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Sun C, Cao C, Zhao T, Guo H, Fleming BC, Owens B, Beveridge J, McAllister S, Wei L. A2M inhibits inflammatory mediators of chondrocytes by blocking IL-1β/NF-κB pathway. J Orthop Res 2023; 41:241-248. [PMID: 35451533 DOI: 10.1002/jor.25348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 03/24/2022] [Accepted: 04/20/2022] [Indexed: 02/04/2023]
Abstract
A hallmark of osteoarthritis (OA) is cartilage degeneration, which has been previously correlated with dramatic increases in inflammatory enzymes. Specifically, interleukin-1β (IL-1β) and subsequent upregulation of nuclear factor kappa B (NF-κB) is implicated as an important player in the development of posttraumatic osteoarthritis (PTOA). Alpha 2-macroglobulin (A2M) can inhibit this inflammatory pathway, making it a promising therapy for PTOA. Herein, we demonstrate that A2M binds and neutralizes IL-1β, blocking downstream NF-κB-induced catabolism seen in in vitro. Human chondrocytes (cell line C28) were incubated with A2M protein and then treated with IL-1β. A2M was labeled with VivoTag™ 680 to localize the protein postincubation. The degree of binding between A2M and IL-1β was evaluated through immunoprecipitation (IP). Catabolic proteins, including IL-1β and NF-kB, were detected by Western blot. Pro-inflammatory and chondrocyte-related gene expression was examined by qRT-PCR. VivoTag™ 680-labeled A2M was observed in the cytoplasm of C28 human chondrocytes by fluorescence microscopy. IP experiments demonstrated that A2M could bind IL-1β. Additionally, western blot analysis revealed that A2M neutralized IL-1β and NF-κB in a dose-dependent manner. Moreover, A2M decreased levels of MMPs and TNF-α and increased the expression of cartilage protective genes Col2, Type2, Smad4, and aggrecan. Mostly importantly, A2M was shown to directly neutralize IL-1β to downregulate the pro-inflammatory responses mediated by the NF-kB pathway. These results demonstrate a mechanism by which A2M reduces inflammatory catabolic activity and protects cartilage after joint injury. Further in vivo studies are needed to fully understand the potential of A2M as a novel PTOA therapy.
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Affiliation(s)
- Changqi Sun
- Department of Orthopaedics, Rhode Island Hospital/Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Can Cao
- Department of Orthopaedics, Rhode Island Hospital/Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Ting Zhao
- Department of Orthopaedics, Rhode Island Hospital/Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Hailing Guo
- Department of Orthopaedics, Rhode Island Hospital/Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Braden C Fleming
- Department of Orthopaedics, Rhode Island Hospital/Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Brett Owens
- Department of Orthopaedics, Rhode Island Hospital/Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | | | - Scott McAllister
- Department of Orthopaedics, Rhode Island Hospital/Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Lei Wei
- Department of Orthopaedics, Rhode Island Hospital/Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
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Blom RP, Mol D, van Ruijven LJ, Kerkhoffs GMMJ, Smit TH. A Single Axial Impact Load Causes Articular Damage That Is Not Visible with Micro-Computed Tomography: An Ex Vivo Study on Caprine Tibiotalar Joints. Cartilage 2021; 13:1490S-1500S. [PMID: 31540553 PMCID: PMC8804841 DOI: 10.1177/1947603519876353] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Excessive articular loading, for example, an ankle sprain, may result in focal osteochondral damage, initiating a vicious degenerative process resulting in posttraumatic osteoarthritis (PTOA). Better understanding of this degenerative process would allow improving posttraumatic care with the aim to prevent PTOA. The primary objective of this study was to establish a drop-weight impact testing model with controllable, reproducible and quantitative axial impact loads to induce osteochondral damage in caprine tibiotalar joints. We aimed to induce osteochondral damage on microscale level of the tibiotalar joint without gross intra-articular fractures of the tibial plafond. DESIGN Fresh-frozen tibiotalar joints of mature goats were used as ex vivo articulating joint models. Specimens were axially impacted by a mass of 10.5 kg dropped from a height of 0.3 m, resulting in a speed of 2.4 m/s, an impact energy of 31.1 J and an impact impulse of 25.6 N·s. Potential osteochondral damage of the caprine tibiotalar joints was assessed using contrast-enhanced high-resolution micro-computed tomography (micro-CT). Subsequently, we performed quasi-static loading experiments to determine postimpact mechanical behavior of the tibiotalar joints. RESULTS Single axial impact loads with a mass of 15.5 kg dropped from 0.3 m, resulted in intra-articular fractures of the tibial plafond, where a mass of 10.55 kg dropped from 0.3 m did not result in any macroscopic damage. In addition, contrast-enhanced high-resolution micro-CT imaging neither reveal any acute microdamage (i.e., microcracks) of the subchondral bone nor any (micro)structural changes in articular cartilage. The Hexabrix content or voxel density (i.e., proteoglycan content of the articular cartilage) on micro-CT did not show any differences between intact and impacted specimens. However, quasi-static whole-tibiotalar-joint loading showed an altered biomechanical behavior after application of a single axial impact (i.e., increased hysteresis when compared with the intact or nonimpacted specimens). CONCLUSIONS Single axial impact loads did not induce osteochondral damage visible with high-resolution contrast-enhanced micro-CT. However, despite the lack of damage on macro- and even microscale, the single axial impact loads resulted in "invisible injuries" because of the observed changes in the whole-joint biomechanics of the caprine tibiotalar joints. Future research must focus on diagnostic tools for the detection of early changes in articular cartilage after a traumatic impact (i.e., ankle sprains or ankle fractures), as it is well known that this could result in PTOA.
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Affiliation(s)
- Robin P. Blom
- Department of Orthopaedic Surgery,
Amsterdam University Medical Center, Amsterdam Movement Sciences, Amsterdam, the
Netherlands
| | - Douwe Mol
- Department of Orthopaedic Surgery,
Amsterdam University Medical Center, Amsterdam Movement Sciences, Amsterdam, the
Netherlands
| | - Leo J. van Ruijven
- Department of Oral Cell Biology and
Functional Anatomy, ACTA–University of Amsterdam and VU University, Amsterdam
Movement Sciences, Amsterdam, the Netherlands
| | - Gino M. M. J. Kerkhoffs
- Department of Orthopaedic Surgery,
Amsterdam University Medical Center, Amsterdam Movement Sciences, Amsterdam, the
Netherlands,Academic Center for Evidence-Based
Sports medicine (ACES), Amsterdam Collaboration for Health and Safety in Sports
(ACHSS), IOC Research Center, Amsterdam, the Netherlands
| | - Theo H. Smit
- Department of Orthopaedic Surgery,
Amsterdam University Medical Center, Amsterdam Movement Sciences, Amsterdam, the
Netherlands,Department of Medical Biology, Amsterdam
University Medical Center, Amsterdam Movement Sciences, Amsterdam, the
Netherlands,Theo H. Smit, Department of Medical Biology,
Amsterdam University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, the
Netherlands.
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Blaker CL, Zaki S, Little CB, Clarke EC. Long-term Effect of a Single Subcritical Knee Injury: Increasing the Risk of Anterior Cruciate Ligament Rupture and Osteoarthritis. Am J Sports Med 2021; 49:391-403. [PMID: 33378213 DOI: 10.1177/0363546520977505] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Rupture of the anterior cruciate ligament (ACL) is a well-known risk factor for the development of posttraumatic osteoarthritis (PTOA), but patients with the "same injury" can have vastly different trajectories for the onset and progression of disease. Minor subcritical injuries preceding the critical injury event may drive this disparity through preexisting tissue pathologies and sensory changes. PURPOSE To investigate the role of subcritical injury on ACL rupture risk and PTOA through the evaluation of pain behaviors, joint mechanics, and tissue structural change in a mouse model of knee injury. STUDY DESIGN Controlled laboratory study. METHODS Ten-week-old male C57BL/6J mice were allocated to naïve control and subcritical knee injury groups. Injury was induced by a single mechanical compression to the right hindlimb, and mice were evaluated using joint histopathology, anteroposterior joint biomechanics, pain behaviors (mechanical allodynia and hindlimb weightbearing), and isolated ACL tensile testing to failure at 1, 2, 4, or 8 weeks after injury. RESULTS Subcritical knee injury produced focal osteochondral lesions in the patellofemoral and lateral tibiofemoral compartments with no resolution for the duration of the study (8 weeks). These lesions were characterized by focal loss of proteoglycan staining, cartilage structural change, chondrocyte pathology, microcracks, and osteocyte cell loss. Injury also resulted in the rapid onset of allodynia (at 1 week), which persisted over time and reduced ACL failure load (P = .006; mean ± SD, 7.91 ± 2.01 N vs 9.37 ± 1.01 N in naïve controls at 8 weeks after injury), accompanied by evidence of ACL remodeling at the femoral enthesis. CONCLUSION The present study in mice establishes a direct effect of a single subcritical knee injury on the development of specific joint tissue pathologies (osteochondral lesions and progressive weakening of the ACL) and allodynic sensitization. These findings demonstrate a predisposition for secondary critical injuries (eg, ACL rupture) and an increased risk of PTOA onset and progression (structurally and symptomatically). CLINICAL RELEVANCE Subcritical knee injuries are a common occurrence and, based on this study, can cause persistent sensory and structural change. These findings have important implications for the understanding of risk factors of ACL injury and subsequent PTOA, particularly with regard to prevention and management strategies following an often underreported event.
