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Wu Y, Boer CG, Hofman A, Schiphof D, van Middelkoop M, Szilagyi IA, Sedaghati-Khayat B, Bierma-Zeinstra SMA, Voortman T, van Meurs JBJ. Weight-Bearing Physical Activity, Lower-Limb Muscle Mass, and Risk of Knee Osteoarthritis. JAMA Netw Open 2024; 7:e248968. [PMID: 38687476 PMCID: PMC11061770 DOI: 10.1001/jamanetworkopen.2024.8968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/22/2024] [Indexed: 05/02/2024] Open
Abstract
Importance It has been demonstrated that total physical activity is not associated with risk of osteoarthritis. However, the association of different types of physical activity with incident knee osteoarthritis remains unclear. Objective To determine whether weight-bearing recreational physical activities are associated with increased risk of incident knee osteoarthritis. Design, Setting, and Participants This prospective cohort study used data from the Rotterdam Study (1996 to 2009), including participants with knee x-ray measurements at baseline and follow-up examinations. Participants with knee osteoarthritis at baseline were excluded. Residents aged 45 years and older of the Ommoord district in the city of Rotterdam in The Netherlands were invited to join the Rotterdam Study (78% response rate). Analysis was conducted in June 2023. Exposure Total, weight-bearing, and non-weight-bearing recreational physical activities collected by questionnaires at baseline. Main Outcomes and Measures Incident radiographic knee osteoarthritis measured by knee x-ray was the primary outcome, and incident symptomatic knee osteoarthritis defined by x-ray and knee pain questionnaire was the secondary outcome. The association of different types of recreational physical activity with radiographic knee osteoarthritis was examined using logistic regression within generalized estimating equation framework after adjusting for potential confounders. A prespecified stratification analysis was planned on the basis of lower-limb muscle mass index (LMI) tertiles, measured by dual-energy x-ray absorptiometry. Results A total of 5003 individuals (2804 women [56.0%]; mean [SD] age, 64.5 [7.9] years) were included. The knee osteoarthritis incident rate was 8.4% (793 of 9483 knees) for a mean (SD) follow-up time of 6.33 (2.46) years. Higher weight-bearing activity was associated with increased odds of incident knee osteoarthritis (odds ratio [OR], 1.22; 95% CI, 1.10-1.35; P < .001), but non-weight-bearing activity was not (OR, 1.04; 95% CI, 0.95-1.15; P = .37). In the analysis stratified by LMI tertiles, the association of weight-bearing activity with incident osteoarthritis was found only among 431 patients in the lowest LMI tertile (OR, 1.53; 95% CI, 1.15-2.04; P = .003), but not among patients in the middle or high LMI tertile. Conclusions and Relevance The findings of this study suggest that weight-bearing activity is associated with incident knee osteoarthritis in people with low levels of lower-limb muscle mass, which might be a promising avenue for tailored advice for physical activity.
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Affiliation(s)
- Yahong Wu
- Department of Epidemiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Cindy G. Boer
- Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Amy Hofman
- Department of Epidemiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Dieuwke Schiphof
- Department of General Practice, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Marienke van Middelkoop
- Department of General Practice, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Ingrid A. Szilagyi
- Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of General Practice, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Bahar Sedaghati-Khayat
- Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Sita M. A. Bierma-Zeinstra
- Department of General Practice, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Orthopedics & Sports Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Joyce B. J. van Meurs
- Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Orthopedics & Sports Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
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Zehr JD, Quadrilatero J, Callaghan JP. Indentation mechanics and native collagen content in the cartilaginous endplate: A comparison between porcine cervical and human lumbar spines. J Mech Behav Biomed Mater 2024; 150:106334. [PMID: 38163418 DOI: 10.1016/j.jmbbm.2023.106334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 12/15/2023] [Accepted: 12/16/2023] [Indexed: 01/03/2024]
Abstract
This study characterized the regional indentation mechanics and native collagen content in cartilaginous endplates (CEPs) from the porcine cervical spine, young human lumbar spine, and aged human lumbar spine. Seventeen endplates were included in this study: six porcine cervical, nine young human lumbar, and two aged human lumbar. Width and depth measurements were obtained using a digital caliper and used to size-normalize and identify the central, anterior, posterior, and lateral regions. Regional microindentation tests were performed using a serial robot, where surface locations were loaded/unloaded at 0.1 mm/s and held at a constant 10 N force for 30 s. Loading stiffness and creep displacement were obtained from force-displacement data. Immunofluorescence staining for type I and type II collagen was subsequently performed on sagittal sections of all endplate regions. 255 images were obtained from which fluorescence intensity, sub-surface void area, and cartilage thickness were measured. CEPs from the young human lumbar spine were, on average, 27% more compliant, 0.891 mm thicker, had a lower fluorescence intensity for native collagen proteins within the cartilage (-58%) and subchondral bone (-24%), and had a sub-surface void area that was 19.7 times greater than porcine cervical CEPs. Compared to aged human lumbar CEPs, young human lumbar CEPs were 57% stiffer, 0.568 mm thicker, had a higher fluorescence intensity for native collagen proteins within the cartilage (+30%) and subchondral bone (+46%), and had a sub-surface void area that was 10.6 times smaller. Although not a perfect mechanical and structural surrogate, porcine cervical CEPs provided initial conditions that may be more representative of the young and healthy human lumbar spine compared to aged human cadaveric specimens. The indentation properties presented may have further applications to finite element models of the human lumbar spine.
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Affiliation(s)
- Jackie D Zehr
- Human Performance Lab, University of Calgary, Calgary, AB, Canada
| | - Joe Quadrilatero
- Department of Kinesiology & Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Jack P Callaghan
- Department of Kinesiology & Health Sciences, University of Waterloo, Waterloo, ON, Canada.
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3
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Esrafilian A, Halonen KS, Dzialo CM, Mannisi M, Mononen ME, Tanska P, Woodburn J, Korhonen RK, Andersen MS. Effects of gait modifications on tissue-level knee mechanics in individuals with medial tibiofemoral osteoarthritis: A proof-of-concept study towards personalized interventions. J Orthop Res 2024; 42:326-338. [PMID: 37644668 PMCID: PMC10952410 DOI: 10.1002/jor.25686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 06/19/2023] [Accepted: 08/24/2023] [Indexed: 08/31/2023]
Abstract
Gait modification is a common nonsurgical approach to alter the mediolateral distribution of knee contact forces, intending to decelerate or postpone the progression of mechanically induced knee osteoarthritis (KOA). Nevertheless, the success rate of these approaches is controversial, with no studies conducted to assess alterations in tissue-level knee mechanics governing cartilage degradation response in KOA patients undertaking gait modifications. Thus, here we investigated the effect of different conventional gait conditions and modifications on tissue-level knee mechanics previously suggested as indicators of collagen network damage, cell death, and loss of proteoglycans in knee cartilage. Five participants with medial KOA were recruited and musculoskeletal finite element analyses were conducted to estimate subject-specific tissue mechanics of knee cartilages during two gait conditions (i.e., barefoot and shod) and six gait modifications (i.e., 0°, 5°, and 10° lateral wedge insoles, toe-in, toe-out, and wide stance). Based on our results, the optimal gait modification varied across the participants. Overall, toe-in, toe-out, and wide stance showed the greatest reduction in tissue mechanics within medial tibial and femoral cartilages. Gait modifications could effectually alter maximum principal stress (~20 ± 7%) and shear strain (~9 ± 4%) within the medial tibial cartilage. Nevertheless, lateral wedge insoles did not reduce joint- and tissue-level mechanics considerably. Significance: This proof-of-concept study emphasizes the importance of the personalized design of gait modifications to account for biomechanical risk factors associated with cartilage degradation.
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Affiliation(s)
- Amir Esrafilian
- Department of Technical PhysicsUniversity of Eastern FinlandKuopioFinland
| | - Kimmo S. Halonen
- Central hospital of Päijät‐HämeLahtiFinland
- Department of Materials and ProductionAalborg UniversityAalborgDenmark
| | | | | | - Mika E. Mononen
- Department of Technical PhysicsUniversity of Eastern FinlandKuopioFinland
| | - Petri Tanska
- Department of Technical PhysicsUniversity of Eastern FinlandKuopioFinland
| | - Jim Woodburn
- Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute QueenslandGriffith UniversityGold CoastQLDAustralia
| | - Rami K. Korhonen
- Department of Technical PhysicsUniversity of Eastern FinlandKuopioFinland
| | - Michael S. Andersen
- Department of Materials and ProductionAalborg UniversityAalborgDenmark
- Center for Mathematical Modeling of Knee Osteoarthritis (MathKOA), Department of Materials and ProductionAalborg UniversityAalborgDenmark
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Suito H, Fujikawa K, Ohsako M. ENPP1 downregulation and FGF23 upregulation in growth-related calcification of the tibial tuberosity in rats. J Anat 2024; 244:333-342. [PMID: 37814911 PMCID: PMC10780148 DOI: 10.1111/joa.13958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 08/15/2023] [Accepted: 09/18/2023] [Indexed: 10/11/2023] Open
Abstract
During tibial tuberosity growth, superficial and deep portions can be observed; however, the deep portion is not observed after the growth period, as it develops into bone tissues. Calcification in vivo is known to be constitutively suppressed by ectonucleotide pyrophosphatase/phosphodiesterase-1 (ENPP1) but promoted by tissue-nonspecific alkaline phosphatase (TNAP). FGF23 promotes calcification of enthesis. Gene expression of FGF23 increased rapidly at 13W in this study. Therefore, the tibial tuberosity is speculated to develop via Enpp1 downregulation and Tnap upregulation; however, the understanding of these processes remains unclear. Hence, in the present study, we aimed to explore the age-related structural changes and underlying gene expression changes in the tibial tuberosity of rats. Male Wistar rats were divided into three groups (3-, 7-, and 13-week-old; eight each). The tibial tuberosity superficial and deep portions were clearly observed in 3- and 7-week-old rats, but the presence of the deep portion was not confirmed in 13-week-old rats. The extracellular matrix of hypertrophic chondrocytes was calcified. Furthermore, the Enpp1 expression was the highest in 3-week-old rats and decreased with growth. The TNAP expression did not differ significantly among the groups. The deep portion area was significantly lower in 3-week-old rats than in 7-week-old rats. Generally, the extracellular matrix of the immature chondrocytes is not calcified. Therefore, we speculated that the cartilaginous tibial tuberosity calcifies and ossifies with growth. The Enpp1 expression decreased with growth, whereas the Tnap expression remained unchanged. Thus, we surmise that the tibial tuberosity calcifies with growth and that this process involves Enpp1 downregulation and FGF23 upregulation. As Osgood-Schlatter disease is closely related to the calcification of the tibial tuberosity, these findings may help clarify the pathogenesis of this disease.
