A drop tower for controlled impact testing of biological tissues

Mechanobiochemical finite element model to analyze impact-loading-induced cell damage, subsequent proteoglycan loss, and anti-oxidative treatment effects in articular cartilage

Joint trauma often leads to articular cartilage degeneration and post-traumatic osteoarthritis (PTOA). Pivotal determinants include trauma-induced excessive tissue strains that damage cartilage cells. As a downstream effect, these damaged cells can trigger cartilage degeneration via oxidative stress, cell death, and proteolytic tissue degeneration. N-acetylcysteine (NAC) has emerged as an antioxidant capable of inhibiting oxidative stress, cell death, and cartilage degeneration post-impact. However, the temporal effects of NAC are not fully understood and remain difficult to assess solely by physical experiments. Thus, we developed a computational finite element analysis framework to simulate a drop-tower impact of cartilage in Abaqus, and subsequent oxidative stress-related cell damage, and NAC treatment upon cartilage proteoglycan content in Comsol Multiphysics, based on prior ex vivo experiments. Model results provide evidence that immediate NAC treatment can reduce proteoglycan loss by mitigating oxidative stress, cell death (improved proteoglycan biosynthesis), and enzymatic proteoglycan depletion. Our simulations also indicate that delayed NAC treatment may not inhibit cartilage proteoglycan loss despite reduced cell death after impact. These results enhance understanding of the temporal effects of impact-related cell damage and treatment that are critical for the development of effective treatments for PTOA. In the future, our modeling framework could increase understanding of time-dependent mechanisms of oxidative stress and downstream effects in injured cartilage and aid in developing better treatments to mitigate PTOA progression.

Comparison of two contrast-enhancing staining agents for use in X-ray imaging and digital volume correlation measurements across the cartilage-bone interface

OBJECTIVE

The pathogenesis of osteoarthritis (OA) is associated with subchondral bone changes, which is linked to abnormal strain distribution in the overlying articular cartilage. This highlights the importance of understanding mechanical interaction at the cartilage-bone interface. The aim of this study is to compare solutions of two contrast-enhancing staining agents (CESA) for combining high-resolution Contrast-Enhanced X-ray microfocus Computed Tomography (CECT) with Digital Volume Correlation (DVC) for full-field strain measurements at the cartilage-bone interface.

DESIGN

Bovine osteochondral plugs were stained with phosphotungstic acid (PTA) in 70% ethanol or 1:2 hafnium-substituted Wells-Dawson polyoxometalate (Hf-WD POM) in PBS. Mechanical properties were assessed using micromechanical probing and nanoindentation. Strain uncertainties (from CECT data) were evaluated following two consecutive unloaded scans. Residual strains were computed following unconfined compression (ex situ) testing.

RESULTS

PTA and Hf-WD POM enabled the visualisation of structural features in cartilage, allowing DVC computation on the CECT data. Residual strains up to ∼10,000 μɛ were detected up to the tidemark. Nanoindentation showed that PTA-staining caused an average ∼6-fold increase in articular cartilage stiffness, a ∼19-fold increase in reduced modulus and ∼7-fold increase in hardness, whereas Hf-WD POM-stained specimens had mechanical properties similar to pre-stain tissue. Micromechanical probing showed a 77% increase in cartilage surface stiffness after PTA-staining, in comparison to a 16% increase in stiffness after staining with Hf-WD POM.

CONCLUSION

Hf-WD POM is a more suitable CESA solution compared to PTA for CECT imaging combined with DVC as it allowed visualisation of structural features in the cartilage tissue whilst more closely maintaining tissue mechanical properties.

Identifying small molecules for protecting chondrocyte function and matrix integrity after controlled compressive injury

Objective

Articular cartilage injury is central for the development of post-traumatic osteoarthritis (PTOA). With few disease-modifying therapies successful at offsetting progressive osteoarthritis (OA), our goal is to use a high throughput screening platform of cartilage injury to identify novel chondroprotective compounds. Targeting articular cartilage damage immediately after injury remains a promising therapeutic strategy to overcome irreversible tissue damage.

Method

We constructed a single impact-cartilage screening method using a multi-platen system that simultaneously impacts 48 samples and makes use of engineered cartilage tissue analogs (known as CTAs). Drug libraries were screened and assessed for their ability to alter two crucial biological responses to impact injuries, namely matrix degradation and cell stress.

