination (p<0.001). Safety factors averaged 30.8+/-7.5 for quiet standing, 7.0+/-2.9 for level hopping, and 5.2+/-0.7 for inclined hopping (mean+/-SEM). These in vivo force parameters will help tissue engineers better design functional tissue engineered constructs for rabbit Achilles tendon and other tendon repairs. Force patterns can also serve as input data for mechanical stimulation of tissue-engineered constructs in culture. Such approaches are expected to help accelerate tendon repair after injury.