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Affiliation(s)
- Hirai Suito
- Graduate School of Human Life Design, Toyo University, Tokyo, Japan
- Japan Society for the Promotion of Science Research Fellowships DC, Tokyo, Japan
| | - Kaoru Fujikawa
- Department of Oral Anatomy and Developmental Biology, Showa University School of Dentistry, Tokyo, Japan
| | - Masafumi Ohsako
- Graduate School of Health and Sports Science, Toyo University, Tokyo, Japan
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5
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Zehr JD, Quadrilatero J, Callaghan JP. Initiation and accumulation of loading induced changes to native collagen content and microstructural damage in the cartilaginous endplate. Spine J 2024; 24:161-171. [PMID: 37487932 DOI: 10.1016/j.spinee.2023.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 07/12/2023] [Accepted: 07/19/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND CONTEXT Injury to the cartilaginous endplate (CEP) is linked to clinically relevant low back disorders, including intervertebral disc degeneration and pain reporting. Despite this link to clinical disorders, the CEP injury pathways and the modulating effect of mechanical loading parameters on the pace of damage accumulation remains poorly understood. PURPOSE This study examined the effect of cyclic loading on the initiation and accumulation of changes to native collagen content (type I, type II) and microstructural damage in the central region of cadaveric porcine CEPs. STUDY DESIGN In vitro longitudinal study. METHODS One hundred fourteen porcine cervical spinal units were included (N=6 per group). The study contained a control group (no cyclic loading) and 18 experimental groups that differed by loading duration (1,000, 3,000, 5,000 cycles), joint posture (flexed, neutral), and cyclic peak compression variation (10%, 20%, 40%). Multicolor immunofluorescence staining was used to quantify loading induced changes to type I (ie, subchondral bone) and type II (ie, endplate) native collagen content (fluorescence area, fluorescence intensity) and microstructural damage (pore area [transverse plane], void area along the CEP-bone border [sagittal plane]). RESULTS Significant main effects of loading duration and posture were observed for fluorescence area and fluorescence intensity of type I and II collagen. In the transverse plane, type II fluorescence area significantly decreased following 1,000 cycles (-12%), but a significant change in fluorescence intensity was not observed until 3,000 cycles (-17%). Type II fluorescence area (-14%) and intensity (-10%) were both significantly less in flexed postures compared to neutral. Similar trends were observed for type I collagen in the sagittal plane sections. Generally, significant changes to fluorescence area were accompanied by the development of microstructural voids along the endplate-subchondral bone border. CONCLUSIONS These findings demonstrate that microstructural damage beneath the endplate surface occurs before significant changes to the density of native type I and II collagen fibers. Although flexed postures were associated with greater and accelerated changes to native collagen content, the injury initiation mechanism appears similar to neutral. CLINICAL SIGNIFICANCE Neutral joint postures can delay the initiation and pace of microdamage accumulation in the CEP during low-to-moderate demand lifting tasks. Furthermore, the management of peak compression exposures appeared relevant only when a neutral posture was maintained. Therefore, clinical low back injury prevention and load management efforts should consider low back posture in parallel with applied joint forces.
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Affiliation(s)
- Jackie D Zehr
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Joe Quadrilatero
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Jack P Callaghan
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.
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6
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Bolcos PO, Mononen ME, Roach KE, Tanaka MS, Suomalainen JS, Mikkonen S, Nissi MJ, Töyräs J, Link TM, Souza R, Majumdar S, Ma B, Li X, Korhonen RK. Subject-specific biomechanical analysis to estimate locations susceptible to osteoarthritis-Finite element modeling and MRI follow-up of ACL reconstructed patients. J Orthop Res 2022; 40:1744-1755. [PMID: 34820897 PMCID: PMC9127000 DOI: 10.1002/jor.25218] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 09/16/2021] [Accepted: 11/09/2021] [Indexed: 02/04/2023]
Abstract
The aims of this case-control study were to: (1) Identify cartilage locations and volumes at risk of osteoarthritis (OA) using subject-specific finite element (FE) models; (2) Quantify the relationships between the simulated biomechanical parameters and T2 and T1ρ relaxation times of magnetic resonance imaging (MRI). We created subject-specific FE models for seven patients with anterior cruciate ligament (ACL) reconstruction and six controls based on a previous proof-of-concept study. We identified locations and cartilage volumes susceptible to OA, based on maximum principal stresses and absolute maximum shear strains in cartilage exceeding thresholds of 7 MPa and 32%, respectively. The locations and volumes susceptible to OA were compared qualitatively and quantitatively against 2-year longitudinal changes in T2 and T1ρ relaxation times. The degeneration volumes predicted by the FE models, based on excessive maximum principal stresses, were significantly correlated (r = 0.711, p < 0.001) with the degeneration volumes determined from T2 relaxation times. There was also a significant correlation between the predicted stress values and changes in T2 relaxation time (r = 0.649, p < 0.001). Absolute maximum shear strains and changes in T1ρ relaxation time were not significantly correlated. Five out of seven patients with ACL reconstruction showed excessive maximum principal stresses in either one or both tibial cartilage compartments, in agreement with follow-up information from MRI. Expectedly, for controls, the FE models and follow-up information showed no degenerative signs. Our results suggest that the presented modelling methodology could be applied to prospectively identify ACL reconstructed patients at risk of biomechanically driven OA, particularly by the analysis of maximum principal stresses of cartilage.
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Affiliation(s)
- Paul O. Bolcos
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland,Corresponding author: Paul Octavian Bolcos, Department of Applied Physics, University of Eastern Finland, POB 1627, FI-70211 Kuopio, Finland, Tel. +358 45 2290653,
| | - Mika E. Mononen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Koren E. Roach
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, Unites States of America
| | - Matthew S. Tanaka
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, Unites States of America
| | | | - Santtu Mikkonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Mikko J. Nissi
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland,Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - Juha Töyräs
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland,School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Australia,Diagnostic Imaging Centre, Kuopio University Hospital, Kuopio Finland
| | - Thomas M. Link
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, Unites States of America
| | - Richard Souza
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, Unites States of America
| | - Sharmila Majumdar
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, Unites States of America
| | - Benjamin Ma
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, Unites States of America
| | - Xiaojuan Li
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Unites States of America
| | - Rami K Korhonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland,Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
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7
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A musculoskeletal finite element model of rat knee joint for evaluating cartilage biomechanics during gait. PLoS Comput Biol 2022; 18:e1009398. [PMID: 35657996 PMCID: PMC9166403 DOI: 10.1371/journal.pcbi.1009398] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 04/26/2022] [Indexed: 12/02/2022] Open
Abstract
Abnormal loading of the knee due to injuries or obesity is thought to contribute to the development of osteoarthritis (OA). Small animal models have been used for studying OA progression mechanisms. However, numerical models to study cartilage responses under dynamic loading in preclinical animal models have not been developed. Here we present a musculoskeletal finite element model of a rat knee joint to evaluate cartilage biomechanical responses during a gait cycle. The rat knee joint geometries were obtained from a 3-D MRI dataset and the boundary conditions regarding loading in the joint were extracted from a musculoskeletal model of the rat hindlimb. The fibril-reinforced poroelastic (FRPE) properties of the rat cartilage were derived from data of mechanical indentation tests. Our numerical results showed the relevance of simulating anatomical and locomotion characteristics in the rat knee joint for estimating tissue responses such as contact pressures, stresses, strains, and fluid pressures. We found that the contact pressure and maximum principal strain were virtually constant in the medial compartment whereas they showed the highest values at the beginning of the gait cycle in the lateral compartment. Furthermore, we found that the maximum principal stress increased during the stance phase of gait, with the greatest values at midstance. We anticipate that our approach serves as a first step towards investigating the effects of gait abnormalities on the adaptation and degeneration of rat knee joint tissues and could be used to evaluate biomechanically-driven mechanisms of the progression of OA as a consequence of joint injury or obesity. Osteoarthritis is a disease of the musculoskeletal system which is characterized by the degradation of articular cartilage. Changes in the knee loading after injuries or obesity contribute to the development of cartilage degeneration. Since injured cartilage cannot be reversed back to intact conditions, small animal models have been widely used for investigating osteoarthritis progression mechanisms. Moreover, experimental studies have been complemented with numerical models to overcome inherent limitations such as cost, difficulties to obtain accurate measures and replicate degenerative situations in the knee joint. However, computational models to study articular cartilage responses under dynamic loading in small animal models have not been developed. Thus, here we present a musculoskeletal finite element model (MSFE) of a rat knee joint to evaluate cartilage biomechanical responses during gait. Our computational model considers both the anatomical and locomotion characteristics of the rat knee joint for estimating mechanical responses in the articular cartilage. We suggest that our approach can be used to investigate tissue adaptations based on the mechanobiological responses of the cartilage to prevent the progression of osteoarthritis.
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Tavakoli J, Torkaman G, Ravanbod R, Abroun S. Regenerative Effect of Low-Intensity Pulsed Ultrasound and Platelet-Rich Plasma on the Joint Friction and Biomechanical Properties of Cartilage: A Non-traumatic Osteoarthritis Model in the Guinea Pig. ULTRASOUND IN MEDICINE & BIOLOGY 2022; 48:862-871. [PMID: 35184911 DOI: 10.1016/j.ultrasmedbio.2022.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/07/2021] [Accepted: 01/16/2022] [Indexed: 06/14/2023]
Abstract
This study was aimed at investigating the effects of platelet-rich plasma (PRP) and low-intensity pulsed ultrasound (LIPUS) on the joint friction parameters and biomechanical properties of articular cartilage in a non-traumatic knee osteoarthritis (OA) model. Fifty adult male Dunkin Hartley guinea pigs were randomly divided into five groups: control, OA60, OA + US, OA + PRP and OA + US + PRP). Non-traumatic knee OA was induced with a single dose of 3 mg of mono-iodoacetate (MIA) by intra-articular injection. Intra-articular PRP was injected twice in the OA + PRP and OA + US + PRP groups. LIPUS was delivered in 10 sessions in the OA + US and OA + US + PRP groups. By use of the pendulum free oscillation test, joint friction (coefficient of friction) was measured. In addition, the instantaneous elastic modulus and aggregate modulus were measured using the stress-relaxation test. MIA injection decreased cartilage thickness, instantaneous elastic modulus and aggregate modulus, and increased joint friction. The friction coefficients in the OA + US and OA + US + PRP groups reached near-normal values, and there was no significant difference compared with the control group (p = 0.232 and p = 0.459, respectively). The instantaneous elastic modulus and aggregate modulus in the OA + US group increased significantly compared with the OA + PRP group (p < 0.05). It seems that both LIPUS and PRP injection effectively improved joint lubrication, but LIPUS was superior to PRP in improving the mechanical properties of the articular cartilage.