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Affiliation(s)
- Carina L Blaker
- Murray Maxwell Biomechanics Laboratory, Institute of Bone and Joint Research, Kolling Institute, Northern Sydney Local Health District, Faculty of Medicine and Health, Northern Clinical School, University of Sydney, St Leonards, Australia.,Raymond Purves Bone and Joint Research Laboratories, Institute of Bone and Joint Research, Kolling Institute, Northern Sydney Local Health District, Faculty of Medicine and Health, Northern Clinical School, University of Sydney, St Leonards, Australia
| | - Sanaa Zaki
- Raymond Purves Bone and Joint Research Laboratories, Institute of Bone and Joint Research, Kolling Institute, Northern Sydney Local Health District, Faculty of Medicine and Health, Northern Clinical School, University of Sydney, St Leonards, Australia.,Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Camperdown, Australia
| | - Christopher B Little
- Raymond Purves Bone and Joint Research Laboratories, Institute of Bone and Joint Research, Kolling Institute, Northern Sydney Local Health District, Faculty of Medicine and Health, Northern Clinical School, University of Sydney, St Leonards, Australia
| | - Elizabeth C Clarke
- Murray Maxwell Biomechanics Laboratory, Institute of Bone and Joint Research, Kolling Institute, Northern Sydney Local Health District, Faculty of Medicine and Health, Northern Clinical School, University of Sydney, St Leonards, Australia
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Komeili A, Luqman S, Federico S, Herzog W. Effect of cracks on the local deformations of articular cartilage. J Biomech 2020; 110:109970. [DOI: 10.1016/j.jbiomech.2020.109970] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 04/21/2020] [Accepted: 07/21/2020] [Indexed: 01/09/2023]
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Rahmani Del Bakhshayesh A, Babaie S, Tayefi Nasrabadi H, Asadi N, Akbarzadeh A, Abedelahi A. An overview of various treatment strategies, especially tissue engineering for damaged articular cartilage. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2020; 48:1089-1104. [DOI: 10.1080/21691401.2020.1809439] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Azizeh Rahmani Del Bakhshayesh
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Tissue Engineering, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Soraya Babaie
- Department of Nanotechnology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamid Tayefi Nasrabadi
- Department of Tissue Engineering, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nahideh Asadi
- Department of Nanotechnology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Abolfazl Akbarzadeh
- Department of Nanotechnology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Abedelahi
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Tissue Engineering, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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Cartilage Trauma Induces Necroptotic Chondrocyte Death and Expulsion of Cellular Contents. Int J Mol Sci 2020; 21:ijms21124204. [PMID: 32545631 PMCID: PMC7352631 DOI: 10.3390/ijms21124204] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/09/2020] [Accepted: 06/10/2020] [Indexed: 12/23/2022] Open
Abstract
Necroptotic cell death is characterized by an activation of RIPK3 and MLKL that leads to plasma membrane permeabilization and the release of immunostimulatory cellular contents. High levels of chondrocyte death occur following intra-articular trauma, which frequently leads to post-traumatic osteoarthritis development. The aim of this study is to assess necroptosis levels in cartilage post-trauma and to examine whether chondrocyte necroptotic mechanisms may be investigated and modified in vitro. Fractured human and murine cartilage, analysed immunohistochemically for necroptosis marker expression, demonstrated significantly higher levels of RIPK3 and phospho-MLKL than uninjured controls. Primary murine chondrocytes stimulated in vitro with the TNFα and AKT-inhibitor alongside the pan-caspase inhibitor Z-VAD-fmk exhibited a significant loss of metabolic activity and viability, accompanied by an increase in MLKL phosphorylation, which was rescued by further treatment of chondrocytes with necrostatin-1. Transmission electron microscopy demonstrated morphological features of necroptosis in chondrocytes following TNFα and Z-VAD-fmk treatment. Release of dsDNA from necroptotic chondrocytes was found to be significantly increased compared to controls. This study demonstrates that cartilage trauma leads to a high prevalence of necroptotic chondrocyte death, which can be induced and inhibited in vitro, indicating that both necroptosis and its consequential release of immunostimulatory cellular contents are potential therapeutic targets in post-traumatic arthritis treatment.
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Faisal TR, Adouni M, Dhaher YY. The effect of fibrillar degradation on the mechanics of articular cartilage: a computational model. Biomech Model Mechanobiol 2019; 18:733-751. [DOI: 10.1007/s10237-018-01112-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 12/20/2018] [Indexed: 12/21/2022]
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8
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Nickien M, Heuijerjans A, Ito K, van Donkelaar CC. Comparison between in vitro and in vivo cartilage overloading studies based on a systematic literature review. J Orthop Res 2018; 36:2076-2086. [PMID: 29644716 PMCID: PMC6120482 DOI: 10.1002/jor.23910] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 03/27/2018] [Indexed: 02/04/2023]
Abstract
Methodological differences between in vitro and in vivo studies on cartilage overloading complicate the comparison of outcomes. The rationale of the current review was to (i) identify consistencies and inconsistencies between in vitro and in vivo studies on mechanically-induced structural damage in articular cartilage, such that variables worth interesting to further explore using either one of these approaches can be identified; and (ii) suggest how the methodologies of both approaches may be adjusted to facilitate easier comparison and therewith stimulate translation of results between in vivo and in vitro studies. This study is anticipated to enhance our understanding of the development of osteoarthritis, and to reduce the number of in vivo studies. Generally, results of in vitro and in vivo studies are not contradicting. Both show subchondral bone damage and intact cartilage above a threshold value of impact energy. At lower loading rates, excessive loads may cause cartilage fissuring, decreased cell viability, collagen network de-structuring, decreased GAG content, an overall damage increase over time, and low ability to recover. This encourages further improvement of in vitro systems, to replace, reduce, and/or refine in vivo studies. However, differences in experimental set up and analyses complicate comparison of results. Ways to bridge the gap include (i) bringing in vitro set-ups closer to in vivo, for example, by aligning loading protocols and overlapping experimental timeframes; (ii) synchronizing analytical methods; and (iii) using computational models to translate conclusions from in vitro results to the in vivo environment and vice versa. © 2018 The Authors. Journal of Orthopaedic Research® Published by Wiley Periodicals, Inc. J Orthop Res 9999:1-11, 2018.
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Affiliation(s)
- Mieke Nickien
- Department of Biomedical Engineering, Orthopaedic BiomechanicsEindhoven University of TechnologyP.O. Box 513, 5600MBEindhovenThe Netherlands
| | - Ashley Heuijerjans
- Department of Biomedical Engineering, Orthopaedic BiomechanicsEindhoven University of TechnologyP.O. Box 513, 5600MBEindhovenThe Netherlands
| | - Keita Ito
- Department of Biomedical Engineering, Orthopaedic BiomechanicsEindhoven University of TechnologyP.O. Box 513, 5600MBEindhovenThe Netherlands
| | - Corrinus C. van Donkelaar
- Department of Biomedical Engineering, Orthopaedic BiomechanicsEindhoven University of TechnologyP.O. Box 513, 5600MBEindhovenThe Netherlands
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9
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Furman BD, Kent CL, Huebner JL, Kraus VB, McNulty AL, Guilak F, Olson SA. CXCL10 is upregulated in synovium and cartilage following articular fracture. J Orthop Res 2018; 36:1220-1227. [PMID: 28906016 PMCID: PMC5851826 DOI: 10.1002/jor.23735] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 09/06/2017] [Indexed: 02/04/2023]
Abstract
The objective of this study was to investigate the expression of the chemokine CXCL10 and its role in joint tissues following articular fracture. We hypothesized that CXCL10 is upregulated following articular fracture and contributes to cartilage degradation associated with post-traumatic arthritis (PTA). To evaluate CXCL10 expression following articular fracture, gene expression was quantified in synovial tissue from knee joints of C57BL/6 mice that develop PTA following articular fracture, and MRL/MpJ mice that are protected from PTA. CXCL10 protein expression was assessed in human cartilage in normal, osteoarthritic (OA), and post-traumatic tissue using immunohistochemistry. The effects of exogenous CXCL10, alone and in combination with IL-1, on porcine cartilage explants were assessed by quantifying the release of catabolic mediators. Synovial tissue gene expression of CXCL10 was upregulated by joint trauma, peaking one day in C57BL/6 mice (25-fold) versus 3 days post-fracture in MRL/MpJ mice (15-fold). CXCL10 protein in articular cartilage was most highly expressed following trauma compared with normal and OA tissue. In a dose dependent manner, exogenous CXCL10 significantly reduced total matrix metalloproteinase (MMP) and aggrecanase activity of culture media from cartilage explants. CXCL10 also trended toward a reduction in IL-1α-stimulated total MMP activity (p = 0.09) and S-GAG (p = 0.09), but not NO release. In conclusion, CXCL10 was upregulated in synovium and chondrocytes following trauma. However, exogenous CXCL10 did not induce a catabolic response in cartilage. CXCL10 may play a role in modulating the chondrocyte response to inflammatory stimuli associated with joint injury and the progression of PTA. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1220-1227, 2018.
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Affiliation(s)
- Bridgette D. Furman
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC 27710
| | - Collin L. Kent
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC 27710
| | | | | | - Amy L. McNulty
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC 27710
| | - Farshid Guilak
- Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO 63110,Shriners’ Hospital for Children-St. Louis, St. Louis, MO 63110
| | - Steven A. Olson
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC 27710
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Henak CR, Bartell LR, Cohen I, Bonassar LJ. Multiscale Strain as a Predictor of Impact-Induced Fissuring in Articular Cartilage. J Biomech Eng 2017; 139:2571657. [PMID: 27760253 DOI: 10.1115/1.4034994] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Indexed: 11/08/2022]
Abstract
Mechanical damage is central to both initiation and progression of osteoarthritis (OA). However, specific causal links between mechanics and cartilage damage are incompletely understood, which results in an inability to predict failure. The lack of understanding is primarily due to the difficulty in simultaneously resolving the high rates and small length scales relevant to the problem and in correlating such measurements to the resulting fissures. This study leveraged microscopy and high-speed imaging to resolve mechanics on the previously unexamined time and length scales of interest in cartilage damage, and used those mechanics to develop predictive models. The specific objectives of this study were to: first, quantify bulk and local mechanics during impact-induced fissuring; second, develop predictive models of fissuring based on bulk mechanics and local strain; and third, evaluate the accuracy of these models in predicting fissures. To achieve these three objectives, bovine tibial cartilage was impacted using a custom spring-loaded device mounted on an inverted microscope. The occurrence of fissures was modulated by varying impact energy. For the first objective, during impact, deformation was captured at 10,000 frames per second and bulk and local mechanics were analyzed. For the second objective, data from samples impacted with a 1.2 mm diameter rod were fit to logistic regression functions, creating models of fissure probability based on bulk and local mechanics. Finally, for the third objective, data from samples impacted with a 0.8 mm diameter rod were used to test the accuracy of model predictions. This study provides a direct comparison between bulk and local mechanical thresholds for the prediction of fissures in cartilage samples, and demonstrates that local mechanics provide more accurate predictions of local failure than bulk mechanics provide. Bulk mechanics were accurate predictors of fissure for the entire sample cohort, but poor predictors of fissure for individual samples. Local strain fields were highly heterogeneous and significant differences were determined between fissured and intact samples, indicating the presence of damage thresholds. In particular, first principal strain rate and maximum shear strain were the best predictors of local failure, as determined by concordance statistics. These data provide an important step in establishing causal links between local mechanics and cartilage damage; ultimately, data such as these can be used to link macro- and micro-scale mechanics and thereby predict mechanically mediated disease on a subject-specific basis.