Results

Over 500 small molecules were screened for their ability to alter proteoglycan loss, matrix metalloproteinase activity, and cell stress or death. Fifty-five compounds passed through secondary screening and were from commercial libraries of natural and redox, stem cell related compounds, as well as protease, kinase and phosphatase inhibitors. Through secondary screening, 16 promising candidates exhibited activity on one or more critical function of chondrocytes. While many are mechanistically known compounds, their function in joint diseases is not known.

Conclusion

This platform was validated for screening drug activity against a tissue engineered model of PTOA. Multiple compounds identified in this manner have potential application as early protective therapy for treating PTOA, and require further study. We propose this screening platform can identify novel molecules that act on early chondrocyte responses to injury and provide an invaluable tool for therapeutic development.

A Single Axial Impact Load Causes Articular Damage That Is Not Visible with Micro-Computed Tomography: An Ex Vivo Study on Caprine Tibiotalar Joints

OBJECTIVE

Excessive articular loading, for example, an ankle sprain, may result in focal osteochondral damage, initiating a vicious degenerative process resulting in posttraumatic osteoarthritis (PTOA). Better understanding of this degenerative process would allow improving posttraumatic care with the aim to prevent PTOA. The primary objective of this study was to establish a drop-weight impact testing model with controllable, reproducible and quantitative axial impact loads to induce osteochondral damage in caprine tibiotalar joints. We aimed to induce osteochondral damage on microscale level of the tibiotalar joint without gross intra-articular fractures of the tibial plafond.

DESIGN

Fresh-frozen tibiotalar joints of mature goats were used as ex vivo articulating joint models. Specimens were axially impacted by a mass of 10.5 kg dropped from a height of 0.3 m, resulting in a speed of 2.4 m/s, an impact energy of 31.1 J and an impact impulse of 25.6 N·s. Potential osteochondral damage of the caprine tibiotalar joints was assessed using contrast-enhanced high-resolution micro-computed tomography (micro-CT). Subsequently, we performed quasi-static loading experiments to determine postimpact mechanical behavior of the tibiotalar joints.

RESULTS

Single axial impact loads with a mass of 15.5 kg dropped from 0.3 m, resulted in intra-articular fractures of the tibial plafond, where a mass of 10.55 kg dropped from 0.3 m did not result in any macroscopic damage. In addition, contrast-enhanced high-resolution micro-CT imaging neither reveal any acute microdamage (i.e., microcracks) of the subchondral bone nor any (micro)structural changes in articular cartilage. The Hexabrix content or voxel density (i.e., proteoglycan content of the articular cartilage) on micro-CT did not show any differences between intact and impacted specimens. However, quasi-static whole-tibiotalar-joint loading showed an altered biomechanical behavior after application of a single axial impact (i.e., increased hysteresis when compared with the intact or nonimpacted specimens).

CONCLUSIONS

Single axial impact loads did not induce osteochondral damage visible with high-resolution contrast-enhanced micro-CT. However, despite the lack of damage on macro- and even microscale, the single axial impact loads resulted in "invisible injuries" because of the observed changes in the whole-joint biomechanics of the caprine tibiotalar joints. Future research must focus on diagnostic tools for the detection of early changes in articular cartilage after a traumatic impact (i.e., ankle sprains or ankle fractures), as it is well known that this could result in PTOA.

Impact-induced cartilage damage assessed using polarisation-sensitive optical coherence tomography

Non-invasive determination of structural changes in articular cartilage immediately after impact and rehydration provides insight into the response and recovery of the soft tissue, as well as provides a potential methodology for clinicians to quantify early degenerative changes. In this study, we use polarisation-sensitive optical coherence tomography (PS-OCT) to examine subtle alterations of the optical properties in healthy and early-stage degenerate articular cartilage immediately after impact loading to identify structurally relevant metrics required for understanding the mechanical factors of osteoarthritic initiation and progression. A custom-designed impact testing rig was used to deliver 0.9 J and 1.4 J impact energies to bovine articular cartilage. A total of 52 (n=26 healthy, n=26 mildly degenerate) cartilage-on-bone samples were imaged before, immediately after, and 3 h after impact. PS-OCT images were analyzed to assess changes relating to surface irregularity, optical attenuation, and birefringence. Mildly degenerate cartilage exhibits a significant change in birefringence following 1.4 J impact energies compared to healthy samples which is believed to be attributable to degenerate cartilage being unable to fully utilise the fluid phase to distribute and dampen the energy. After rehydration, the polarisation-sensitive images appear to 'optically-recover' reducing the reliability of birefringence as an absolute metric. Surface irregularity and optical attenuation encode diagnostically relevant information and may serve as markers to predict the mechanical response of articular cartilage. PS-OCT with its ability to non-invasively image the sub-surface microstructural abnormalities of cartilage presents as an ideal modality for cartilage degeneration assessment and identification of mechanically vulnerable tissue.