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Affiliation(s)
- Jalal Tavakoli
- Department of Physical Therapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Giti Torkaman
- Department of Physical Therapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Roya Ravanbod
- Department of Physical Therapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Saeid Abroun
- Department of Hematology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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9
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Mohammadi A, te Moller NCR, Ebrahimi M, Plomp S, Brommer H, van Weeren PR, Mäkelä JTA, Töyräs J, Korhonen RK. Site- and Zone-Dependent Changes in Proteoglycan Content and Biomechanical Properties of Bluntly and Sharply Grooved Equine Articular Cartilage. Ann Biomed Eng 2022; 50:1787-1797. [PMID: 35754073 PMCID: PMC9794534 DOI: 10.1007/s10439-022-02991-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 06/09/2022] [Indexed: 12/31/2022]
Abstract
In this study, we mapped and quantified changes of proteoglycan (PG) content and biomechanical properties in articular cartilage in which either blunt or sharp grooves had been made, both close to the groove and more remote of it, and at the opposing joint surface (kissing site) in equine carpal joints. In nine adult Shetland ponies, standardized blunt and sharp grooves were surgically made in the radiocarpal and middle carpal joints of a randomly chosen front limb. The contralateral control limb was sham-operated. At 39 weeks after surgery, ponies were euthanized. In 10 regions of interest (ROIs) (six remote from the grooves and four directly around the grooves), PG content as a function of tissue-depth and distance-to-groove was estimated using digital densitometry. Biomechanical properties of the cartilage were evaluated in the six ROIs remote from the grooves. Compared to control joints, whole tissue depth PG loss was found in sites adjacent to sharp and, to a larger extent, blunt grooves. Also, superficial PG loss of the surgically untouched kissing cartilage layers was observed. Significant PG loss was observed up to 300 µm (sharp) and at 500 µm (blunt) from the groove into the surrounding tissue. Equilibrium modulus was lower in grooved cartilage than in controls. Grooves, in particular blunt grooves, gave rise to severe PG loss close to the grooved sites and to mild degeneration more remote from the grooves in both sharply and bluntly grooved cartilage and at the kissing sites, resulting in loss of mechanical strength over the 9-month period.
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Affiliation(s)
- Ali Mohammadi
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Nikae C. R. te Moller
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Mohammadhossein Ebrahimi
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland ,Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Saskia Plomp
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Harold Brommer
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - P. René van Weeren
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Janne T. A. Mäkelä
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Juha Töyräs
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland ,School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Australia ,Science Service Center, Kuopio University Hospital, Kuopio, Finland
| | - Rami K. Korhonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
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10
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Yuh C, O'Bryan CS, Angelini TE, Wimmer MA. Microindentation of cartilage before and after articular loading in a bioreactor: assessment of length-scale dependency using two analysis methods. EXPERIMENTAL MECHANICS 2021; 61:1069-1080. [PMID: 35528779 PMCID: PMC9075500 DOI: 10.1007/s11340-021-00742-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 06/04/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Microindentation is a technique with high sensitivity and spatial resolution, allowing for measurements at small-scale indentation depths. Various methods of indentation analysis to determine output properties exist. OBJECTIVE Here, the Oliver-Pharr Method and Hertzian Method were compared for stiffness analyses of articular cartilage at varying length-scales before and after bioreactor loading. METHODS Using three different conospherical tips with varying radii (20, 100, 793.75 μm), a bioreactor-indenter workflow was performed on cartilage explants to assess changes in stiffness due to articular loading. For all data, both the Oliver-Pharr Method and Hertzian Method were applied for indentation analysis. RESULTS The reduced moduli calculated by the Hertzian Method were found to be similar to those of the Oliver-Pharr Method when the 20 μm tip size was used. The reduced moduli calculated using the Hertzian Method were found to be consistent across the varying length-scales, whereas for the Oliver-Pharr Method, adhesion/suction led to the largest tip exhibiting an increased average reduced modulus compared to the two smaller tips. Loading induced stiffening of articular cartilage was observed consistently, regardless of tip size or indentation analysis applied. CONCLUSIONS Overall, geometric linearity is preserved across all tip sizes for the Hertzian Method and may be assumed for the two smaller tip sizes using the Oliver-Pharr Method. These findings further validate the previously described stiffening response of the superficial zone of cartilage after articular loading and demonstrate that the finding is length-scale independent.
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Affiliation(s)
- C Yuh
- Rush University Medical Center, Chicago, IL
| | - C S O'Bryan
- University of Florida, Gainesville, FL
- University of Pennsylvania, Philadelphia, PA
| | | | - M A Wimmer
- Rush University Medical Center, Chicago, IL
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11
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Seitz AM, Osthaus F, Schwer J, Warnecke D, Faschingbauer M, Sgroi M, Ignatius A, Dürselen L. Osteoarthritis-Related Degeneration Alters the Biomechanical Properties of Human Menisci Before the Articular Cartilage. Front Bioeng Biotechnol 2021; 9:659989. [PMID: 34026741 PMCID: PMC8134692 DOI: 10.3389/fbioe.2021.659989] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/24/2021] [Indexed: 12/15/2022] Open
Abstract
An exact understanding of the interplay between the articulating tissues of the knee joint in relation to the osteoarthritis (OA)-related degeneration process is of considerable interest. Therefore, the aim of the present study was to characterize the biomechanical properties of mildly and severely degenerated human knee joints, including their menisci and tibial and femoral articular cartilage (AC) surfaces. A spatial biomechanical mapping of the articulating knee joint surfaces of 12 mildly and 12 severely degenerated human cadaveric knee joints was assessed using a multiaxial mechanical testing machine. To do so, indentation stress relaxation tests were combined with thickness and water content measurements at the lateral and medial menisci and the AC of the tibial plateau and femoral condyles to calculate the instantaneous modulus (IM), relaxation modulus, relaxation percentage, maximum applied force during the indentation, and the water content. With progressing joint degeneration, we found an increase in the lateral and the medial meniscal instantaneous moduli (p < 0.02), relaxation moduli (p < 0.01), and maximum applied forces (p < 0.01), while for the underlying tibial AC, the IM (p = 0.01) and maximum applied force (p < 0.01) decreased only at the medial compartment. Degeneration had no influence on the relaxation percentage of the soft tissues. While the water content of the menisci did not change with progressing degeneration, the severely degenerated tibial AC contained more water (p < 0.04) compared to the mildly degenerated tibial cartilage. The results of this study indicate that degeneration-related (bio-)mechanical changes seem likely to be first detectable in the menisci before the articular knee joint cartilage is affected. Should these findings be further reinforced by structural and imaging analyses, the treatment and diagnostic paradigms of OA might be modified, focusing on the early detection of meniscal degeneration and its respective treatment, with the final aim to delay osteoarthritis onset.
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Affiliation(s)
- Andreas M Seitz
- Institute of Orthopedic Research and Biomechanics, Center of Trauma Research Ulm, Ulm University Medical Center, Ulm, Germany
| | - Felix Osthaus
- Institute of Orthopedic Research and Biomechanics, Center of Trauma Research Ulm, Ulm University Medical Center, Ulm, Germany
| | - Jonas Schwer
- Institute of Orthopedic Research and Biomechanics, Center of Trauma Research Ulm, Ulm University Medical Center, Ulm, Germany
| | - Daniela Warnecke
- Institute of Orthopedic Research and Biomechanics, Center of Trauma Research Ulm, Ulm University Medical Center, Ulm, Germany
| | - Martin Faschingbauer
- Department of Orthopedic Surgery, Universitäts- und Rehabilitationskliniken Ulm (RKU), Ulm University Medical Center, Ulm, Germany
| | - Mirco Sgroi
- Department of Orthopedic Surgery, Universitäts- und Rehabilitationskliniken Ulm (RKU), Ulm University Medical Center, Ulm, Germany
| | - Anita Ignatius
- Institute of Orthopedic Research and Biomechanics, Center of Trauma Research Ulm, Ulm University Medical Center, Ulm, Germany
| | - Lutz Dürselen
- Institute of Orthopedic Research and Biomechanics, Center of Trauma Research Ulm, Ulm University Medical Center, Ulm, Germany
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12
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Orozco GA, Bolcos P, Mohammadi A, Tanaka MS, Yang M, Link TM, Ma B, Li X, Tanska P, Korhonen RK. Prediction of local fixed charge density loss in cartilage following ACL injury and reconstruction: A computational proof-of-concept study with MRI follow-up. J Orthop Res 2021; 39:1064-1081. [PMID: 32639603 PMCID: PMC7790898 DOI: 10.1002/jor.24797] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 06/15/2020] [Accepted: 06/25/2020] [Indexed: 02/04/2023]
Abstract
The purpose of this proof-of-concept study was to develop three-dimensional patient-specific mechanobiological knee joint models to simulate alterations in the fixed charged density (FCD) around cartilage lesions during the stance phase of the walking gait. Two patients with anterior cruciate ligament (ACL) reconstructed knees were imaged at 1 and 3 years after surgery. The magnetic resonance imaging (MRI) data were used for segmenting the knee geometries, including the cartilage lesions. Based on these geometries, finite element (FE) models were developed. The gait of the patients was obtained using a motion capture system. Musculoskeletal modeling was utilized to calculate knee joint contact and lower extremity muscle forces for the FE models. Finally, a cartilage adaptation algorithm was implemented in both FE models. In the algorithm, it was assumed that excessive maximum shear and deviatoric strains (calculated as the combination of principal strains), and fluid velocity, are responsible for the FCD loss. Changes in the longitudinal T1ρ and T2 relaxation times were postulated to be related to changes in the cartilage composition and were compared with the numerical predictions. In patient 1 model, both the excessive fluid velocity and strain caused the FCD loss primarily near the cartilage lesion. T1ρ and T2 relaxation times increased during the follow-up in the same location. In contrast, in patient 2 model, only the excessive fluid velocity led to a slight FCD loss near the lesion, where MRI parameters did not show evidence of alterations. Significance: This novel proof-of-concept study suggests mechanisms through which a local FCD loss might occur near cartilage lesions. In order to obtain statistical evidence for these findings, the method should be investigated with a larger cohort of subjects.