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Affiliation(s)
- Corinne R Henak
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY 14853
| | - Lena R Bartell
- Department of Applied and Engineering Physics, Cornell University, Ithaca, NY 14853
| | - Itai Cohen
- Department of Physics, Cornell University, Ithaca, NY 14853
| | - Lawrence J Bonassar
- Meinig School of Biomedical Engineering, 149 Weill Hall, Cornell University, Ithaca, NY 14853; Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY 14853 e-mail:
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Liang D, Sun J, Wei F, Zhang J, Li P, Xu Y, Shang X, Deng J, Zhao T, Wei L. Establishment of rat ankle post-traumatic osteoarthritis model induced by malleolus fracture. BMC Musculoskelet Disord 2017; 18:464. [PMID: 29149841 PMCID: PMC5693506 DOI: 10.1186/s12891-017-1821-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 11/08/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malleolar fracture, which is present in 37-53% of human ankle osteoarthritis (OA), is the most common type of fracture in the ankle joint. In spite of this, no rat animal model has been developed for this type of injury to date. Here, we established a rat ankle post-traumatic OA (PTOA) model induced by malleolar fracture; this model will be useful in ankle OA research. METHODS Two-month-old male Sprague Dawley (SD) rats were randomized into 2 groups (n = 19 per group): 1) malleolus articular fracture, dislocation, and immediate reduction on the right joints and 2) malleolus articular fracture on the right ankle. The contralateral ankle joints were used as controls. The fracture and healing processes were confirmed and monitored by radiography. Changes in inflammation were monitored in vivo by fluorescence molecular tomography (FMT). Cartilage damage and changes in expression of OA-related genes were analyzed by histology, immunohistochemistry, Real-time quantitative PCR (qPCR) and enzyme-linked immunosorbent assay (ELISA) at 8 weeks post-surgery. RESULTS X-rays showed that all fractures were healed at 8 weeks post-surgery. A reproducible, mild to moderate degree of OA cartilage damage with reduced aggrecan was detected by histology in all animals in both groups but there was no significant difference between the two groups. Decreased Col-II and increased Col-X and MMP-13 levels were detected by qPCR, immunohistochemistry, ELISA and FMT from both groups cartilage. CONCLUSIONS Malleolus articular fracture alone induces ankle OA with lesions on the central weight bearing area of the tibiotalar joint in rats. This model will provide a reproducible and useful tool for researchers to study ankle OA.
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Affiliation(s)
- Dawei Liang
- Department of Orthopaedics, The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Jian Sun
- Department of Orthopaedics, The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Fangyuan Wei
- Foot and Ankle Orthopaedic Surgery Center, Beijing Tongren Hospital, Beijing, China
| | - Jianzhong Zhang
- Foot and Ankle Orthopaedic Surgery Center, Beijing Tongren Hospital, Beijing, China
| | - Pengcui Li
- Department of Orthopaedics, The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Yingke Xu
- School of Community Health Science, Nevada Institute of Personalized Medicine, University of Nevada, Las Vegas, Nevada USA
| | - Xianwen Shang
- Department of Orthopaedics, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Jin Deng
- Department of Orthopaedics, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Ting Zhao
- Department of Orthopaedics, Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, RI USA
| | - Lei Wei
- Department of Orthopaedics, The Second Hospital of Shanxi Medical University, Taiyuan, China
- Department of Orthopaedics, Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, RI USA
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Godoy-Santos AL, Ranzoni L, Teodoro WR, Capelozzi V, Giglio P, Fernandes TD, Rammelt S. Increased cytokine levels and histological changes in cartilage, synovial cells and synovial fluid after malleolar fractures. Injury 2017; 48 Suppl 4:S27-S33. [PMID: 29145965 DOI: 10.1016/s0020-1383(17)30772-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Malleolar fractures are among the most common fractures in the human skeleton with a high risk of later development of post-traumatic osteoarthritis (OA). The acute ankle injury initiates a sequence of events potentially leading to progressive articular surface damage resulting from inflammatory changes in cartilage, synovial tissue and synovial fluid. We hypothesised that in the acute phase of ankle fracture, these changes occur at the same time in the different tissues. METHODS Specimens of chondral tissue, synovial tissue and synovial fluid were collected from 16 patients with acute articular ankle fracture (study group). Additional samples were obtained from five male fresh cadavers within 12 hours of death (control group). Chondral tissue was assessed for cellularity, irregularities and chondrocyte disarray. Synovial tissue was assessed for synovitis, proteoglycans and collagen deposition. Synovial fluid was assessed for cytokines IL-2, IL-6, IL-10, IL-17, IFN-γ and TGF-β1. RESULTS Chondral tissue showed discontinuity in the tidemark between cartilage and subchondral bone, chondrocyte disarray, increased cellularity (both at the cartilage surface and subchondral bone), articular surface irregularities and increased deposition of proteoglycans and collagen fibres. Synovial tissue showed a statistically significant difference between the study and control groups in the concentration per tissue area of both thin collagen fibres (p=0.0274) and thick collagen fibres (p<0.0001). Cytokine concentrations in synovial fluid samples were significantly higher in ankle fracture tissue compared with controls for IL-2 (p=0.0002), IL-6 (p<0.0001), IL-10 (p=0.002) and IL-17 (p<0.0001). No statistically significant differences were observed for IFN-γ (p=0.06303) and TGF-β1 (p=0.8832). CONCLUSION We observed a pattern of simultaneous and interrelated pathological changes in cartilage, subchondral bone, synovial tissue and synovial fluid after acute malleolar fracture. As the observed inflammatory changes could lead to the development of OA, a more thorough knowledge of these early processes could be helpful to find strategies for prevention or delay of this common complication.
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Affiliation(s)
- Alexandre L Godoy-Santos
- Department of Orthopedic Surgery, University of São Paulo, Rua Ovidio Pires de Campos, 333, 05403-010, São Paulo, Brasil.
| | - Lucas Ranzoni
- Department of Orthopedic Surgery, University of São Paulo, Rua Ovidio Pires de Campos, 333, 05403-010, São Paulo, Brasil
| | - Walcy R Teodoro
- Department of Rheumatology, University of São Paulo, Av. Dr. Arnaldo, 455, 01246-903, São Paulo, Brasil
| | - Vera Capelozzi
- Department of Phatology, University of São Paulo, São Paulo, Brazil, Av. Dr. Arnaldo, 455, 01246-903, São Paulo, Brasil
| | - Pedro Giglio
- Department of Orthopedic Surgery, University of São Paulo, Rua Ovidio Pires de Campos, 333, 05403-010, São Paulo, Brasil
| | - Tulio Diniz Fernandes
- Department of Orthopedic Surgery, University of São Paulo, Rua Ovidio Pires de Campos, 333, 05403-010, São Paulo, Brasil
| | - Stefan Rammelt
- Klinik für Unfall und Wiederherstellungschirurgie, Universitätsklinikum Carl Gustav Carus, Fetscherstr. 74, 01307, Dresden, Germany
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Zhang Y, Wei X, Browning S, Scuderi G, Hanna LS, Wei L. Targeted designed variants of alpha-2-macroglobulin (A2M) attenuate cartilage degeneration in a rat model of osteoarthritis induced by anterior cruciate ligament transection. Arthritis Res Ther 2017; 19:175. [PMID: 28743292 PMCID: PMC5526282 DOI: 10.1186/s13075-017-1363-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 06/06/2017] [Indexed: 12/01/2022] Open
Abstract
Background The study was performed to evaluate whether targeted alpha-2-macroglobulin (A2M) variants have a similar or enhanced function at wild-type (wt)-A2M to attenuate cartilage degeneration in vivo. Methods In and ex-vivo experiment, bovine cartilage explants (BCE) were incubated with TNF-α and IL-1β with or without wt-A2M or A2M variants. Cartilage catabolism was measured in culture supernatant by sulfated glycosaminoglycan (sGAG). In an in-vivo experiment, 2-month-old male Wistar rats (n = 77) were randomly divided into seven groups and treated with different doses of A2M or its variants by intra-articular injection at 24 hours and day 14 after anterior cruciate ligament transection (ACLT), receiving (1) ACLT/PBS; (2) ACLT/wt-A2M (0.153 mg); (3) ACLT/CYT-108 A2M (0.153 mg); (4) ACLT/CYT-108 A2M (0.077 mg); (5) ACLT/CYT-98 A2M (0.153 mg); (6) ACLT/CYT-98 A2M (0.077 mg); or (7) sham/PBS. The joints and synovial lavage were collected 8 weeks after surgery. Fluorescence molecular tomography was used to monitor inflammation in vivo using probes ProSense and MMPSense at 24 hours, and weeks 2, 4, and 6 after surgery. The cartilage damage was quantified using Osteoarthritis Research Society International score and matrix metalloproteinase (MMP)-3, -13, collagen (Col) X, Col 2, Runx2, and aggrecan (Acan) were detected by immunohistochemical analysis (IHC), ELISA, and RT-PCR. Results A2M variants inhibited catabolism in the BCE model by up to 200% compared with wt-A2M. ProSense and MMPSense were dramatically increased in all groups after surgery. Supplemental A2M or its variants reduced ProSense and MMPSense compared with the PBS treatment. Less cartilage damage, lower MMP-13 and Col 2 degraded product, and stronger Col 2 synthesis were detected in animals treated with A2M or its variants compared with PBS-treated animals. A2M and its variants enhanced Col 2 and Acan synthesis, and suppressed MMP-3, MMP-13, Runx2, and Col X production. A2M-108 variant demonstrated less cartilage damage compared with wt-A2M and A2M-98 variant. Conclusion The targeted variants of A2M have a chondroprotective effect similar to wt-A2M. However, A2M-108 variant has enhanced function to attenuate cartilage degeneration compared with wt-A2M.