Design and Fabrication of a Drop Tower Testing Apparatus to Investigate the Impact Behavior of Spinal Motion Segments

Background

The vertebral column is the second most common fracture site in individuals with high-grade osteoporosis (30-50%). Most of these fractures are caused by falls. This information reveals the importance of considering impact loading conditions of spinal motion segments, while no commercial apparatus is available for this purpose. Therefore, the goal was set to fabricate an impact testing device for the measurement of impact behavior of the biological tissues.

Methods

In the present study, first, a drop-weight impact testing apparatus was designed and fabricated to record both force and displacement at a sample rate of 100 kHz. A load cell was placed under the sample, and an accelerometer was located on the impactor. Previous devices have mostly measured the force and not the deformation. Thereafter, the effect of high axial compression load was investigated on a biological sample, i.e., the lumbar motion segment, was investigated. To this end, nine ovine segments subjected to vertical impact load were examined using the fabricated device, and the mechanical properties of the lumbar segments were extracted and later compared with quasi-static loading results.

Results

The results indicated that the specimen stiffness and failure energy in impact loading were higher than those in the quasi-static loading. In terms of the damage site, fracture mainly occurred in the body of the vertebra during impact loading; although, during quasi-static loading, the fracture took place in the endplates.

Conclusion

The present study introduces an inexpensive drop-test device capable of recording both the force and the deformation of the biological specimens when subjected to high-speed impacts. The mechanical properties of the spinal segments have also been extracted and compared with quasi-static loading results.

Effects of in vivo fatigue-induced subchondral bone microdamage on the mechanical response of cartilage-bone under a single impact compression

Subchondral bone (SCB) microdamage is prevalent in the joints of human athletes and animals subjected to high rate and magnitude cyclic loading of the articular surface. Quantifying the effect of such focal in vivo fatigue-induced microdamage on the mechanical response of the tissue is critical for the understanding of joint surface injury and the development of osteoarthritis. Thus, we aimed to quantify the mechanical properties of cartilage-bone from equine third metacarpal (MC3) condyles, which is a common area of accumulated microdamage due to repetitive impact loading. We chose a non-destructive technique, i.e. high-resolution microcomputed tomography (µCT) imaging, to identify various degrees of in vivo microdamage in SCB prior to mechanical testing; because µCT imaging can only identify a proportion of accumulated microdamage, we aimed to identify racing and training history variables that provide additional information on the prior loading history of the samples. We then performed unconfined high-rate compression of approximately 2% strain at 45%/s strain rate to simulate a cycle of gallop and used real-time strain measurements using digital image correlation (DIC) techniques to find the stiffness and shock absorbing ability (relative energy loss) of the cartilage-bone unit, and those associated with cartilage and SCB. Results indicated that stiffness of cartilage-bone and those associated with the SCB decreased with increasing grade of damage. Whole specimen stiffness also increased, and relative energy loss decreased with higher TMD, whereas bone volume fraction of the SCB was only associated negatively with the stiffness of the bone. Overall, the degree of subchondral bone damage observed with µCT was the main predictor of stiffness and relative energy loss of the articular surface of the third metacarpal bone of Thoroughbred racehorses under impact loading.

Biomechanics of osteochondral impact with cushioning and graft Insertion: Cartilage damage is correlated with delivered energy

Articular cartilage is susceptible to impact injury. Impact may occur during events ranging from trauma to surgical insertion of an OsteoChondral Graft (OCG) into an OsteoChondral Recipient site (OCR). To evaluate energy density as a mediator of cartilage damage, a specialized drop tower apparatus was used to impact adult bovine samples while measuring contact force, cartilage surface displacement, and OCG advancement. When a single impact was applied to an isolated (non-inserted) OCG, force and surface displacement each rose monotonically and then declined. In each of five sequential impacts of increasing magnitude, applied to insert an OCG into an OCR, force rose rapidly to an initial peak, with minimal OCG advancement, and then to a second prolonged peak, with distinctive oscillations. Energy delivered to cartilage was confirmed to be higher with larger drop height and mass, and found to be lower with an interposed cushion or OCG insertion into an OCR. For both single and multiple impacts, the total energy density delivered to the articular cartilage correlated to damage, quantified as total crack length. The corresponding fracture toughness of the articular cartilage was 12.0 mJ/mm². Thus, the biomechanics of OCG insertion exhibits distinctive features compared to OCG impact without insertion, with energy delivery to the articular cartilage being a factor highly correlated with damage.