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Affiliation(s)
- Gustavo A. Orozco
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland Yliopistonranta 1, FI-70210 Kuopio, Finland.,Corresponding author: Gustavo A. Orozco, Department of Applied Physics, University of Eastern Finland, Kuopio, Finland, Yliopistonranta 1, 70210 Kuopio, FI, Tel: +358 50 3485018,
| | - Paul Bolcos
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland Yliopistonranta 1, FI-70210 Kuopio, Finland
| | - Ali Mohammadi
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland Yliopistonranta 1, FI-70210 Kuopio, Finland
| | - Matthew S. Tanaka
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 1500 Owens St, San Francisco, CA 94158, USA
| | - Mingrui Yang
- Department of Biomedical Engineering, Lerner Research Institute, Program of Advanced Musculoskeletal Imaging (PAMI), 9500 Euclid Avenue, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Thomas M. Link
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 1500 Owens St, San Francisco, CA 94158, USA
| | - Benjamin Ma
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 1500 Owens St, San Francisco, CA 94158, USA
| | - Xiaojuan Li
- Department of Biomedical Engineering, Lerner Research Institute, Program of Advanced Musculoskeletal Imaging (PAMI), 9500 Euclid Avenue, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Petri Tanska
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland Yliopistonranta 1, FI-70210 Kuopio, Finland
| | - Rami K. Korhonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland Yliopistonranta 1, FI-70210 Kuopio, Finland
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Zimmerman BK, Nims RJ, Chen A, Hung CT, Ateshian GA. Direct Osmotic Pressure Measurements in Articular Cartilage Demonstrate Nonideal and Concentration-Dependent Phenomena. J Biomech Eng 2021; 143:041007. [PMID: 33210125 PMCID: PMC7872001 DOI: 10.1115/1.4049158] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 11/01/2020] [Indexed: 11/08/2022]
Abstract
The osmotic pressure in articular cartilage serves an important mechanical function in healthy tissue. Its magnitude is thought to play a role in advancing osteoarthritis. The aims of this study were to: (1) isolate and quantify the magnitude of cartilage swelling pressure in situ; and (2) identify the effect of salt concentration on material parameters. Confined compression stress-relaxation testing was performed on 18 immature bovine and six mature human cartilage samples in solutions of varying osmolarities. Direct measurements of osmotic pressure revealed nonideal and concentration-dependent osmotic behavior, with magnitudes approximately 1/3 those predicted by ideal Donnan law. A modified Donnan constitutive behavior was able to capture the aggregate behavior of all samples with a single adjustable parameter. Results of curve-fitting transient stress-relaxation data with triphasic theory in febio demonstrated concentration-dependent material properties. The aggregate modulus HA increased threefold as the external concentration decreased from hypertonic 2 M to hypotonic 0.001 M NaCl (bovine: HA=0.420±0.109 MPa to 1.266±0.438 MPa; human: HA=0.499±0.208 MPa to 1.597±0.455 MPa), within a triphasic theory inclusive of osmotic effects. This study provides a novel and simple analytical model for cartilage osmotic pressure which may be used in computational simulations, validated with direct in situ measurements. A key finding is the simultaneous existence of Donnan osmotic and Poisson-Boltzmann electrostatic interactions within cartilage.
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Affiliation(s)
- Brandon K Zimmerman
- Department of Mechanical Engineering, Columbia University, New York, NY 10027
| | - Robert J Nims
- Department of Biomedical Engineering, Columbia University, New York, NY 10027
| | - Alex Chen
- Department of Mechanical Engineering, Columbia University, New York, NY 10027
| | - Clark T Hung
- Department of Biomedical Engineering, Columbia University, New York, NY 10027
| | - Gerard A Ateshian
- Department of Mechanical Engineering, Columbia University, New York, NY 10027; Department of Biomedical Engineering, Columbia University, New York, NY 10027
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14
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Westermann LM, Fleischhauer L, Vogel J, Jenei-Lanzl Z, Ludwig NF, Schau L, Morellini F, Baranowsky A, Yorgan TA, Di Lorenzo G, Schweizer M, de Souza Pinheiro B, Guarany NR, Sperb-Ludwig F, Visioli F, Oliveira Silva T, Soul J, Hendrickx G, Wiegert JS, Schwartz IVD, Clausen-Schaumann H, Zaucke F, Schinke T, Pohl S, Danyukova T. Imbalanced cellular metabolism compromises cartilage homeostasis and joint function in a mouse model of mucolipidosis type III gamma. Dis Model Mech 2020; 13:dmm046425. [PMID: 33023972 PMCID: PMC7687858 DOI: 10.1242/dmm.046425] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 09/15/2020] [Indexed: 11/23/2022] Open
Abstract
Mucolipidosis type III (MLIII) gamma is a rare inherited lysosomal storage disorder caused by mutations in GNPTG encoding the γ-subunit of GlcNAc-1-phosphotransferase, the key enzyme ensuring proper intracellular location of multiple lysosomal enzymes. Patients with MLIII gamma typically present with osteoarthritis and joint stiffness, suggesting cartilage involvement. Using Gnptg knockout (Gnptgko ) mice as a model of the human disease, we showed that missorting of a number of lysosomal enzymes is associated with intracellular accumulation of chondroitin sulfate in Gnptgko chondrocytes and their impaired differentiation, as well as with altered microstructure of the cartilage extracellular matrix (ECM). We also demonstrated distinct functional and structural properties of the Achilles tendons isolated from Gnptgko and Gnptab knock-in (Gnptabki ) mice, the latter displaying a more severe phenotype resembling mucolipidosis type II (MLII) in humans. Together with comparative analyses of joint mobility in MLII and MLIII patients, these findings provide a basis for better understanding of the molecular reasons leading to joint pathology in these patients. Our data suggest that lack of GlcNAc-1-phosphotransferase activity due to defects in the γ-subunit causes structural changes within the ECM of connective and mechanosensitive tissues, such as cartilage and tendon, and eventually results in functional joint abnormalities typically observed in MLIII gamma patients. This idea was supported by a deficit of the limb motor function in Gnptgko mice challenged on a rotarod under fatigue-associated conditions, suggesting that the impaired motor performance of Gnptgko mice was caused by fatigue and/or pain at the joint.This article has an associated First Person interview with the first author of the paper.
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Affiliation(s)
- Lena Marie Westermann
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Lutz Fleischhauer
- Laboratory of Experimental Surgery and Regenerative Medicine, Clinic for General Trauma and Reconstructive Surgery, Ludwig-Maximilians University, 80336 Munich, Germany
- Center for Applied Tissue Engineering and Regenerative Medicine (Canter), University of Applied Sciences, 80533 Munich, Germany
| | - Jonas Vogel
- Center for Applied Tissue Engineering and Regenerative Medicine (Canter), University of Applied Sciences, 80533 Munich, Germany
| | - Zsuzsa Jenei-Lanzl
- Dr. Rolf M. Schwiete Research Unit for Osteoarthritis, Orthopedic University Hospital Friedrichsheim gGmbH, 60528 Frankfurt/Main, Germany
| | - Nataniel Floriano Ludwig
- Post-Graduate Program in Genetics and Molecular Biology, Federal University of Rio Grande do Sul, 90040-060 Porto Alegre, Brazil
| | - Lynn Schau
- RG Behavioral Biology, Center for Molecular Neurobiology Hamburg (ZMNH), University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Fabio Morellini
- RG Behavioral Biology, Center for Molecular Neurobiology Hamburg (ZMNH), University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Anke Baranowsky
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Timur A Yorgan
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Giorgia Di Lorenzo
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Michaela Schweizer
- Center for Molecular Neurobiology Hamburg (ZMNH), University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Bruna de Souza Pinheiro
- Department of Genetics, Federal University of Rio Grande do Sul, 90040-060 Porto Alegre, Brazil
| | - Nicole Ruas Guarany
- Occupational Therapy Faculty, Federal University of Pelotas, 96010-610 Pelotas, Brazil
| | - Fernanda Sperb-Ludwig
- Department of Genetics, Federal University of Rio Grande do Sul, 90040-060 Porto Alegre, Brazil
| | - Fernanda Visioli
- Pathology Department, Federal University of Rio Grande do Sul, 90040-060 Porto Alegre, Brazil
| | - Thiago Oliveira Silva
- Post-Graduate Program in Medicine: Medical Sciences, Federal University of Rio Grande do Sul, 90040-060 Porto Alegre, Brazil
| | - Jamie Soul
- Skeletal Research Group, Biosciences Institute, Newcastle University, Newcastle upon Tyne NE1 3BZ, UK
| | - Gretl Hendrickx
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - J Simon Wiegert
- RG Synaptic Wiring and Information Processing, Center for Molecular Neurobiology Hamburg (ZMNH), University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Ida V D Schwartz
- Department of Genetics, Federal University of Rio Grande do Sul, 90040-060 Porto Alegre, Brazil
- Post-Graduate Program in Medicine: Medical Sciences, Federal University of Rio Grande do Sul, 90040-060 Porto Alegre, Brazil
| | - Hauke Clausen-Schaumann
- Center for Applied Tissue Engineering and Regenerative Medicine (Canter), University of Applied Sciences, 80533 Munich, Germany
| | - Frank Zaucke
- Dr. Rolf M. Schwiete Research Unit for Osteoarthritis, Orthopedic University Hospital Friedrichsheim gGmbH, 60528 Frankfurt/Main, Germany
| | - Thorsten Schinke
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Sandra Pohl
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Tatyana Danyukova
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
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15
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Progressive deformation-induced degradation of knee articular cartilage and osteoarthritis. J Biomech 2020; 111:109995. [DOI: 10.1016/j.jbiomech.2020.109995] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/28/2020] [Accepted: 08/08/2020] [Indexed: 11/23/2022]
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16
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Identification of locations susceptible to osteoarthritis in patients with anterior cruciate ligament reconstruction: Combining knee joint computational modelling with follow-up T 1ρ and T 2 imaging. Clin Biomech (Bristol, Avon) 2020; 79:104844. [PMID: 31439361 DOI: 10.1016/j.clinbiomech.2019.08.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 06/28/2019] [Accepted: 08/07/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Finite element modelling can be used to evaluate altered loading conditions and failure locations in knee joint tissues. One limitation of this modelling approach has been experimental comparison. The aims of this proof-of-concept study were: 1) identify areas susceptible to osteoarthritis progression in anterior cruciate ligament reconstructed patients using finite element modelling; 2) compare the identified areas against changes in T2 and T1ρ values between 1-year and 3-year follow-up timepoints. METHODS Two patient-specific finite element models of knee joints with anterior cruciate ligament reconstruction were created. The knee geometry was based on clinical magnetic resonance imaging and joint loading was obtained via motion capture. We evaluated biomechanical parameters linked with cartilage degeneration and compared the identified risk areas against T2 and T1ρ maps. FINDINGS The risk areas identified by the finite element models matched the follow-up magnetic resonance imaging findings. For Patient 1, excessive values of maximum principal stresses and shear strains were observed in the posterior side of the lateral tibial and femoral cartilage. For Patient 2, high values of maximum principal stresses and shear strains of cartilage were observed in the posterior side of the medial joint compartment. For both patients, increased T2 and T1ρ values between the follow-up times were observed in the same areas. INTERPRETATION Finite element models with patient-specific geometries and motions and relatively simple material models of tissues were able to identify areas susceptible to post-traumatic knee osteoarthritis. We suggest that the methodology presented here may be applied in large cohort studies.