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Affiliation(s)
- Yang Zhang
- Department of Orthopedics, the second hospital of the Shanxi Medical University, Taiyuan, China
| | - Xiaochun Wei
- Department of Orthopedics, the second hospital of the Shanxi Medical University, Taiyuan, China
| | - Shawn Browning
- Cytonics Corporation, 6917 Vista Pkwy N., Suite 14, West Palm Beach, FL, 33411, USA
| | - Gaetano Scuderi
- Cytonics Corporation, 6917 Vista Pkwy N., Suite 14, West Palm Beach, FL, 33411, USA
| | - Lewis S Hanna
- Cytonics Corporation, 6917 Vista Pkwy N., Suite 14, West Palm Beach, FL, 33411, USA
| | - Lei Wei
- Department of Orthopedics, the second hospital of the Shanxi Medical University, Taiyuan, China. .,Department of Orthopedics, Alpert Medical School of Brown University/Rhode Island Hospital, Providence, RI, USA.
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14
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Bonitsky CM, McGann ME, Selep MJ, Ovaert TC, Trippel SB, Wagner DR. Genipin crosslinking decreases the mechanical wear and biochemical degradation of impacted cartilage in vitro. J Orthop Res 2017; 35:558-565. [PMID: 27584857 PMCID: PMC5518482 DOI: 10.1002/jor.23411] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 08/29/2016] [Indexed: 02/04/2023]
Abstract
High energy trauma to cartilage causes surface fissures and microstructural damage, but the degree to which this damage renders the tissue more susceptible to wear and contributes to the progression of post-traumatic osteoarthritis (PTOA) is unknown. Additionally, no treatments are currently available to strengthen cartilage after joint trauma and to protect the tissue from subsequent degradation and wear. The purposes of this study were to investigate the role of mechanical damage in the degradation and wear of cartilage, to evaluate the effects of impact and subsequent genipin crosslinking on the changes in the viscoelastic parameters of articular cartilage, and to test the hypothesis that genipin crosslinking is an effective treatment to enhance the resistance to biochemical degradation and mechanical wear. Results demonstrate that cartilage stiffness decreases after impact loading, likely due to the formation of fissures and microarchitectural damage, and is partially or fully restored by crosslinking. The wear resistance of impacted articular cartilage was diminished compared to undamaged cartilage, suggesting that mechanical damage that is directly induced by the impact may contribute to the progression of PTOA. However, the decrease in wear resistance was completely reversed by the crosslinking treatments. Additionally, the crosslinking treatments improved the resistance to collagenase digestion at the impact-damaged articular surface. These results highlight the potential therapeutic value of collagen crosslinking via genipin in the prevention of cartilage degeneration after traumatic injury. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:558-565, 2017.
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Affiliation(s)
- Craig M. Bonitsky
- Department of Aerospace and Mechanical Engineering, University of Notre Dame, Notre Dame, Indiana
| | - Megan E. McGann
- Department of Aerospace and Mechanical Engineering, University of Notre Dame, Notre Dame, Indiana
| | - Michael J. Selep
- Department of Aerospace and Mechanical Engineering, University of Notre Dame, Notre Dame, Indiana
| | - Timothy C. Ovaert
- Department of Aerospace and Mechanical Engineering, University of Notre Dame, Notre Dame, Indiana
| | - Stephen B. Trippel
- Deparment of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| | - Diane R. Wagner
- Department of Mechanical Engineering, Indiana University-Purdue University Indianapolis, 723 W. Michigan St. SL 260, Indianapolis, Indiana 46202
- Department of Biomedical Engineering, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana
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15
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Hatcher CC, Collins AT, Kim SY, Michel LC, Mostertz WC, Ziemian SN, Spritzer CE, Guilak F, DeFrate LE, McNulty AL. Relationship between T1rho magnetic resonance imaging, synovial fluid biomarkers, and the biochemical and biomechanical properties of cartilage. J Biomech 2017; 55:18-26. [PMID: 28237185 DOI: 10.1016/j.jbiomech.2017.02.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 01/27/2017] [Accepted: 02/01/2017] [Indexed: 01/01/2023]
Abstract
Non-invasive techniques for quantifying early biochemical and biomechanical changes in articular cartilage may provide a means of more precisely assessing osteoarthritis (OA) progression. The goals of this study were to determine the relationship between T1rho magnetic resonance (MR) imaging relaxation times and changes in cartilage composition, cartilage mechanical properties, and synovial fluid biomarker levels and to demonstrate the application of T1rho imaging to evaluate cartilage composition in human subjects in vivo. Femoral condyles and synovial fluid were harvested from healthy and OA porcine knee joints. Sagittal T1rho relaxation MR images of the condyles were acquired. OA regions of OA joints exhibited an increase in T1rho relaxation times as compared to non-OA regions. Furthermore in these regions, cartilage sGAG content and aggregate modulus decreased, while percent degraded collagen and water content increased. In OA joints, synovial fluid concentrations of sGAG decreased and C2C concentrations increased compared to healthy joints. T1rho relaxation times were negatively correlated with cartilage and synovial fluid sGAG concentrations and aggregate modulus and positively correlated with water content and permeability. Additionally, we demonstrated the application of these in vitro findings to the study of human subjects. Specifically, we demonstrated that walking results in decreased T1rho relaxation times, consistent with water exudation and an increase in proteoglycan concentration with in vivo loading. Together, these findings demonstrate that cartilage MR imaging and synovial fluid biomarkers provide powerful non-invasive tools for characterizing changes in the biochemical and biomechanical environments of the joint.
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Affiliation(s)
- Courtney C Hatcher
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Amber T Collins
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Sophia Y Kim
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Lindsey C Michel
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - William C Mostertz
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Sophia N Ziemian
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Charles E Spritzer
- Department of Radiology, Duke University Medical Center, Durham, NC, USA
| | - Farshid Guilak
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Louis E DeFrate
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Amy L McNulty
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA.
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16
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Nahas RM, Porto LCK, Ikemoto RY, Tenório FA, Zilio G, Costa RA, Lanna RMDS, Montenegro TB. VISCOSSUPLEMENTAÇÃO NO TRATAMENTO DE ARTRITE PÓS-TRAUMÁTICA DE JOELHO DURANTE 12 MESES. REV BRAS MED ESPORTE 2016. [DOI: 10.1590/1517-869220162206167840] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
RESUMO Introdução: A artrite pós-traumática é uma complicação frequente nas fraturas intra-articulares de joelho, que ocasiona dor e limitação funcional. Uma opção terapêutica que tem mostrado resultados promissores é a infusão intra-articular do ácido hialurônico (viscossuplementação), associada ou não a exercícios e dieta para perder peso. Objetivo: Verificar a resposta ao tratamento de artrite pós-traumática de joelho com uso de viscossuplementação associada ou não a exercícios físicos. Métodos: Avaliaram-se o arco de movimento articular, ângulo de retração poplíteo, a escala visual de dor, o escore de Lysholm e a circunferência da coxa em pacientes submetidos à correção cirúrgica de fratura do platô tibial em nossa instituição, os quais, depois de alta cirúrgica e fisioterápica, foram tratados com viscossuplementação em infusão única associada ou não a exercícios físicos programados, durante seguimento de 12 meses. Resultados: Houve diferença significativa a favor do grupo submetido à viscossuplementação associada a exercícios para o ângulo de retração poplíteo (p = 0,012) e espessura da coxa 10 cm acima da patela (p = 0,047). Em todas as demais variáveis estudadas, os resultados nesse grupo também foram superiores, porém sem alcançar significância estatística correspondente. Todos os pacientes estariam dispostos a repetir a infusão após 12 meses. Conclusão: A viscossuplementação trouxe melhora da dor e função aos pacientes com artrite pós-traumática de joelho e a melhora é maior quando os exercícios são associados em seguimentos de 12 meses.
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Affiliation(s)
| | | | | | | | - Geovani Zilio
- Secretaria da Saúde do Governo do Estado de São Paulo, Brasil
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17
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Ko FC, Dragomir CL, Plumb DA, Hsia AW, Adebayo OO, Goldring SR, Wright TM, Goldring MB, van der Meulen MC. Progressive cell-mediated changes in articular cartilage and bone in mice are initiated by a single session of controlled cyclic compressive loading. J Orthop Res 2016; 34:1941-1949. [PMID: 26896841 PMCID: PMC5349861 DOI: 10.1002/jor.23204] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 02/15/2016] [Indexed: 02/04/2023]
Abstract
We previously showed that repetitive cyclic loading of the mouse knee joint causes changes that recapitulate the features of osteoarthritis (OA) in humans. By applying a single loading session, we characterized the temporal progression of the structural and compositional changes in subchondral bone and articular cartilage. We applied loading during a single 5-minute session to the left tibia of adult (26-week-old) C57Bl/6 male mice at a peak load of 9.0N for 1,200 cycles. Knee joints were collected at times 0, 1, and 2 weeks after loading. The changes in articular cartilage and subchondral bone were analyzed by histology, immunohistochemistry (caspase-3 and cathepsin K), and microcomputed tomography. At time 0, no change was evident in chondrocyte viability or cartilage or subchondral bone integrity. However, cartilage pathology demonstrated by localized thinning and proteoglycan loss occurred at 1 and 2 weeks after the single session of loading. Transient cancellous bone loss was evident at 1 week, associated with increased osteoclast number. Bone loss was reversed to control levels at 2 weeks. We observed formation of fibrous and cartilaginous tissues at the joint margins at 1 and 2 weeks. Our findings demonstrate that a single session of noninvasive loading leads to the development of OA-like morphological and cellular alterations in articular cartilage and subchondral bone. The loss in subchondral trabecular bone mass and thickness returns to control levels at 2 weeks, whereas the cartilage thinning and proteoglycan loss persist. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1941-1949, 2016.