Cavitation nucleation in gelatin: Experiment and mechanism

Dynamic cavitation in soft materials is becoming increasingly relevant due to emerging medical implications such as the potential of cavitation-induced brain injury or cavitation created by therapeutic medical devices. However, the current understanding of dynamic cavitation in soft materials is still very limited, mainly due to lack of robust experimental techniques. To experimentally characterize cavitation nucleation under dynamic loading, we utilize a recently developed experimental instrument, the integrated drop tower system. This technique allows quantitative measurements of the critical acceleration (a_cr) that corresponds to cavitation nucleation while concurrently visualizing time evolution of cavitation. Our experimental results reveal that a_cr increases with increasing concentration of gelatin in pure water. Interestingly, we have observed the distinctive transition from a sharp increase (pure water to 1% gelatin) to a much slower rate of increase (∼10× slower) between 1% and 7.5% gelatin. Theoretical cavitation criterion predicts the general trend of increasing a_cr, but fails to explain the transition rates. As a likely mechanism, we consider concentration-dependent material properties and non-spherical cavitation nucleation sites, represented by pre-existing bubbles in gels, due to possible interplay between gelatin molecules and nucleation sites. This analysis shows that cavitation nucleation is very sensitive to the initial configuration of a bubble, i.e., a non-spherical bubble can significantly increase a_cr. This conclusion matches well with the experimentally observed liquid-to-gel transition in the critical acceleration for cavitation nucleation.

STATEMENT OF SIGNIFICANCE

From a medical standpoint, understanding dynamic cavitation within soft materials, i.e., tissues, is important as there are both potential injury implications (blast-induced cavitation within the brain) as well as treatments utilizing the phenomena (lithotripsy). In this regard, the main results of the present work are (1) quantitative characterization of cavitation nucleation in gelatin samples as a function of gel concentration utilizing well-controlled mechanical impacts and (2) mechanistic understanding of complex coupling between cavitation and liquid-/solid-like material properties of gel. The new capabilities of testing soft gels, which can be tuned to mimic material properties of target organs, at high loading rate conditions and accurately predicting their cavitation behavior are an important step towards developing reliable cavitation criteria in the scope of their biomedical applications.

Characterization and detection of acceleration-induced cavitation in soft materials using a drop-tower-based integrated system

The material response of biologically relevant soft materials, e.g., extracellular matrix or cell cytoplasm, at high rate loading conditions is becoming increasingly important for emerging medical implications including the potential of cavitation-induced brain injury or cavitation created by medical devices, whether intentional or not. However, accurately probing soft samples remains challenging due to their delicate nature, which often excludes the use of conventional techniques requiring direct contact with a sample-loading frame. We present a drop-tower-based method, integrated with a unique sample holder and a series of effective springs and dampers, for testing soft samples with an emphasis on high-rate loading conditions. Our theoretical studies on the transient dynamics of the system show that well-controlled impacts between a movable mass and sample holder can be used as a means to rapidly load soft samples. For demonstrating the integrated system, we experimentally quantify the critical acceleration that corresponds to the onset of cavitation nucleation for pure water and 7.5% gelatin samples. This study reveals that 7.5% gelatin has a significantly higher, approximately double, critical acceleration as compared to pure water. Finally, we have also demonstrated a non-optical method of detecting cavitation in soft materials by correlating cavitation collapse with structural resonance of the sample container.

Genipin crosslinking decreases the mechanical wear and biochemical degradation of impacted cartilage in vitro