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17
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Transient stiffening of cartilage during joint articulation: A microindentation study. J Mech Behav Biomed Mater 2020; 113:104113. [PMID: 33032010 DOI: 10.1016/j.jmbbm.2020.104113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 08/23/2020] [Accepted: 09/24/2020] [Indexed: 11/21/2022]
Abstract
As a mechanoactive tissue, articular cartilage undergoes compression and shear on a daily basis. With the advent of high resolution and sensitive mechanical testing methods, such as micro- and nanoindentation, it has become possible to assess changes in small-scale mechanical properties due to compression and shear of the tissue. However, investigations on the changes of these properties before and after joint articulation have been limited. To simulate articular loading of cartilage in the context of human gait, a previously developed bioreactor system was used. Immediately after bioreactor testing, the stiffness was measured using microindentation. Specifically, we investigated whether the mechanical response of the tissue was transient or permanent, dependent on counterface material, and an effect limited to the superficial zone of cartilage. We found that cartilage surface stiffness increases immediately after articular loading and returns to baseline values within 3 hr. Cartilage-on-cartilage stiffening was found to be higher compared to both alumina- and cobalt chromium-on-cartilage stiffening, which were not significantly different from each other. This stiffening response was found to be unique to the superficial zone, as articular loading on cartilage with the superficial zone removed showed no changes in stiffness. The findings of this study suggest that the cartilage superficial zone may adapt its stiffness as a response to articular loading. As the superficial zone is often compromised during the course of osteoarthritic disease, this finding is of clinical relevance, suggesting that the load-bearing function deteriorates over time.
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18
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Argote PF, Kaplan JT, Poon A, Xu X, Cai L, Emery NC, Pierce DM, Neu CP. Chondrocyte viability is lost during high-rate impact loading by transfer of amplified strain, but not stress, to pericellular and cellular regions. Osteoarthritis Cartilage 2019; 27:1822-1830. [PMID: 31526876 PMCID: PMC7028439 DOI: 10.1016/j.joca.2019.07.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 07/29/2019] [Accepted: 07/31/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Deleterious impact loading to cartilage initiates post-traumatic osteoarthritis (OA). While cytokine and enzyme levels regulate disease progression, specific mechanical cues that elucidate cellular OA origins merit further investigation. We defined the dominant pericellular and cellular strain/stress transfer mechanisms following bulk-tissue injury associated with cell death. METHOD Using an in vitro model, we investigated rate-dependent loading and spatial localization of cell viability in acute indentation and time-course studies. Atomic force microscopy (AFM) and magnetic resonance imaging (MRI) confirmed depth-wise changes in cartilage micro-/macro-mechanics and structure post-indentation. To understand the transfer of loading to cartilage domains, we computationally modeled full-field strain and stress measures in interstitial matrix, pericellular and cellular regions. RESULTS Chondrocyte viability decreased following rapid impact (80%/s) vs slow loading (0.1%/s) or unloaded controls. Viability was lost immediately during impact within regions near the indenter-tissue contact but did not change over 7 days of tissue culture. AFM studies revealed a loss of stiffness following 80%/s loading, and MRI studies confirmed an increased tensile and shear strain, but not relaxometry. Image-based patterns of chondrocyte viability closely matched computational estimates of amplified maximum principal and shear strain in interstitial matrix, pericellular and cellular regions. CONCLUSION Rapid indentation worsens chondrocyte death and degrades cartilage matrix stiffness in indentation regions. Cell death at high strain rates may be driven by elevated tensile strains, but not matrix stress. Strain amplification beyond critical thresholds in the pericellular matrix and cells may define a point of origin for early damage in post-traumatic OA.
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Affiliation(s)
- Pablo F. Argote
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Jonathan T. Kaplan
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA,Biomechanics Research and Engineering, Natick Soldier RD&E Center, Natick, MA, USA
| | - Alan Poon
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Xin Xu
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA,Department of Mechanical Engineering, University of Colorado, Boulder, CO, USA
| | - Luyao Cai
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Nancy C. Emery
- Department of Ecology and Evolutionary Biology, University of Colorado, Boulder, CO, USA
| | - David M. Pierce
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA,Department of Mechanical Engineering, University of Connecticut, Storrs, CT, USA,Corresponding Authors: Corey P. Neu, Tel: (303) 492-7330, , and David M. Pierce, Tel: (860) 486-5088,
| | - Corey P. Neu
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA,Department of Mechanical Engineering, University of Colorado, Boulder, CO, USA,Corresponding Authors: Corey P. Neu, Tel: (303) 492-7330, , and David M. Pierce, Tel: (860) 486-5088,
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19
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Vazquez KJ, Andreae JT, Henak CR. Cartilage-on-cartilage cyclic loading induces mechanical and structural damage. J Mech Behav Biomed Mater 2019; 98:262-267. [PMID: 31280053 DOI: 10.1016/j.jmbbm.2019.06.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 05/20/2019] [Accepted: 06/25/2019] [Indexed: 02/01/2023]
Abstract
Cartilage breaks down during mechanically-mediated osteoarthritis (OA). While previous research has begun to elucidate mechanical, structural and cellular damage in response to cyclic loading, gaps remain in our understanding of the link between cyclic cartilage loading and OA-like mechanical damage. Thus, the aim of this study was to quantify irreversible cartilage damage in response to cyclic loading. A novel in vitro model of damage through cartilage-on-cartilage cyclic loading was established. Cartilage was loaded at 1 Hz to two different doses (10,000 or 50,000 cycles) between -6.0 ± 0.2 MPa and -10.3 ± 0.2 MPa 1st Piola-Kirchhoff stress. After loading, mechanical damage (altered mechanical properties: elastic moduli and dissipated energy) and structural damage (surface damage and specimen thickness) were quantified. Linear and tangential moduli were determined by fitting the loading portion of the stress-strain curves. Dissipated energy was calculated from the area between loading and unloading stress-strain curves. Specimen thickness was measured both before and after loading. Surface damage was assessed by staining samples with India ink, then imaging the articular surface. Cyclic loading resulted in dose-dependent decreases in linear and tangential moduli, energy dissipation, thickness, and intact area. Collectively, these results show that cartilage damage can be initiated by mechanical loading alone in vitro, suggesting that cyclic loading can cause in vivo damage. This study demonstrated that with increased number of cycles, cartilage undergoes both tissue softening and structural damage. These findings are a first step towards characterizing the cartilage response to cyclic loading, which can ultimately provide important insight for delaying the initiation and slowing the progression of OA.
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Affiliation(s)
- Kelly J Vazquez
- Department of Mechanical Engineering, University of Wisconsin-Madison, Madison, WI, USA
| | - Jacob T Andreae
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA
| | - Corinne R Henak
- Department of Mechanical Engineering, University of Wisconsin-Madison, Madison, WI, USA; Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA; Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI, USA.
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Lin AH, Zitnay JL, Li Y, Yu SM, Weiss JA. Microplate assay for denatured collagen using collagen hybridizing peptides. J Orthop Res 2019; 37:431-438. [PMID: 30474872 PMCID: PMC6576259 DOI: 10.1002/jor.24185] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 11/13/2018] [Indexed: 02/04/2023]
Abstract
The purpose of this study was to develop a microplate assay for quantifying denatured collagen by measuring the fluorescence of carboxyfluorescein bound collagen hybridizing peptides (F-CHP). We have shown that F-CHP binds selectively with denatured collagen, and that mechanical overload of tendon fascicles causes collagen denaturation. Proteinase K was used to homogenize tissue samples after F-CHP staining, allowing fluorescence measurement using a microplate reader. We compared our new assay to our previous image analysis method and the trypsin-hydroxyproline assay, which is the only other available method to directly quantify denatured collagen. Relative quantification of denatured collagen was performed in rat tail tendon fascicles subjected to incremental tensile overload, and normal and ostoeoarthritic guinea pig cartilage. In addition, the absolute amount of denatured collagen was determined in rat tail tendon by correlating F-CHP fluorescence with percent denatured collagen as determined by the trypsin-hydroxyproline assay. Rat tail tendon fascicles stretched to low strains (<7.5%) exhibited minimal denatured collagen, but values rapidly increased at medium strains (7.5-10.5%) and plateaued at high strains (≥12%). Osteoarthritic cartilage had higher F-CHP fluorescence than healthy cartilage. Both of these outcomes are consistent with previous studies. With the calibration curve, the microplate assay was able to absolutely quantify denatured collagen in mechanically damaged rat tail tendon fascicles as reliably as the trypsin-hydroxyproline assay. Further, we achieved these results more efficiently than current methods in a rapid, high-throughput manner, with multiple types of collagenous tissue while maintaining accuracy. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:431-438, 2019.
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Affiliation(s)
- Allen H. Lin
- Department of Bioengineering, University of Utah,Scientific Computing and Imaging Institute, University of Utah
| | - Jared L. Zitnay
- Department of Bioengineering, University of Utah,Scientific Computing and Imaging Institute, University of Utah
| | - Yang Li
- Department of Bioengineering, University of Utah
| | - S. Michael Yu
- Department of Bioengineering, University of Utah,Department of Pharmaceutics and Pharmaceutical Chemistry, University of Utah
| | - Jeffrey A. Weiss
- Department of Bioengineering, University of Utah,Scientific Computing and Imaging Institute, University of Utah,Department of Orthopaedics, University of Utah
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21
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Ronkainen A, Tanska P, Fick J, Herzog W, Korhonen R. Interrelationship of cartilage composition and chondrocyte mechanics after a partial meniscectomy in the rabbit knee joint – Experimental and numerical analysis. J Biomech 2019; 83:65-75. [DOI: 10.1016/j.jbiomech.2018.11.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 11/14/2018] [Accepted: 11/14/2018] [Indexed: 12/17/2022]
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22
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Bolcos PO, Mononen ME, Mohammadi A, Ebrahimi M, Tanaka MS, Samaan MA, Souza RB, Li X, Suomalainen JS, Jurvelin JS, Töyräs J, Korhonen RK. Comparison between kinetic and kinetic-kinematic driven knee joint finite element models. Sci Rep 2018; 8:17351. [PMID: 30478347 PMCID: PMC6255758 DOI: 10.1038/s41598-018-35628-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 11/08/2018] [Indexed: 12/11/2022] Open
Abstract
Use of knee joint finite element models for diagnostic purposes is challenging due to their complexity. Therefore, simpler models are needed for studies where a high number of patients need to be analyzed, without compromising the results of the model. In this study, more complex, kinetic (forces and moments) and simpler, kinetic-kinematic (forces and angles) driven finite element models were compared during the stance phase of gait. Patella and tendons were included in the most complex model, while they were absent in the simplest model. The greatest difference between the most complex and simplest models was observed in the internal-external rotation and axial joint reaction force, while all other rotations, translations and joint reaction forces were similar to one another. In terms of cartilage stresses and strains, the simpler models behaved similarly with the more complex models in the lateral joint compartment, while minor differences were observed in the medial compartment at the beginning of the stance phase. We suggest that it is feasible to use kinetic-kinematic driven knee joint models with a simpler geometry in studies with a large cohort size, particularly when analyzing cartilage responses and failures related to potential overloads.