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Affiliation(s)
- Frank C. Ko
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY
| | | | - Darren A. Plumb
- Research Division, Hospital for Special Surgery, New York, NY
| | - Allison W. Hsia
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY
| | | | | | | | | | - Marjolein C.H. van der Meulen
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY,Research Division, Hospital for Special Surgery, New York, NY
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18
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Punzi L, Galozzi P, Luisetto R, Favero M, Ramonda R, Oliviero F, Scanu A. Post-traumatic arthritis: overview on pathogenic mechanisms and role of inflammation. RMD Open 2016; 2:e000279. [PMID: 27651925 PMCID: PMC5013366 DOI: 10.1136/rmdopen-2016-000279] [Citation(s) in RCA: 107] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 08/10/2016] [Accepted: 08/19/2016] [Indexed: 02/06/2023] Open
Abstract
Post-traumatic arthritis (PTA) develops after an acute direct trauma to the joints. PTA causes about 12% of all osteoarthritis cases, and a history of physical trauma may also be found in patients with chronic inflammatory arthritis. Symptoms include swelling, synovial effusion, pain and sometimes intra-articular bleeding. Usually, PTA recoveries spontaneously, but the persistence of symptoms after 6 months may be considered pathological and so-called chronic PTA. A variety of molecular, mechanobiological and cellular events involved in the pathogenesis and the progression of PTA have been identified. The activation of inflammatory mechanisms during the PTA acute phase appears to play a critical role in the chronic disease onset. Human studies and experimental models have revealed that a series of inflammatory mediators are released in synovial fluid immediately after the joint trauma. These molecules have been proposed as markers of disease and as a potential target for the development of specific and preventative interventions. Currently, chronic PTA cannot be prevented, although a large number of agents have been tested in preclinical studies. Given the relevance of inflammatory reaction, anticytokines therapy, in particular the inhibition of interleukin 1 (IL-1), seems to be the most promising strategy. At the present time, intra-articular injection of IL-1 receptor antagonist is the only anticytokine approach that has been used in a human study of PTA. Despite the fact that knowledge in this area has increased in the past years, the identification of more specific disease markers and new therapeutic opportunities are needed.
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Affiliation(s)
- Leonardo Punzi
- Rheumatology Unit, Department of Medicine-DIMED , University of Padova , Padova , Italy
| | - Paola Galozzi
- Rheumatology Unit, Department of Medicine-DIMED , University of Padova , Padova , Italy
| | - Roberto Luisetto
- Department of Surgical Oncological and Gastroenterological Sciences , University of Padova , Padova , Italy
| | - Marta Favero
- Rheumatology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy; Laboratory of Immunorheumatology and Tissue Regeneration, Rizzoli Orthopedic Research Institute, Bologna, Italy
| | - Roberta Ramonda
- Rheumatology Unit, Department of Medicine-DIMED , University of Padova , Padova , Italy
| | - Francesca Oliviero
- Rheumatology Unit, Department of Medicine-DIMED , University of Padova , Padova , Italy
| | - Anna Scanu
- Rheumatology Unit, Department of Medicine-DIMED , University of Padova , Padova , Italy
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19
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Genemaras AA, Ennis H, Kaplan L, Huang CY. Inflammatory cytokines induce specific time- and concentration-dependent MicroRNA release by chondrocytes, synoviocytes, and meniscus cells. J Orthop Res 2016; 34:779-90. [PMID: 26505891 DOI: 10.1002/jor.23086] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 10/12/2015] [Indexed: 02/04/2023]
Abstract
In knee osteoarthritis (OA), concentrations of interleukin (IL)-1β and tumor necrosis factor (TNF)-α increase in joint tissues and synovial fluid which incite a catabolic cascade and further the progression of OA. Several microRNAs (miRNA) have been associated with apoptosis (miR-16), inflammation (miR-22, miR-146a), and matrix degradation (miR-140, miR-27b) in developed OA or its symptoms. In this study, the time- and concentration-dependent nature of cellular and extracellular miRNAs in synoviocytes, meniscus cells, and chondrocytes as influenced by inflammatory cytokines was investigated. For time-dependent studies, three cell types were stimulated with 10 ng/ml IL-1β or 50 ng/ml TNF-α for 8, 16, and 24 h. For concentration-dependent studies, chondrocytes were stimulated with a higher level of IL-1β (20 ng/ml) or TNF-α (100 ng/ml) for 8 h. Cellular and extracellular expressions of miR-22, miR-16, miR-146a, miR-27b, and miR-140 were analyzed by RT-PCR. Time-dependent cellular miRNA expressions were similar across the three cell types with miR-146a significantly up-regulated and miR-27b significantly down-regulated at all time points. However, chondrocytes exhibited a unique extracellular miRNA profile with an increased release rate of miR-27b at 24 h. Our findings support further research into the characterization of miRNAs in synovial fluid for the development of early detection strategies of OA or cartilage injury. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:779-790, 2016.
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Affiliation(s)
- Amaris A Genemaras
- Department of Biomedical Engineering, College of Engineering, University of Miami, Coral Gables, Florida
| | - Hayley Ennis
- Department of Orthopedics, Division of Sports Medicine, University of Miami Miller School of Medicine, Miami, Florida
| | - Lee Kaplan
- Department of Biomedical Engineering, College of Engineering, University of Miami, Coral Gables, Florida
| | - Chun-Yuh Huang
- Department of Biomedical Engineering, College of Engineering, University of Miami, Coral Gables, Florida
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20
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McGann ME, Bonitsky CM, Jackson ML, Ovaert TC, Trippel SB, Wagner DR. Genipin crosslinking of cartilage enhances resistance to biochemical degradation and mechanical wear. J Orthop Res 2015; 33:1571-1579. [PMID: 25939430 PMCID: PMC4591111 DOI: 10.1002/jor.22939] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 04/29/2015] [Indexed: 02/04/2023]
Abstract
Collagen crosslinking enhances many beneficial properties of articular cartilage, including resistance to chemical degradation and mechanical wear, but many crosslinking agents are cytotoxic. The purpose of this study was to evaluate the effectiveness of genipin, a crosslinking agent with favorable biocompatibility and cytotoxicity, as a potential treatment to prevent the degradation and wear of articular cartilage. First, the impact of genipin concentration and treatment duration on the viscoelastic properties of bovine articular cartilage was quantified. Next, two short-term (15 min) genipin crosslinking treatments were chosen, and the change in collagenase digestion, cartilage wear, and the friction coefficient of the tissue with these treatments was measured. Finally, chondrocyte viability after exposure to these genipin treatments was assessed. Genipin treatment increased the stiffness of healthy, intact cartilage in a dose-dependent manner. The 15-min crosslinking treatments improved cartilage's resistance to both chemical degradation, particularly at the articular surface, and to damage due to mechanical wear. These enhancements were achieved without sacrificing the low coefficient of friction of the tissue and at a genipin dose that preserved chondrocyte viability. The results of this study suggest that collagen crosslinking via genipin may be a promising preventative treatment to slow the degradation of cartilage.
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Affiliation(s)
- Megan E. McGann
- Department of Aerospace and Mechanical Engineering, University of Notre Dame
| | - Craig M. Bonitsky
- Department of Aerospace and Mechanical Engineering, University of Notre Dame
| | - Mariah L. Jackson
- Department of Aerospace and Mechanical Engineering, University of Notre Dame
| | - Timothy C. Ovaert
- Department of Aerospace and Mechanical Engineering, University of Notre Dame
| | | | - Diane R. Wagner
- Department of Aerospace and Mechanical Engineering, University of Notre Dame
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21
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Genemaras AA, Reiner T, Huang CY, Kaplan L. Early intervention with Interleukin-1 Receptor Antagonist Protein modulates catabolic microRNA and mRNA expression in cartilage after impact injury. Osteoarthritis Cartilage 2015; 23:2036-44. [PMID: 26521750 DOI: 10.1016/j.joca.2015.05.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 04/30/2015] [Accepted: 05/20/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The purpose of this controlled laboratory study was to determine the efficacy of Interleukin-1 Receptor Antagonist Protein (IRAP) treatment as an early intervention strategy by examining the changes in microRNA and mRNA expression in cartilage in an ex-vivo porcine knee joint impact model. METHODS Custom impact device was used to create replicable injury ex-vivo to intact porcine knee joint. Injury was caused by dropping a 10 kg weight one time from 1 m directly above the knee in extension. One hour after impact 20 μg/ml IRAP solution was intra-articularly injected. At 8 h post-injury, cartilage samples were harvested for cell viability and genetic expression analysis. Genetic expression of miR-27b, miR-140, miR-125b, ADAMTS-4, ADAMTS-5, MMP-3, IL-1β, and TNF-α were analyzed by RT-PCR. Cell viability image analysis was performed using ImageJ software. Groups were compared by analysis of variance (ANOVA) followed by Tukey's post-hoc test. A P-value <0.05 was considered significant. RESULTS At 8 h after IRAP treatment, expressions of ADAMTS-4, ADAMTS-5, MMP-3, IL-1β, and TNF-α in cartilage were significantly down-regulated from injury group (all P < 0.001). MiR-140, miR-125b, and miR-27b expressions were significantly up-regulated after treatment as compared to control and injury groups (all P < 0.001). CONCLUSION This study demonstrates that IRAP treatment administered during acute phase of cartilage impact injury increases expression levels of miR-140, miR-125b, and miR-27b in cartilage, indicating increased inhibition of their respective matrix-degrading enzymes. Clinically, these findings support the potential of IRAP treatment as an early intervention strategy for the prevention of cartilage degeneration after impact injury.
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Affiliation(s)
- A A Genemaras
- Department of Biomedical Engineering, College of Engineering, University of Miami, Coral Gables, FL, USA.
| | - T Reiner
- Geriatric Research, Education, and Clinical Center and Research Service, Bruce W. Carter Veterans Affairs Medical Center, Miami, FL, USA.
| | - C-Y Huang
- Department of Biomedical Engineering, College of Engineering, University of Miami, Coral Gables, FL, USA.
| | - L Kaplan
- Department of Biomedical Engineering, College of Engineering, University of Miami, Coral Gables, FL, USA; Department of Orthopedics, Division of Sports Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.