High energy trauma to cartilage causes surface fissures and microstructural damage, but the degree to which this damage renders the tissue more susceptible to wear and contributes to the progression of post-traumatic osteoarthritis (PTOA) is unknown. Additionally, no treatments are currently available to strengthen cartilage after joint trauma and to protect the tissue from subsequent degradation and wear. The purposes of this study were to investigate the role of mechanical damage in the degradation and wear of cartilage, to evaluate the effects of impact and subsequent genipin crosslinking on the changes in the viscoelastic parameters of articular cartilage, and to test the hypothesis that genipin crosslinking is an effective treatment to enhance the resistance to biochemical degradation and mechanical wear. Results demonstrate that cartilage stiffness decreases after impact loading, likely due to the formation of fissures and microarchitectural damage, and is partially or fully restored by crosslinking. The wear resistance of impacted articular cartilage was diminished compared to undamaged cartilage, suggesting that mechanical damage that is directly induced by the impact may contribute to the progression of PTOA. However, the decrease in wear resistance was completely reversed by the crosslinking treatments. Additionally, the crosslinking treatments improved the resistance to collagenase digestion at the impact-damaged articular surface. These results highlight the potential therapeutic value of collagen crosslinking via genipin in the prevention of cartilage degeneration after traumatic injury. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:558-565, 2017.

The role of subcutaneous tissue stiffness on microneedle performance in a representative in vitro model of skin

There has been growing interest in the mechanical behaviour of skin due to the rapid development of microneedle devices for drug delivery applications into skin. However, most in vitro experimentation studies that are used to evaluate microneedle performance do not consider the biomechanical properties of skin or that of the subcutaneous layers. In this study, a representative experimental model of skin was developed which was comprised of subcutaneous and muscle mimics. Neonatal porcine skin from the abdominal and back regions was used, with gelatine gels of differing water content (67, 80, 88 and 96%) to represent the subcutaneous tissue, and a type of ballistic gelatine, Perma-Gel®, as a muscle mimic. Dynamic nanoindentation was used to characterize the mechanical properties of each of these layers. A custom-developed impact test rig was used to apply dense polymethylmethacrylate (PMMA) microneedles to the skin models in a controlled and repeatable way with quantification of the insertion force and velocity. Image analysis methods were used to measure penetration depth and area of the breach caused by microneedle penetration following staining and optical imaging. The nanoindentation tests demonstrated that the tissue mimics matched expected values for subcutaneous and muscle tissue, and that the compliance of the subcutaneous mimics increased linearly with water content. The abdominal skin was thinner and less stiff as compared to back skin. The maximum force decreased with gel water content in the abdominal skin but not in the back skin. Overall, larger and deeper perforations were found in the skin models with increasing water content. These data demonstrate the importance of subcutaneous tissue on microneedle performance and the need for representative skin models in microneedle technology development.

Characterization of Tissue Response to Impact Loads Delivered Using a Hand-Held Instrument for Studying Articular Cartilage Injury

OBJECTIVE

The objective of this study was to fully characterize the mechanics of an in vivo impactor and correlate the mechanics with superficial cracking of articular surfaces.

DESIGN

A spring-loaded impactor was used to apply energy-controlled impacts to the articular surfaces of neonatal bovine cartilage. The simultaneous use of a load cell and displacement sensor provided measurements of stress, stress rate, strain, strain rate, and strain energy density. Application of India ink after impact was used to correlate the mechanical inputs during impact with the resulting severity of tissue damage. Additionally, a signal processing method to deconvolve inertial stresses from impact stresses was developed and validated.

RESULTS

Impact models fit the data well (root mean square error average ~0.09) and provided a fully characterized impact. Correlation analysis between mechanical inputs and degree of superficial cracking made visible through India ink application provided significant positive correlations for stress and stress rate with degree of surface cracking (R (2) = 0.7398 and R (2) = 0.5262, respectively). Ranges of impact parameters were 7 to 21 MPa, 6 to 40 GPa/s, 0.16 to 0.38, 87 to 236 s(-1), and 0.3 to 1.1 MJ/m(3) for stress, stress rate, strain, strain rate, and strain energy density, respectively. Thresholds for damage for all inputs were determined at 13 MPa, 15 GPa/s, 0.23, 160 s(-1), and 0.59 MJ/m(3) for this system.

CONCLUSIONS

This study provided the mechanical basis for use of a portable, sterilizable, and maneuverable impacting device. Use of this device enables controlled impact loads in vitro or in vivo to connect mechanistic studies with long-term monitoring of disease progression.