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Affiliation(s)
- Paul O Bolcos
- Department of Applied Physics, University of Eastern Finland, POB 1627, FI-70211, Kuopio, Finland.
| | - Mika E Mononen
- Department of Applied Physics, University of Eastern Finland, POB 1627, FI-70211, Kuopio, Finland
| | - Ali Mohammadi
- Department of Applied Physics, University of Eastern Finland, POB 1627, FI-70211, Kuopio, Finland
| | - Mohammadhossein Ebrahimi
- Department of Applied Physics, University of Eastern Finland, POB 1627, FI-70211, Kuopio, Finland
| | - Matthew S Tanaka
- Department of Radiology and Biomedical Imaging, University of California San Francisco, CA, 94158, San Francisco, USA
| | - Michael A Samaan
- Department of Radiology and Biomedical Imaging, University of California San Francisco, CA, 94158, San Francisco, USA
- Dept. of Kinesiology & Health Promotion, University of Kentucky, Lexington, KY, 40506, USA
| | - Richard B Souza
- Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, CA, 94158, USA
| | - Xiaojuan Li
- Department of Radiology and Biomedical Imaging, University of California San Francisco, CA, 94158, San Francisco, USA
- Program of Advanced Musculoskeletal Imaging (PAMI), Department of Biomedical Engineering, Cleveland Clinic, OH, 44195, Cleveland, USA
| | - Juha-Sampo Suomalainen
- Diagnostic Imaging Centre, Kuopio University Hospital, POB 100, FI-70029, KUH, Kuopio, Finland
| | - Jukka S Jurvelin
- Department of Applied Physics, University of Eastern Finland, POB 1627, FI-70211, Kuopio, Finland
| | - Juha Töyräs
- Department of Applied Physics, University of Eastern Finland, POB 1627, FI-70211, Kuopio, Finland
- Diagnostic Imaging Centre, Kuopio University Hospital, POB 100, FI-70029, KUH, Kuopio, Finland
- School of Information Technology and Electrical Engineering, The University of Queensland, QLD-4072, Brisbane, Australia
| | - Rami K Korhonen
- Department of Applied Physics, University of Eastern Finland, POB 1627, FI-70211, Kuopio, Finland
- Diagnostic Imaging Centre, Kuopio University Hospital, POB 100, FI-70029, KUH, Kuopio, Finland
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23
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Orozco GA, Tanska P, Florea C, Grodzinsky AJ, Korhonen RK. A novel mechanobiological model can predict how physiologically relevant dynamic loading causes proteoglycan loss in mechanically injured articular cartilage. Sci Rep 2018; 8:15599. [PMID: 30348953 PMCID: PMC6197240 DOI: 10.1038/s41598-018-33759-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 10/02/2018] [Indexed: 12/13/2022] Open
Abstract
Cartilage provides low-friction properties and plays an essential role in diarthrodial joints. A hydrated ground substance composed mainly of proteoglycans (PGs) and a fibrillar collagen network are the main constituents of cartilage. Unfortunately, traumatic joint loading can destroy this complex structure and produce lesions in tissue, leading later to changes in tissue composition and, ultimately, to post-traumatic osteoarthritis (PTOA). Consequently, the fixed charge density (FCD) of PGs may decrease near the lesion. However, the underlying mechanisms leading to these tissue changes are unknown. Here, knee cartilage disks from bovine calves were injuriously compressed, followed by a physiologically relevant dynamic compression for twelve days. FCD content at different follow-up time points was assessed using digital densitometry. A novel cartilage degeneration model was developed by implementing deviatoric and maximum shear strain, as well as fluid velocity controlled algorithms to simulate the FCD loss as a function of time. Predicted loss of FCD was quite uniform around the cartilage lesions when the degeneration algorithm was driven by the fluid velocity, while the deviatoric and shear strain driven mechanisms exhibited slightly discontinuous FCD loss around cracks. Our degeneration algorithm predictions fitted well with the FCD content measured from the experiments. The developed model could subsequently be applied for prediction of FCD depletion around different cartilage lesions and for suggesting optimal rehabilitation protocols.
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Affiliation(s)
- Gustavo A Orozco
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.
| | - Petri Tanska
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Cristina Florea
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
- Departments of Biological Engineering, Electrical Engineering and Computer Science and Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Alan J Grodzinsky
- Departments of Biological Engineering, Electrical Engineering and Computer Science and Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Rami K Korhonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
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24
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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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25
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Collagen Damage Location in Articular Cartilage Differs if Damage is Caused by Excessive Loading Magnitude or Rate. Ann Biomed Eng 2018; 46:605-615. [PMID: 29423727 PMCID: PMC5861170 DOI: 10.1007/s10439-018-1986-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 01/29/2018] [Indexed: 01/30/2023]
Abstract
Collagen damage in articular cartilage is considered nearly irreversible and may be an early indication of cartilage degeneration. Surface fibrillation and internal collagen damage may both develop after overloading. This study hypothesizes that damage develops at these different locations, because the distribution of excessive strains varies with loading rate as a consequence of time-dependent cartilage properties. The objective is to explore whether collagen damage could preferentially occur superficially or internally, depending on the magnitude and rate of overloading. Bovine osteochondral plugs were compressed with a 2 mm diameter indenter to 15, 25, 35 and 45 N, and at 5, 60 and 120 mm/min. Surface fibrillation and internal collagen damage were graded by four observers, based on histology and staining of collagen damage. Results show that loading magnitude affects the degree of collagen damage, while loading rate dominates the location of network damage: low rates predominantly damage superficial collagen, while at high rates, internal collagen damage occurs. The proposed explanation for the rate-dependent location is that internal fluid flows govern the time-dependent internal tissue deformation and therewith the location of overstained and damaged areas. This supports the hypothesis that collagen damage development is influenced by the time-dependent material behaviour of cartilage.
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26
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Firner S, Zaucke F, Michael J, Dargel J, Schiwy-Bochat KH, Heilig J, Rothschild MA, Eysel P, Brüggemann GP, Niehoff A. Extracellular Distribution of Collagen II and Perifibrillar Adapter Proteins in Healthy and Osteoarthritic Human Knee Joint Cartilage. J Histochem Cytochem 2017; 65:593-606. [PMID: 28846474 DOI: 10.1369/0022155417729154] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Perifibrillar adapter proteins, interconnecting collagen fibrils, and linking the collagen network with the aggrecan matrix seem to play a crucial role in the pathogenesis of osteoarthritis (OA). Therefore, we examined immunohistochemically the extracellular distribution of collagen II and the main perifibrillar adapter proteins-collagen IX, decorin, cartilage oligomeric matrix protein (COMP), and matrilin-3-in human samples of healthy (n=4) and OA (n=42) knee joint cartilage. Histopathology assessment was performed using an OA score. Staining patterns were evaluated in relation to the disease stage. The perifibrillar adapter proteins were uniformly distributed in the upper zones of healthy cartilage. In moderate OA (n=8; score 14.3 ± 4.7), all proteins analyzed were locally absent in the fibrillated area or the superficial and upper mid zone. In advanced OA (n=20; score 18.9 ± 5.3), they were uniformly distributed in these zones and accumulated pericellularly. Perifibrillar adapter proteins are important for the stabilization of the collagen network in the upper zones of healthy cartilage. Their degradation might be a critical event in early OA. In advanced OA, there are indications for an increased synthesis in an attempt to regenerate the lost tissue and to protect the remaining cartilage from further destruction.
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Affiliation(s)
- Sara Firner
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Cologne, Germany
| | - Frank Zaucke
- Dr. Rolf M. Schwiete Research Unit for Osteoarthritis, Orthopaedic University Hospital Friedrichsheim gGmbH, Frankfurt, Germany.,Cologne Center for Musculoskeletal Biomechanics (CCMB), Medical Faculty, University of Cologne, Cologne, Germany
| | - Joern Michael
- Department of Orthopaedic and Trauma Surgery, University Hospital Cologne, Cologne, Germany
| | - Jens Dargel
- Department of Orthopaedic and Trauma Surgery, University Hospital Cologne, Cologne, Germany
| | | | - Juliane Heilig
- Cologne Center for Musculoskeletal Biomechanics (CCMB), Medical Faculty, University of Cologne, Cologne, Germany
| | | | - Peer Eysel
- Department of Orthopaedic and Trauma Surgery, University Hospital Cologne, Cologne, Germany.,Cologne Center for Musculoskeletal Biomechanics (CCMB), Medical Faculty, University of Cologne, Cologne, Germany
| | - Gert-Peter Brüggemann
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Cologne, Germany.,Cologne Center for Musculoskeletal Biomechanics (CCMB), Medical Faculty, University of Cologne, Cologne, Germany
| | - Anja Niehoff
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Cologne, Germany.,Cologne Center for Musculoskeletal Biomechanics (CCMB), Medical Faculty, University of Cologne, Cologne, Germany
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27
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Liukkonen MK, Mononen ME, Klets O, Arokoski JP, Saarakkala S, Korhonen RK. Simulation of Subject-Specific Progression of Knee Osteoarthritis and Comparison to Experimental Follow-up Data: Data from the Osteoarthritis Initiative. Sci Rep 2017; 7:9177. [PMID: 28835668 PMCID: PMC5569023 DOI: 10.1038/s41598-017-09013-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 07/21/2017] [Indexed: 01/05/2023] Open
Abstract
Economic costs of osteoarthritis (OA) are considerable. However, there are no clinical tools to predict the progression of OA or guide patients to a correct treatment for preventing OA. We tested the ability of our cartilage degeneration algorithm to predict the subject-specific development of OA and separate groups with different OA levels. The algorithm was able to predict OA progression similarly with the experimental follow-up data and separate subjects with radiographical OA (Kellgren-Lawrence (KL) grade 2 and 3) from healthy subjects (KL0). Maximum degeneration and degenerated volumes within cartilage were significantly higher (p < 0.05) in OA compared to healthy subjects, KL3 group showing the highest degeneration values. Presented algorithm shows a great potential to predict subject-specific progression of knee OA and has a clinical potential by simulating the effect of interventions on the progression of OA, thus helping decision making in an attempt to delay or prevent further OA symptoms.