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Haller JM, Swearingen CA, Partridge D, McFadden M, Thirunavukkarasu K, Higgins TF. Intraarticular Matrix Metalloproteinases and Aggrecan Degradation Are Elevated After Articular Fracture. Clin Orthop Relat Res 2015; 473:3280-8. [PMID: 26162411 PMCID: PMC4562930 DOI: 10.1007/s11999-015-4441-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 06/29/2015] [Indexed: 01/31/2023]
Abstract
BACKGROUND Posttraumatic osteoarthritis (OA) is a variant of OA that can develop after articular injury. Although the mechanism(s) of posttraumatic OA are uncertain, the presence and impact of postinjury proteolytic enzymes on articular cartilage remain unknown. To our knowledge, there are no studies that evaluate the presence of matrix metalloproteinases (MMPs) or aggrecan degradation after articular fracture. QUESTIONS/PURPOSES (1) Are MMP concentrations and aggrecan degradation elevated after intraarticular fracture? (2) Are MMP concentrations and aggrecan degradation greater in high-energy injuries compared with low-energy injuries? (3) Do the concentrations of these biomarkers remain elevated at a secondary aspiration? METHODS Between December 2011 and June 2013, we prospectively enrolled patients older than 18 years of age with acute tibial plateau fracture. Exclusion criteria included age older than 60 years, preexisting knee OA, injury greater than 24 hours before evaluation, contralateral knee injury, history of autoimmune disease, open fracture, and non-English-speaking patients. During the enrollment period, we enrolled 45 of the 91 (49%) tibial plateau fractures treated at our facility. Knee synovial fluid aspirations were obtained from both the injured and uninjured knees; two patients received aspirations in the emergency department and the remaining patients received aspirations in the operating room. Twenty patients who underwent spanning external fixator followed by definitive fixation were aspirated during both surgical procedures. MMP-1, -2, -3, -7, -9, -10, -12, and -13 concentrations were quantified using multiplex assays. Aggrecan degradation was quantified using sandwich enzyme-linked immunosorbent assay. RESULTS There were higher concentrations of MMP-1 (3.89 ng/mL [95% confidence interval {CI}, 2.37-6.37] versus 0.37 ng/mL [95% CI, 0.23-0.61], p < 0.001), MMP-3 (457.35 ng/mL [95% CI, 274.5-762.01] versus 129.17 ng/mL [95% CI, 77.01-216.66], p < 0.001), MMP-9 (6.52 ng/mL [95% CI, 3.86-11.03] versus 0.96 ng/mL [95% CI, 0.56-1.64], p < 0.001), MMP-10 (0.52 ng/mL [95% CI, 0.40-0.69] versus 0.23 ng/mL [95% CI, 0.17-0.30], p < 0.001), and MMP-12 (0.18 ng/mL [95% CI, 0.14-0.23] versus 0.10 ng/mL [95% CI, 0.0.081-0.14], p = 0.005) in injured knees compared with uninjured knees. There was not a detectable difference in MMP concentrations or aggrecan degradation between high- and low-energy injuries. MMP-1 (53.25 versus 3.89 ng/mL, p < 0.001), MMP-2 (76.04 versus 0.37 ng/mL, p < 0.001), MMP-3 (1250.62 versus 457.35 ng/mL, p = 0.002), MMP-12 (1.37 versus 0.18, p < 0.001), MMP-13 (0.98 versus 0.032 ng/mL, p < 0.001), and aggrecan degradation (0.58 versus 0.053, p < 0.001) were increased at the second procedure (mean, 9.5 days; range, 3-21 days) as compared with the initial procedure. CONCLUSIONS Because MMPs and aggrecan degradation are elevated after articular fracture, future studies are necessary to evaluate the impact of elevated MMPs and aggrecan degradation on human articular cartilage. CLINICAL RELEVANCE If further clinical followup can demonstrate a relationship between posttraumatic OA and elevated MMPs and aggrecan degradation, they may provide potential for therapeutic targets to prevent or delay the destruction of the joint. Additionally, these markers may offer prognostic information for patients.
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Affiliation(s)
- Justin M. Haller
- />Department of Orthopaedics, University of Utah School of Medicine, 590 Wakara Way, Salt Lake City, UT 84108 USA
| | - Craig A. Swearingen
- />Musculoskeletal Research, Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN USA
| | - Deveree Partridge
- />Department of Orthopaedics, University of Utah School of Medicine, 590 Wakara Way, Salt Lake City, UT 84108 USA
| | - Molly McFadden
- />Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT USA
| | - Kannan Thirunavukkarasu
- />Musculoskeletal Research, Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN USA
| | - Thomas F. Higgins
- />Department of Orthopaedics, University of Utah School of Medicine, 590 Wakara Way, Salt Lake City, UT 84108 USA
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Goetz JE, Fredericks D, Petersen E, Rudert MJ, Baer T, Swanson E, Roberts N, Martin J, Tochigi Y. A clinically realistic large animal model of intra-articular fracture that progresses to post-traumatic osteoarthritis. Osteoarthritis Cartilage 2015; 23:1797-805. [PMID: 26033166 DOI: 10.1016/j.joca.2015.05.022] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2014] [Revised: 04/28/2015] [Accepted: 05/21/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Translation of promising treatments for post-traumatic osteoarthritis (PTOA) to patients with intra-articular fracture (IAF) has been limited by the lack of a realistic large animal model. To address this issue we developed a large animal model of IAF in the distal tibia of Yucatan minipigs and documented the natural progression of this injury. DESIGN Twenty-two fractures were treated using open reduction and internal fixation with either an anatomic reduction or an intentional 2-mm step-off. Pre-operatively, and 3 days, 1, 2, 4, 8, and 12 weeks post-operatively, animals were sedated for synovial fluid draws and radiographs. Limb loading was monitored at the same time points using a Tekscan Walkway. Animals were sacrificed at 12 weeks and the limbs were harvested for histological evaluation. RESULTS All animals achieved bony union by 12 weeks, facilitating nearly complete recovery of the initial 60% decrease in limb loading. TNFα, IL1β, IL6, and IL8 concentrations in the fractured limbs were elevated (P < 0.05) at specific times during the 2 weeks after fracture. Histological cartilage degeneration was more severe in the step-off group (0.0001 < P < 0.27 compared to normal) than in the anatomic reconstruction group (0.27 < P < 0.99 compared to normal). CONCLUSIONS This model replicated key features of a human IAF, including surgical stabilization, inflammatory responses, and progression to osteoarthritic cartilage degeneration, thereby providing a potentially useful model for translating promising treatment options to clinical practice.
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Affiliation(s)
- J E Goetz
- Department of Orthopaedics & Rehabilitation, University of Iowa, Iowa City, IA, USA; Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA.
| | - D Fredericks
- Department of Orthopaedics & Rehabilitation, University of Iowa, Iowa City, IA, USA
| | - E Petersen
- Department of Orthopaedics & Rehabilitation, University of Iowa, Iowa City, IA, USA
| | - M J Rudert
- Department of Orthopaedics & Rehabilitation, University of Iowa, Iowa City, IA, USA
| | - T Baer
- Department of Orthopaedics & Rehabilitation, University of Iowa, Iowa City, IA, USA
| | - E Swanson
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - N Roberts
- Department of Orthopaedics & Rehabilitation, University of Iowa, Iowa City, IA, USA
| | - J Martin
- Department of Orthopaedics & Rehabilitation, University of Iowa, Iowa City, IA, USA; Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA
| | - Y Tochigi
- Department of Orthopaedics, Dokkyo Medical University Koshigaya Hospital, Saitama, Japan
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Bartell LR, Fortier LA, Bonassar LJ, Cohen I. Measuring microscale strain fields in articular cartilage during rapid impact reveals thresholds for chondrocyte death and a protective role for the superficial layer. J Biomech 2015; 48:3440-6. [PMID: 26150096 DOI: 10.1016/j.jbiomech.2015.05.035] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 05/11/2015] [Accepted: 05/26/2015] [Indexed: 10/23/2022]
Abstract
Articular cartilage is a heterogeneous soft tissue that dissipates and distributes loads in mammalian joints. Though robust, cartilage is susceptible to damage from loading at high rates or magnitudes. Such injurious loads have been implicated in degenerative changes, including chronic osteoarthritis (OA), which remains a leading cause of disability in developed nations. Despite decades of research, mechanisms of OA initiation after trauma remain poorly understood. Indeed, although bulk cartilage mechanics are measurable during impact, current techniques cannot access microscale mechanics at those rapid time scales. We aimed to address this knowledge gap by imaging the microscale mechanics and corresponding acute biological changes of cartilage in response to rapid loading. In this study, we utilized fast-camera and confocal microscopy to achieve roughly 85 µm spatial resolution of both the cartilage deformation during a rapid (~3 ms), localized impact and the chondrocyte death following impact. Our results showed that, at these high rates, strain and chondrocyte death were highly correlated (p<0.001) with a threshold of 8% microscale strain norm before any cell death occurred. Additionally, chondrocyte death had developed by two hours after impact, suggesting a time frame for clinical therapeutics. Moreover, when the superficial layer was removed, strain - and subsequently chondrocyte death - penetrated deeper into the samples (p<0.001), suggesting a protective role for the superficial layer of articular cartilage. Combined, these results provide insight regarding the detailed biomechanics that drive early chondrocyte damage after trauma and emphasize the importance of understanding cartilage and its mechanics on the microscale.
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Affiliation(s)
- Lena R Bartell
- School of Applied and Engineering Physics, C7 Clark Hall, Cornell University, Ithaca, NY 14853, USA.
| | - Lisa A Fortier
- Department of Clinical Sciences, Cornell University, Ithaca, NY, USA
| | - Lawrence J Bonassar
- Department of Biomedical Engineering, Cornell University, Ithaca, NY, USA; Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA
| | - Itai Cohen
- Department of Physics, Cornell University, Ithaca, NY, USA
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Caldwell KL, Wang J. Cell-based articular cartilage repair: the link between development and regeneration. Osteoarthritis Cartilage 2015; 23:351-62. [PMID: 25450846 PMCID: PMC4339504 DOI: 10.1016/j.joca.2014.11.004] [Citation(s) in RCA: 113] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 10/02/2014] [Accepted: 11/01/2014] [Indexed: 02/02/2023]
Abstract
Clinical efforts to repair damaged articular cartilage (AC) currently face major obstacles due to limited intrinsic repair capacity of the tissue and unsuccessful biological interventions. This highlights a need for better therapeutic strategies. This review summarizes the recent advances in the field of cell-based AC repair. In both animals and humans, AC defects that penetrate into the subchondral bone marrow are mainly filled with fibrocartilaginous tissue through the differentiation of bone marrow mesenchymal stem cells (MSCs), followed by degeneration of repaired cartilage and osteoarthritis (OA). Cell therapy and tissue engineering techniques using culture-expanded chondrocytes, bone marrow MSCs, or pluripotent stem cells with chondroinductive growth factors may generate cartilaginous tissue in AC defects but do not form hyaline cartilage-based articular surface because repair cells often lose chondrogenic activity or result in chondrocyte hypertrophy. The new evidence that AC and synovium develop from the same pool of precursors with similar gene profiles and that synovium-derived chondrocytes have stable chondrogenic activity has promoted use of synovium as a new cell source for AC repair. The recent finding that NFAT1 and NFAT2 transcription factors (TFs) inhibit chondrocyte hypertrophy and maintain metabolic balance in AC is a significant advance in the field of AC repair. The use of synovial MSCs and discovery of upstream transcriptional regulators that help maintain the AC phenotype have opened new avenues to improve the outcome of AC regeneration.