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Affiliation(s)
- Mimmi K Liukkonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.
| | - Mika E Mononen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.
| | - Olesya Klets
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
- Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Jari P Arokoski
- Department of Physical and Rehabilitation Medicine, Helsinki University Hospital, Helsinki, Finland
- University of Helsinki, Helsinki, Finland
| | - Simo Saarakkala
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
- Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Rami K Korhonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
- Diagnostic Imaging Centre, Kuopio University Hospital, Kuopio, Finland
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28
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van Haaften EE, Ito K, van Donkelaar CC. The initial repair response of articular cartilage after mechanically induced damage. J Orthop Res 2017; 35:1265-1273. [PMID: 27500885 DOI: 10.1002/jor.23382] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 08/05/2016] [Indexed: 02/04/2023]
Abstract
The regenerative potential of articular cartilage (AC) defects is limited and depends on defect size, biomechanical conditions, and age. Early events after overloading might be predictive for cartilage degeneration in the long term. Therefore, the present aim is to investigate the temporal response of cartilage to overloading at cell, matrix, and tissue level during the first period after mechanical overloading. In the present study, the effect of high loading (∼8 MPa) at a high rate (∼14 MPa/s) at day 0 during a 9 day period on collagen damage, gene expression, cell death, and biochemical composition in AC was investigated. A model system was developed which enabled culturing osteochondral explants after loading. Proteoglycan content was repeatedly monitored over time using μCT, whereas other evaluations required destructive measurements. Changes in matrix related gene expressions indicated a degenerative response during the first 6 h after loading. After 24 h, this was restored and data suggested an initial repair response. Cell death and microscopic damage increased after 24 h following loading. These degradative changes were not restored within the 9 day culture period, and were accompanied by a slight loss of proteoglycans at the articular surface that extended into the middle zones. The combined findings indicate that high magnitude loading of articular cartilage at a high rate induces an initial damage that later initiates a healing response that can probably not be retained due to loss of cell viability. Consequently, the matrix cannot be restored in the short term. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1265-1273, 2017.
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Affiliation(s)
- Eline E van Haaften
- Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Keita Ito
- Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Corrinus C van Donkelaar
- Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
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29
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Jørgensen AEM, Kjær M, Heinemeier KM. The Effect of Aging and Mechanical Loading on the Metabolism of Articular Cartilage. J Rheumatol 2017; 44:410-417. [PMID: 28250141 DOI: 10.3899/jrheum.160226] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2017] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The morphology of articular cartilage (AC) enables painless movement. Aging and mechanical loading are believed to influence development of osteoarthritis (OA), yet the connection remains unclear. METHODS This narrative review describes the current knowledge regarding this area, with the literature search made on PubMed using appropriate keywords regarding AC, age, and mechanical loading. RESULTS Following skeletal maturation, chondrocyte numbers decline while increasing senescence occurs. Lower cartilage turnover causes diminished maintenance capacity, which produces accumulation of fibrillar crosslinks by advanced glycation end products, resulting in increased stiffness and thereby destruction susceptibility. CONCLUSION Mechanical loading changes proteoglycan content. Moderate mechanical loading causes hypertrophy and reduced mechanical loading causes atrophy. Overloading produces collagen network damage and proteoglycan loss, leading to irreversible cartilage destruction because of lack of regenerative capacity. Catabolic pathways involve inflammation and the transcription factor nuclear factor-κB. Thus, age seems to be a predisposing factor for OA, with mechanical overload being the likely triggering cause.
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Affiliation(s)
- Adam El Mongy Jørgensen
- From the Institute of Sports Medicine, Department of Orthopedic Surgery M, Bispebjerg Hospital, and the Department of Biomedical Sciences, Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. .,A.E. Jørgensen, MD, Institute of Sports Medicine, Department of Orthopedic Surgery M, Bispebjerg Hospital, Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen; M. Kjær, MD, DMSc, Institute of Sports Medicine, Department of Orthopedic Surgery M, Bispebjerg Hospital, Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen; K.M. Heinemeier, MSc, PhD, Institute of Sports Medicine, Department of Orthopedic Surgery M, Bispebjerg Hospital, and Department of Biomedical Sciences, Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen.
| | - Michael Kjær
- From the Institute of Sports Medicine, Department of Orthopedic Surgery M, Bispebjerg Hospital, and the Department of Biomedical Sciences, Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,A.E. Jørgensen, MD, Institute of Sports Medicine, Department of Orthopedic Surgery M, Bispebjerg Hospital, Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen; M. Kjær, MD, DMSc, Institute of Sports Medicine, Department of Orthopedic Surgery M, Bispebjerg Hospital, Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen; K.M. Heinemeier, MSc, PhD, Institute of Sports Medicine, Department of Orthopedic Surgery M, Bispebjerg Hospital, and Department of Biomedical Sciences, Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Katja Maria Heinemeier
- From the Institute of Sports Medicine, Department of Orthopedic Surgery M, Bispebjerg Hospital, and the Department of Biomedical Sciences, Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,A.E. Jørgensen, MD, Institute of Sports Medicine, Department of Orthopedic Surgery M, Bispebjerg Hospital, Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen; M. Kjær, MD, DMSc, Institute of Sports Medicine, Department of Orthopedic Surgery M, Bispebjerg Hospital, Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen; K.M. Heinemeier, MSc, PhD, Institute of Sports Medicine, Department of Orthopedic Surgery M, Bispebjerg Hospital, and Department of Biomedical Sciences, Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen
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30
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Ultrasound palpation for fast in-situ quantification of articular cartilage stiffness, thickness and relaxation capacity. Biomech Model Mechanobiol 2017; 16:1171-1185. [PMID: 28210824 DOI: 10.1007/s10237-017-0880-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 01/24/2017] [Indexed: 12/13/2022]
Abstract
Most current cartilage testing devices require the preparation of excised samples and therefore do not allow intra-operative application for diagnostic purposes. The gold standard during open or arthroscopic surgery is still the subjective perception of manual palpation. This work presents a new diagnostic method of ultrasound palpation (USP) to acquire applied stress and strain data during manual palpation of articular cartilage. With the proposed method, we obtain cartilage thickness and stiffness. Moreover, repeated palpations allow the quantification of relaxation effects. USP measurements on elastomer phantoms demonstrated very good repeatability for both, stage-guided (97.2%) and handheld (96.0%) applications. The USP measurements were compared with conventional indentation experiments and revealed very good agreement on elastomer phantoms ([Formula: see text]) and good agreement on porcine cartilage samples ([Formula: see text]). Artificially degenerated cartilage samples showed reduced stiffness, weak capacity to relax after palpation and an increase of stiffness of approximately 50% with each single palpation. Intact cartilage was measured by USP directly at the patella (in situ) and after excision and removal of the subchondral bone (ex situ), leading to stiffness values of [Formula: see text] and [Formula: see text] ([Formula: see text]), respectively. The results demonstrate the potential of the USP system for cartilage testing, its sensitivity to degenerative changes and as a method for quantifying relaxation processes by means of repeated palpations. Furthermore, the differences in the results of in-situ and ex-situ measurements are of general interest, since such comparison has not been reported previously. We point out the limited comparability of ex-situ cartilage with its in-situ biomechanical behavior.
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31
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32
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Nims RJ, Durney KM, Cigan AD, Dusséaux A, Hung CT, Ateshian GA. Continuum theory of fibrous tissue damage mechanics using bond kinetics: application to cartilage tissue engineering. Interface Focus 2016; 6:20150063. [PMID: 26855751 DOI: 10.1098/rsfs.2015.0063] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
This study presents a damage mechanics framework that employs observable state variables to describe damage in isotropic or anisotropic fibrous tissues. In this mixture theory framework, damage is tracked by the mass fraction of bonds that have broken. Anisotropic damage is subsumed in the assumption that multiple bond species may coexist in a material, each having its own damage behaviour. This approach recovers the classical damage mechanics formulation for isotropic materials, but does not appeal to a tensorial damage measure for anisotropic materials. In contrast with the classical approach, the use of observable state variables for damage allows direct comparison of model predictions to experimental damage measures, such as biochemical assays or Raman spectroscopy. Investigations of damage in discrete fibre distributions demonstrate that the resilience to damage increases with the number of fibre bundles; idealizing fibrous tissues using continuous fibre distribution models precludes the modelling of damage. This damage framework was used to test and validate the hypothesis that growth of cartilage constructs can lead to damage of the synthesized collagen matrix due to excessive swelling caused by synthesized glycosaminoglycans. Therefore, alternative strategies must be implemented in tissue engineering studies to prevent collagen damage during the growth process.
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Affiliation(s)
- Robert J Nims
- Department of Biomedical Engineering , Columbia University , 500 West 120th Street, MC4703, New York, NY 10027 , USA
| | - Krista M Durney
- Department of Biomedical Engineering , Columbia University , 500 West 120th Street, MC4703, New York, NY 10027 , USA
| | - Alexander D Cigan
- Department of Biomedical Engineering , Columbia University , 500 West 120th Street, MC4703, New York, NY 10027 , USA
| | - Antoine Dusséaux
- Department of Mechanical Engineering , Columbia University , 500 West 120th Street, MC4703, New York, NY 10027 , USA
| | - Clark T Hung
- Department of Biomedical Engineering , Columbia University , 500 West 120th Street, MC4703, New York, NY 10027 , USA
| | - Gerard A Ateshian
- Department of Biomedical Engineering, Columbia University, 500 West 120th Street, MC4703, New York, NY 10027, USA; Department of Mechanical Engineering, Columbia University, 500 West 120th Street, MC4703, New York, NY 10027, USA
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Spiesz EM, Thorpe CT, Chaudhry S, Riley GP, Birch HL, Clegg PD, Screen HR. Tendon extracellular matrix damage, degradation and inflammation in response to in vitro overload exercise. J Orthop Res 2015; 33:889-97. [PMID: 25721513 PMCID: PMC4855636 DOI: 10.1002/jor.22879] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Accepted: 02/13/2015] [Indexed: 02/04/2023]
Abstract
The role of inflammation in tendon injury is uncertain and a topic of current interest. In vitro studies of tendon accelerated overload damage can serve as a valuable source of information on the early stages of tendinopathy. Viable fascicle bundles from bovine flexor tendons were subjected to cyclic uniaxial loading from 1-10% strain. Immuno-staining for inflammatory markers and matrix degradation markers was performed on the samples after mechanical testing. Loaded samples exhibited visible extracellular matrix damage, with disrupted collagen fibers and fiber kinks, and notable damage to the interfascicular matrix. Inflammatory markers COX-2 and IL-6 were only expressed in the cyclically loaded samples. Collagen degradation markers MMP-1 and C1,2C were colocalized in many areas, with staining occurring in the interfascicular matrix or the fascicular tenocytes. These markers were present in control samples, but staining became increasingly intense with loading. Little MMP-3 or MMP-13 was evident in control sections. In loaded samples, some sections showed intense staining of these markers, again localized to interfascicular regions. This study suggests that inflammatory markers may be expressed rapidly after tendon overload exercise. Interestingly, both inflammation and damage-induced matrix remodeling seem to be concentrated in, or in the vicinity of, the highly cellular interfascicular matrix.
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Affiliation(s)
- Ewa M. Spiesz
- School of Engineering and Materials Science; Queen Mary University of London; London United Kingdom
| | - Chavaunne T. Thorpe
- School of Engineering and Materials Science; Queen Mary University of London; London United Kingdom
| | - Saira Chaudhry
- School of Engineering and Materials Science; Queen Mary University of London; London United Kingdom
| | - Graham P. Riley
- School of Biological Sciences; University of East Anglia; Norwich United Kingdom
| | - Helen L. Birch
- Institute of Orthopaedics and Musculoskeletal Science; University College London; London United Kingdom
| | - Peter D. Clegg
- Department of Musculoskeletal Biology; University of Liverpool; Liverpool United Kingdom
| | - Hazel R.C. Screen
- School of Engineering and Materials Science; Queen Mary University of London; London United Kingdom
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Moyer RF, Ratneswaran A, Beier F, Birmingham TB. Osteoarthritis year in review 2014: mechanics--basic and clinical studies in osteoarthritis. Osteoarthritis Cartilage 2014; 22:1989-2002. [PMID: 25456294 DOI: 10.1016/j.joca.2014.06.034] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 06/18/2014] [Accepted: 06/25/2014] [Indexed: 02/02/2023]
Abstract
The purpose of this review was to highlight recent research in mechanics and osteoarthritis (OA) by summarizing results from selected studies spanning basic and clinical research methods. Databases were searched from January 2013 through to March 2014. Working in pairs, reviewers selected 67 studies categorized into four themes--mechanobiology, ambulatory mechanics, biomechanical interventions and mechanical risk factors. Novel developments in mechanobiology included the identification of cell signaling pathways that mediated cellular responses to loading of articular cartilage. Studies in ambulatory mechanics included an increased focus on instrumented knee implants and progress in computational models, both emphasizing the importance of muscular contributions to load. Several proposed biomechanical interventions (e.g., shoe insoles and knee braces) produced variable changes in external knee joint moments during walking, while meta-analysis of randomized clinical trials did not support the use of lateral wedge insoles for decreasing pain. Results from high quality randomized trials suggested diet with or without exercise decreased indicators of knee joint load during walking, whereas similar effects from exercise alone were not detected with the measures used. Data from longitudinal cohorts suggested mechanical alignment was a risk factor for incidence and progression of OA, with the mechanism involving damage to the meniscus. In combination, the basic and clinical studies highlight the importance of considering multiple contributors to joint loading that can evoke both protective and damaging responses. Although challenges clearly exist, future studies should strive to integrate basic and clinical research methods to gain a greater understanding of the interactions among mechanical factors in OA and to develop improved preventive and therapeutic strategies.
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Affiliation(s)
- R F Moyer
- School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, ON, Canada
| | - A Ratneswaran
- Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - F Beier
- Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - T B Birmingham
- School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, ON, Canada.
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Impact of hip anatomical variations on the cartilage stress: a finite element analysis towards the biomechanical exploration of the factors that may explain primary hip arthritis in morphologically normal subjects. Clin Biomech (Bristol, Avon) 2014; 29:444-50. [PMID: 24530154 DOI: 10.1016/j.clinbiomech.2014.01.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 01/09/2014] [Accepted: 01/09/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND Hip arthritis is a pathology linked to hip-cartilage degeneration. Although the etiology of this disease is not well defined, it is known that age is a determinant risk factor. However, hip arthritis in young patients could be largely promoted by biomechanical factors. The objective of this paper is to analyze the impact of some normal anatomical variations on the cartilage stress distributions numerically predicted at the hip joint during walking. METHODS A three-dimensional finite element model of the femur and the pelvis with the most relevant axial components of muscle forces was used to simulate normal walking activity. The hip anatomical condition was defined by: neck shaft angle, femoral anteversion angle, and acetabular anteversion angle with a range of 110-130°, 0-20°, and 0-20°, respectively. The direct boundary method was used to simulate the hip contact. FINDINGS The hydrostatic stress found at the cartilage and labrum showed that a ±10° variation with respect to the reference brings significant differences between the anatomic models. Acetabular anteversion angle of 0° and femoral anteversion angle of 0° were the most affected anatomical conditions with values of hydrostatic stress in the cartilage near 5MPa under compression. INTERPRETATION Cartilage stresses and contact areas were equivalent to the results found in literature and the most critical anatomical regions in terms of tissue loads were in a good accordance with clinical evidence. Altogether, results showed that decreasing femoral or acetabular anteversion angles isolatedly causes a dramatic increase in cartilage loads.
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Iijima H, Aoyama T, Ito A, Tajino J, Nagai M, Zhang X, Yamaguchi S, Akiyama H, Kuroki H. Immature articular cartilage and subchondral bone covered by menisci are potentially susceptive to mechanical load. BMC Musculoskelet Disord 2014; 15:101. [PMID: 24669849 PMCID: PMC3973825 DOI: 10.1186/1471-2474-15-101] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Accepted: 03/20/2014] [Indexed: 11/30/2022] Open
Abstract
Background The differences of mechanical and histological properties between cartilage covered by menisci and uncovered by menisci may contribute to the osteoarthritis after meniscectomy and these differences are not fully understood. The purpose of this study is to investigate potential differences in the mechanical and histological properties, and in particular the collagen architecture, of the superficial cartilage layer and subchondral bone between regions covered and uncovered by menisci using immature knee. Methods Osteochondral plugs were obtained from porcine tibial cartilage that was either covered or uncovered by menisci. Investigation of the thickness, mechanical properties, histology, and water content of the cartilage as well as micro-computed tomography analysis of the subchondral bone was performed to compare these regions. Collagen architecture was also assessed by using scanning electron microscopy. Results Compared to the cartilage uncovered by menisci, that covered by menisci was thinner and showed a higher deformity to compression loading and higher water content. In the superficial layer of cartilage in the uncovered regions, collagen fibers showed high density, whereas they showed low density in covered regions. Furthermore, subchondral bone architecture varied between the 2 regions, and showed low bone density in covered regions. Conclusions Cartilage covered by menisci differed from that uncovered in both its mechanical and histological properties, especially with regards to the density of the superficial collagen layer. These regional differences may be related to local mechanical environment in normal condition and indicate that cartilage covered by menisci is tightly guarded by menisci from extreme mechanical loading. Our results indicate that immature cartilage degeneration and subchondral microfracture may occur easily to extreme direct mechanical loading in covered region after meniscectomy.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Hiroshi Kuroki
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
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Shimomura K, Moriguchi Y, Ando W, Nansai R, Fujie H, Hart DA, Gobbi A, Kita K, Horibe S, Shino K, Yoshikawa H, Nakamura N. Osteochondral repair using a scaffold-free tissue-engineered construct derived from synovial mesenchymal stem cells and a hydroxyapatite-based artificial bone. Tissue Eng Part A 2014; 20:2291-304. [PMID: 24655056 DOI: 10.1089/ten.tea.2013.0414] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
For an ideal osteochondral repair, it is important to facilitate zonal restoration of the subchondral bone and the cartilage, layer by layer. Specifically, restoration of the osteochondral junction and secure integration with adjacent cartilage could be considered key factors. The purpose of the present study was to investigate the feasibility of a combined material comprising a scaffold-free tissue-engineered construct (TEC) derived from synovial mesenchymal stem cells (MSCs) and a hydroxyapatite (HA) artificial bone using a rabbit osteochondral defect model. Osteochondral defects were created on the femoral groove of skeletally mature rabbits. The TEC and HA artificial bone were hybridized to develop a combined implant just before use, which was then implanted into defects (N=23). In the control group, HA alone was implanted (N=18). Histological evaluation and micro-indentation testing was performed for the evaluation of repair tissue. Normal knees were used as an additional control group for biomechanical testing (N=5). At hybridization, the TEC rapidly attached onto the surface of HA artificial bone block, which was implantable to osteochondral defects. Osteochondral defects treated with the combined implants exhibited more rapid subchondral bone repair coupled with the development of cartilaginous tissue with good tissue integration to the adjacent host cartilage when assessed at 6 months post implantation. Conversely, the control group exhibited delayed subchondral bone repair. In addition, the repair cartilaginous tissue in this group had poor integration to adjacent cartilage and contained clustered chondrocytes, suggesting an early osteoarthritis (OA)-like degenerative change at 6 months post implantation. Biomechanically, the osteochondral repair tissue treated with the combined implants at 6 months restored tissue stiffness, similar to normal osteochondral tissue. The combined implants significantly accelerated and improved osteochondral repair. Specifically, earlier restoration of subchondral bone, as well as good tissue integration of repair cartilage to adjacent host tissue could be clinically relevant in terms of the acceleration of postoperative rehabilitation and longer-term durability of repaired articular surface in patients with osteochondral lesions, including those with OA. In addition, the combined implant could be considered a promising MSC-based bio-implant with regard to safety and cost-effectiveness, considering that the TEC is a scaffold-free implant and HA artificial bone has been widely used in clinical practice.
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Affiliation(s)
- Kazunori Shimomura
- 1 Department of Orthopaedics, Osaka University Graduate School of Medicine , Suita, Osaka, Japan
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Hosseini SM, Wilson W, Ito K, van Donkelaar CC. A numerical model to study mechanically induced initiation and progression of damage in articular cartilage. Osteoarthritis Cartilage 2014; 22:95-103. [PMID: 24185112 DOI: 10.1016/j.joca.2013.10.010] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 09/29/2013] [Accepted: 10/23/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Proteoglycan (PG) loss and surface roughening, early signs of osteoarthritis (OA), are likely preceded by softening of the ground substance and the collagen network. Insight in their relative importance to progression of OA may assist the development of treatment strategies for early OA. To support interpretation of experimental data, a numerical model is proposed that can predict damage progression in cartilage over time, as a consequence of excessive mechanical loading. The objective is to assess the interaction between ground substance softening and collagen fiber damage using this model. DESIGN An established cartilage mechanics model is extended with the assumption that excessive strains may damage the ground substance or the collagen network, resulting in softening of the overstrained constituent. During subsequent loading cycles the strain may or may not cross a threshold, resulting in damage to stabilize or to progress. To evaluate how softening of the ground substance and collagen may interact, damage progression is computed when either one of them, or both together are allowed to occur during stepwise increased loading. RESULTS Softening in the ground substance was predicted to localize in the superficial and transitional zone and resulted in cartilage softening. Collagen damage was most prominent in the superficial zone, with more diffuse damage penetrating deeper into the tissue, resulting in adverse strain gradients. Effects were more pronounced if both constituents developed damage in parallel. CONCLUSION Ground substance softening and collagen damage have distinct effects on cartilage mechanopathology, and damage in either one of them may promote each other.
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Affiliation(s)
- S M Hosseini
- Department of Biomedical Engineering, Gem-Z 4.101, Eindhoven University of Technology, PO Box 513, 5600 MB Eindhoven, The Netherlands.
| | - W Wilson
- Department of Biomedical Engineering, Gem-Z 4.101, Eindhoven University of Technology, PO Box 513, 5600 MB Eindhoven, The Netherlands.
| | - K Ito
- Department of Biomedical Engineering, Gem-Z 4.101, Eindhoven University of Technology, PO Box 513, 5600 MB Eindhoven, The Netherlands.
| | - C C van Donkelaar
- Department of Biomedical Engineering, Gem-Z 4.101, Eindhoven University of Technology, PO Box 513, 5600 MB Eindhoven, The Netherlands.
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