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Affiliation(s)
| | - Jinxi Wang
- Corresponding Author: Jinxi Wang, Address: University of Kansas Medical Center, Department of Orthopedic Surgery, 3901 Rainbow Blvd., Mail Stop 3017, Kansas City, KS 66160, USA, Phone: +1 913-588-0870, Fax: +1 913-945-7773,
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Role of Complement on Broken Surfaces After Trauma. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2015; 865:43-55. [PMID: 26306442 DOI: 10.1007/978-3-319-18603-0_3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Activation of both the complement and coagulation cascade after trauma and subsequent local and systemic inflammatory response represent a major scientific and clinical problem. After severe tissue injury and bone fracture, exposure of innate immunity to damaged cells and molecular debris is considered a main trigger of the posttraumatic danger response. However, the effects of cellular fragments (e.g., histones) on complement activation remain enigmatic. Furthermore, direct effects of "broken" bone and cartilage surfaces on the fluid phase response of complement and its interaction with key cells of connective tissues are still unknown. Here, we summarize data suggesting direct and indirect complement activation by extracellular and cellular danger associated molecular patterns. In addition, key complement components and the corresponding receptors (such as C3aR, C5aR) have been detected on "exposed surfaces" of the damaged regions. On a cellular level, multiple effects of complement activation products on osteoblasts, osteoclasts, chondrocytes and mesenchymal stem cells have been found.In conclusion, the complement system may be activated by trauma-altered surfaces and is crucially involved in connective tissue healing and posttraumatic systemic inflammatory response.
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Diestelmeier BW, Rudert MJ, Tochigi Y, Baer TE, Fredericks DC, Brown TD. An instrumented pendulum system for measuring energy absorption during fracture insult to large animal joints in vivo. J Biomech Eng 2014; 136:064502. [PMID: 24760051 DOI: 10.1115/1.4025113] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2013] [Accepted: 07/30/2013] [Indexed: 11/08/2022]
Abstract
For systematic laboratory studies of bone fractures in general and intra-articular fractures in particular, it is often necessary to control for injury severity. Quantitatively, a parameter of primary interest in that regard is the energy absorbed during the injury event. For this purpose, a novel technique has been developed to measure energy absorption in experimental impaction. The specific application is for fracture insult to porcine hock (tibiotalar) joints in vivo, for which illustrative intra-operative data are reported. The instrumentation allowed for the measurement of the delivered kinetic energy and of the energy passed through the specimen during impaction. The energy absorbed by the specimen was calculated as the difference between those two values. A foam specimen validation study was first performed to compare the energy absorption measurements from the pendulum instrumentation versus the work of indentation performed by an MTS machine. Following validation, the pendulum apparatus was used to measure the energy absorbed during intra-articular fractures created in 14 minipig hock joints in vivo. The foam validation study showed close correspondence between the pendulum-measured energy absorption and MTS-performed work of indentation. In the survival animal series, the energy delivered ranged from 31.5 to 48.3 Js (41.3±4.0, mean±s.d.) and the proportion of energy absorbed to energy delivered ranged from 44.2% to 64.7% (53.6%±4.5%). The foam validation results support the reliability of the energy absorption measure provided by the instrumented pendulum system. Given that a very substantial proportion of delivered energy passed--unabsorbed--through the specimens, the energy absorption measure provided by this novel technique arguably provides better characterization of injury severity than is provided simply by energy delivery.
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28
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Wang S, Wei X, Zhou J, Zhang J, Li K, Chen Q, Terek R, Fleming BC, Goldring MB, Ehrlich MG, Zhang G, Wei L. Identification of α2-macroglobulin as a master inhibitor of cartilage-degrading factors that attenuates the progression of posttraumatic osteoarthritis. Arthritis Rheumatol 2014; 66:1843-53. [PMID: 24578232 DOI: 10.1002/art.38576] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Accepted: 02/20/2014] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To determine if supplemental intraarticular α2-macroglobulin (α2 M) has a chondroprotective effect in a rat model of osteoarthritis (OA). METHODS Using Western blotting, mass spectrometry, enzyme-linked immunosorbent assay (ELISA), and immunohistochemistry, α2 M was identified as a potential therapeutic agent through a comparison of α2 M concentrations in serum, synovial fluid (SF), and cartilage from normal subjects and patients with OA. In cultured chondrocytes, the effects of α2 M on interleukin-1 (IL-1)-induced cartilage catabolic enzymes were evaluated by Luminex assay and ELISA. In vivo effects on cartilage degeneration and matrix metalloproteinase 13 (MMP-13) concentration were evaluated in male rats (n = 120) randomized to 1 of 4 treatments: 1) anterior cruciate ligament transection (ACLT) and saline injections, 2) ACLT and 1 IU/kg injections of α2 M, 3) ACLT and 2 IU/kg injections of α2 M, or 4) sham operation and saline injections. Rats were administered intraarticular injections for 6 weeks. The concentration of MMP-13 in SF lavage fluid was measured using ELISA. OA-related gene expression was quantified by real-time quantitative polymerase chain reaction. The extent of OA progression was graded by histologic examination. RESULTS In both normal subjects and OA patients, α2 M levels were lower in SF as compared to serum, and in OA patients, MMP-13 levels were higher in SF than in serum. In vitro, α2 M inhibited the induction of MMP-13 by IL-1 in a dose-dependent manner in human chondrocytes. In the rat model of ACLT OA, supplemental intraarticular injection of α2 M reduced the concentration of MMP-13 in SF, had a favorable effect on OA-related gene expression, and attenuated OA progression. CONCLUSION The plasma protease inhibitor α2 M is not present in sufficient concentrations to inactivate the high concentrations of catabolic factors found in OA SF. Our findings suggest that supplemental intraarticular α2 M provides chondral protection in posttraumatic OA.
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Affiliation(s)
- Shaowei Wang
- Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, Rhode Island; The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China, and Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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29
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Novakofski KD, Williams RM, Fortier LA, Mohammed HO, Zipfel WR, Bonassar LJ. Identification of cartilage injury using quantitative multiphoton microscopy. Osteoarthritis Cartilage 2014; 22:355-62. [PMID: 24185113 PMCID: PMC4117377 DOI: 10.1016/j.joca.2013.10.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 08/27/2013] [Accepted: 10/23/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Cartilage injury can lead to post-traumatic osteoarthritis (PTOA). Immediate post-trauma cellular and structural changes are not widely understood. Furthermore, current cellular-resolution cartilage imaging techniques require sectioning of cartilage and/or use of dyes not suitable for patient imaging. In this study, we used multiphoton microscopy (MPM) data with FDA-approved sodium fluorescein to identify and evaluate the pattern of chondrocyte death after traumatic injury. METHOD Mature equine distal metacarpal or metatarsal osteochondral blocks (OCBs) were injured by 30 MPa compressive loading delivered over 1 s. Injured and control sites were imaged unfixed and in situ 1 h post-injury with sodium fluorescein using rasterized z-scanning. MPM data was quantified in MATLAB, reconstructed in 3-D, and projected in 2-D to determine the damage pattern. RESULTS MPM images (600 per sample) were reconstructed and analyzed for cell death. The overall distribution of cell death appeared to cluster into circular (n = 7) or elliptical (n = 4) patterns (p = 0.006). Dead cells were prevalent near cracks in the matrix, with only 26.3% (SE = 5.0%, p < 0.0001) of chondrocytes near cracks being viable. CONCLUSION This study demonstrates the first application of MPM for evaluating cellular-scale cartilage injury in situ in live tissue, with clinical potential for detecting early cartilage damage. With this technique, we were able to uniquely observe two death patterns resulting from the same compressive loading, which may be related to local variability in matrix structure. These results also demonstrate proof-of-concept MPM diagnostic use in detecting subtle and early cartilage damage not detectable in any other way.
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Affiliation(s)
- K D Novakofski
- Department of Clinical Sciences, Cornell University, Ithaca, NY, USA
| | - R M Williams
- Department of Biomedical Engineering, Cornell University, Ithaca, NY 14853, USA
| | - L A Fortier
- Department of Clinical Sciences, Cornell University, Ithaca, NY, USA
| | - H O Mohammed
- Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, NY 14853, USA
| | - W R Zipfel
- Department of Biomedical Engineering, Cornell University, Ithaca, NY 14853, USA
| | - L J Bonassar
- Department of Biomedical Engineering, Cornell University, Ithaca, NY 14853, USA.
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Schenker ML, Mauck RL, Ahn J, Mehta S. Pathogenesis and prevention of posttraumatic osteoarthritis after intra-articular fracture. J Am Acad Orthop Surg 2014; 22:20-8. [PMID: 24382876 PMCID: PMC4425936 DOI: 10.5435/jaaos-22-01-20] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Posttraumatic osteoarthritis (PTOA) occurs after traumatic injury to the joint. It is most common following injuries that disrupt the articular surface or lead to joint instability. The reported risk of PTOA following significant joint trauma is as high as 75%; articular fractures can increase the risk more than 20-fold. Despite recent advances in surgical management, the incidence of PTOA following intra-articular fractures has remained relatively unchanged over the last few decades. Pathogenesis of PTOA after intra-articular fracture is likely multifactorial and may be associated with acute cartilage injury as well as chronic joint overload secondary to instability, incongruity, and malalignment. Additional studies are needed to better elucidate how these factors contribute to the development of PTOA and to develop advanced treatment algorithms that consist of both acute biologic interventions targeted to decrease inflammation and cellular death in response to injury and improved surgical methods to restore stability, congruity, and alignment.
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Abstract
The development of arthritis after joint injury is commonly known as posttraumatic arthritis (PTA). The inciting traumatic event may range from cartilage contusion and bone bruise combined with meniscus or ligament tear, to intra-articular fracture. End-stage PTA is often indistinguishable from primary osteoarthritis. However, knowing the time of the inciting traumatic event in a patient with PTA provides an opportunity to understand the events following joint injury that lead to the progression of arthritis. Joint injury often leads to mechanical alterations in loading of the injured joint, and restoration of joint mechanics through surgical repair remains an important aspect of treatment. However, the accuracy of joint reduction by itself does not account for the variability in outcome following joint injury, as evidenced by the fact that PTA remains a significant clinical problem. Emerging research in animal models and human subjects indicates that several inflammatory cytokines and related inflammatory mediators are elevated following joint injury. Data from animal studies and early clinical trials suggest that early inhibition of the intra-articular inflammatory response may improve clinical outcomes.
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Stolberg-Stolberg JA, Furman BD, Garrigues NW, Lee J, Pisetsky DS, Stearns NA, DeFrate LE, Guilak F, Olson SA. Effects of cartilage impact with and without fracture on chondrocyte viability and the release of inflammatory markers. J Orthop Res 2013; 31:1283-92. [PMID: 23620164 PMCID: PMC3966619 DOI: 10.1002/jor.22348] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Accepted: 02/25/2013] [Indexed: 02/04/2023]
Abstract
Post-traumatic arthritis (PTA) frequently develops after intra-articular fracture of weight bearing joints. Loss of cartilage viability and post-injury inflammation have both been implicated as possible contributing factors to PTA progression. To further investigate chondrocyte response to impact and fracture, we developed a blunt impact model applying 70%, 80%, or 90% surface-to-surface compressive strain with or without induction of an articular fracture in a cartilage explant model. Following mechanical loading, chondrocyte viability, and apoptosis were assessed. Culture media were evaluated for the release of double-stranded DNA (dsDNA) and immunostimulatory activity via nuclear factor kappa B (NF-κB) activity in Toll-like receptor (TLR) -expressing Ramos-Blue reporter cells. High compressive strains, with or without articular fracture, resulted in significantly reduced chondrocyte viability. Blunt impact at 70% strain induced a loss in viability over time through a combination of apoptosis and necrosis, whereas blunt impact above 80% strain caused predominantly necrosis. In the fracture model, a high level of primarily necrotic chondrocyte death occurred along the fracture edges. At sites away from the fracture, viability was not significantly different than controls. Interestingly, both dsDNA release and NF-κB activity in Ramos-Blue cells increased with blunt impact, but was only significantly increased in the media from fractured cores. This study indicates that the mechanism of trauma determines the type of chondrocyte death and the potential for post-injury inflammation.
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Affiliation(s)
- Josef A. Stolberg-Stolberg
- Department of Orthopaedic Surgery Duke University Medical Center Durham, NC, USA,Department of Orthopaedic Surgery Klinikum Rechts der Isar Technical University Munich Munich, Germany
| | - Bridgette D. Furman
- Department of Orthopaedic Surgery Duke University Medical Center Durham, NC, USA
| | - N. William Garrigues
- Department of Orthopaedic Surgery Duke University Medical Center Durham, NC, USA
| | - Jaewoo Lee
- Department of Surgery Duke University Medical Center Durham, NC, USA
| | - David S. Pisetsky
- Department of Medicine Duke University and Durham VA Medical Centers Durham, NC, USA
| | - Nancy A Stearns
- Department of Medicine Duke University and Durham VA Medical Centers Durham, NC, USA
| | - Louis E. DeFrate
- Department of Orthopaedic Surgery Duke University Medical Center Durham, NC, USA
| | - Farshid Guilak
- Department of Orthopaedic Surgery Duke University Medical Center Durham, NC, USA
| | - Steven A. Olson
- Department of Orthopaedic Surgery Duke University Medical Center Durham, NC, USA
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Abstract
OBJECTIVE The development of osteoarthritis after intra-articular fractures has been described for decades, although the exact mechanical and cellular changes that occur remain poorly understood. There are several animal models to study this phenomenon, but they are mechanistically different from physiologic fractures in several important ways. This article describes a novel model that recreates the kinematics present in high-energy trauma and intra-articular fractures. METHODS We designed a "drop tower" for the creation of intercondylar femoral fractures in rats and tested it on cadaveric rats to determine the optimal kinetic parameters. Intra-articular fractures were then created in live rats and the animals were killed at 0, 24, and 72 hours after the fracture. Cartilage samples were obtained for live/dead staining, and the relationships among fracture time, cartilage depth, and cell viability were evaluated. RESULTS The model reproduced intra-articular fractures very similar to those seen in high-energy trauma, although we required significantly higher energies (3600 mJ) than those reported in other fracture models (40-200 mJ). Cartilage viability decreased with time (68% immediately after the fracture and 46% at 72 hours, P = 0.02) and increased with depth from the articular surface (47% at the surface vs. 66% in the deepest layer, P = 0.001). CONCLUSIONS This model is a physiologically relevant reliable method for creating intra-articular fractures in rats and can produce meaningful data about the biologic changes occurring in cartilage after injury. Cell viability decreases with time postfracture and with proximity to the articular surface.
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Tochigi Y, Zhang P, Rudert MJ, Baer TE, Martin JA, Hillis SL, Brown TD. A novel impaction technique to create experimental articular fractures in large animal joints. Osteoarthritis Cartilage 2013; 21:200-8. [PMID: 23069855 PMCID: PMC3538937 DOI: 10.1016/j.joca.2012.10.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Revised: 09/22/2012] [Accepted: 10/04/2012] [Indexed: 02/02/2023]
Abstract
OBJECTIVE A novel impaction fracture insult technique, developed for modeling post-traumatic osteoarthritis in porcine hocks in vivo, was tested to determine the extent to which it could replicate the cell-level cartilage pathology in human clinical intra-articular fractures. DESIGN Eight fresh porcine hocks (whole-joint specimens with fully viable chondrocytes) were subjected to fracture insult. From the fractured distal tibial surfaces, osteoarticular fragments were immediately sampled and cultured in vitro for 48 h. These samples were analyzed for the distribution and progression of chondrocyte death, using the Live/Dead assay. Five control joints, in which "fractures" were simulated by means of surgical osteotomy, were also similarly analyzed. RESULTS In the impaction-fractured joints, chondrocyte death was concentrated in regions adjacent to fracture lines (near-fracture regions), as evidenced by fractional cell death significantly higher (P < 0.0001) than in central non-fracture (control) regions. Although nominally similar spatial distribution patterns were identified in the osteotomized joints, fractional cell death in the near-osteotomy regions was nine-fold lower (P < 0.0001) than in the near-fracture regions. Cell death in the near-fracture regions increased monotonically during 48 h after impaction, dominantly within 1 mm from the fracture lines. CONCLUSION The impaction-fractured joints exhibited chondrocyte death characteristics reasonably consistent with those in human intra-articular fractures, but were strikingly different from those in "fractures" simulated by surgical osteotomy. These observations support promise of this new impaction fracture technique as a mechanical insult modality to replicate the pathophysiology of human intra-articular fractures in large animal joints in vivo.
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Affiliation(s)
- Yuki Tochigi
- Department of Orthopaedics and Rehabilitation, University of Iowa,
| | - Peng Zhang
- Department of Orthopaedics and Rehabilitation, University of Iowa, and Department of Orthopaedics, Affiliated Hospital of Shan Dong University of Traditional Chinese Medicine,
| | - M. James Rudert
- Department of Orthopaedics and Rehabilitation, University of Iowa,
| | - Thomas E. Baer
- Department of Orthopaedics and Rehabilitation, University of Iowa,
| | - James A. Martin
- Department of Orthopaedics and Rehabilitation, University of Iowa,
| | - Stephen L. Hillis
- Department of Biostatistics, University of Iowa, and Center for Research in the Implementation of Innovative Strategies in Practice (CRIISP), VA Iowa City Medical Center,
| | - Thomas D. Brown
- Department of Orthopaedics and Rehabilitation, and Department of Biomedical Engineering, University of Iowa,
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Anderson DD, Chubinskaya S, Guilak F, Martin JA, Oegema TR, Olson SA, Buckwalter JA. Post-traumatic osteoarthritis: improved understanding and opportunities for early intervention. J Orthop Res 2011; 29:802-9. [PMID: 21520254 PMCID: PMC3082940 DOI: 10.1002/jor.21359] [Citation(s) in RCA: 430] [Impact Index Per Article: 33.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2010] [Accepted: 12/17/2010] [Indexed: 02/04/2023]
Abstract
Even with current treatments of acute joint injuries, more than 40% of people who suffer significant ligament or meniscus tears, or articular surface injuries, will develop osteoarthritis (OA). Correspondingly, 12% or more of all patients with lower extremity OA have a history of joint injury. Recent research suggests that acute joint damage that occurs at the time of an injury initiates a sequence of events that can lead to progressive articular surface damage. New molecular interventions, combined with evolving surgical methods, aim to minimize or prevent progressive tissue damage triggered by joint injury. Seizing the potential for progress in the treatment of joint injuries to forestall OA will depend on advances in (1) quantitative methods of assessing the injury severity, including both structural damage and biologic responses, (2) understanding of the pathogenesis of post-traumatic OA, taking into account potential interactions among the different tissues and the role of post-traumatic incongruity and instability, and (3) application of engineering and molecular research to develop new methods of treating injured joints. This paper highlights recent advances in understanding of the structural damage and the acute biological response following joint injury, and it identifies important directions for future research.
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Affiliation(s)
- Donald D. Anderson
- Department of Orthopaedics & Rehabilitation, The University of Iowa, Iowa City, IA, Department of Biomedical Engineering, The University of Iowa, Iowa City, IA
| | - Susan Chubinskaya
- Departments of Biochemistry, Orthopedic Surgery and Internal Medicine (Section of Rheumatology), Rush University Medical Center, Chicago, IL
| | - Farshid Guilak
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC
| | - James A. Martin
- Department of Orthopaedics & Rehabilitation, The University of Iowa, Iowa City, IA, Department of Biomedical Engineering, The University of Iowa, Iowa City, IA
| | - Theodore R. Oegema
- Departments of Biochemistry, Orthopedic Surgery and Internal Medicine (Section of Rheumatology), Rush University Medical Center, Chicago, IL
| | - Steven A. Olson
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC
| | - Joseph A. Buckwalter
- Department of Orthopaedics & Rehabilitation, The University of Iowa, Iowa City, IA, Veterans Affairs Medical Center, Iowa City, IA
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