Inhibition of cell-matrix adhesions prevents cartilage chondrocyte death following impact injury

Focal adhesions are transmembrane protein complexes that attach chondrocytes to the pericellular cartilage matrix and in turn, are linked to intracellular organelles via cytoskeleton. We previously found that excessive compression of articular cartilage leads to cytoskeleton-dependent chondrocyte death. Here we tested the hypothesis that this process also requires integrin activation and signaling via focal adhesion kinase (FAK) and Src family kinase (SFK). Osteochondral explants were treated with FAK and SFK inhibitors (FAKi, SFKi, respectively) for 2 h and then subjected to a death-inducing impact load. Chondrocyte viability was assessed by confocal microscopy immediately and at 24 h post-impact. With no treatment immediate post-impact viability was 59%. Treatment with 10 µM SFKi, 10 μM, or 100 µM FAKi improved viability to 80%, 77%, and 82%, respectively (p < 0.05). After 24 h viability declined to 34% in controls, 48% with 10 µM SFKi, 45% with 10 µM FAKi, and 56% with 100 µM FAKi (p < 0.01) treatment. These results confirmed that most of the acute chondrocyte mortality was FAK- and SFK-dependent, which implicates integrin-cytoskeleton interactions in the death signaling pathway. Together with previous findings, these data support the hypothesis that the excessive tissue strains accompanying impact loading induce death via a pathway initiated by strain on cell adhesion receptors.

Effect of hydration on the frequency-dependent viscoelastic properties of articular cartilage

The aim of this study was to determine the effect of tissue hydration on the frequency-dependant viscoelastic properties of articular cartilage. Such changes were determined at frequencies associated with normal (1–10 Hz) and impulsive/traumatic (90 Hz) heel-strike times. Cartilage on bone samples, obtained from bovine humeral heads, was tested when hypo-hydrated and hyper-hydrated using dynamic mechanical analysis. Dynamic mechanical analysis was performed at a range of frequencies between 1 and 90 Hz. Hypo-hydration increased the stiffness of cartilage as compared to hyper-hydrated cartilage; this increase was greater at higher frequencies. The storage modulus and stiffness increased in hypo-hydrated cartilage as compared to hyper-hydrated cartilage. However, the loss modulus and stiffness increased when cartilage was hypo-hydrated as compared to hyper-hydrated, but these increases were not frequency dependent. An impulsive heel-strike time may result in a greater increase of stiffness in hypo-hydrated cartilage, compared with hyper-hydrated cartilage. However, the ratio of storage to loss stiffness was greater for hyper-hydrated cartilage, thereby, reducing the tissue’s ability to dissipate energy and increasing the likelihood of cartilage rupture.

Development of a Spring-Loaded Impact Device to Deliver Injurious Mechanical Impacts to the Articular Cartilage Surface

OBJECTIVE

Traumatic impacts on the articular joint surface in vitro are known to lead to degeneration of the cartilage. The main objective of this study was to develop a spring-loaded impact device that can be used to deliver traumatic impacts of consistent magnitude and rate and to find whether impacts cause catabolic activities in articular cartilage consistent with other previously reported impact models and correlated with the development of osteoarthritic lesions. In developing the spring-loaded impactor, the operating hypothesis is that a single supraphysiologic impact to articular cartilage in vitro can affect cartilage integrity, cell viability, sulfated glycosaminoglycan and inflammatory mediator release in a dose-dependent manner.

DESIGN

Impacts of increasing force are delivered to adult bovine articular cartilage explants in confined compression. Impact parameters are correlated with tissue damage, cell viability, matrix and inflammatory mediator release, and gene expression 24 hours postimpact.

RESULTS

Nitric oxide release is first detected after 7.7 MPa impacts, whereas cell death, glycosaminoglycan release, and prostaglandin E2 release are first detected at 17 MPa. Catabolic markers increase linearly to maximal levels after ≥36 MPa impacts.

CONCLUSIONS

A single supraphysiologic impact negatively affects cartilage integrity, cell viability, and GAG release in a dose-dependent manner. Our findings showed that 7 to 17 MPa impacts can induce cell death and catabolism without compromising the articular surface, whereas a 17 MPa impact is sufficient to induce increases in most common catabolic markers of osteoarthritic degeneration.

Is collagen fiber damage the cause of early softening in articular cartilage?

OBJECTIVE

Because collagen damage and cartilage softening have not yet been determined simultaneously in one study for the very early onset of osteoarthritis (OA), it remains questionable whether they are associated. The aim of the present study is therefore to evaluate whether indeed, initial collagen damage can be found when tissue softening occurs as a result of excessive mechanical loading.

METHODS

To investigate this aim, a series of specific indentation loading protocols were designed to induce and monitor cartilage softening in osteochondral explants of bovine carpometacarpal joints. The experiment contained one control group (n = 6) in which no damage was induced and four experimental groups in which samples received either a constant load of 3 (n = 5), 6 (n = 5) or 15 N (n = 6), or an increasing load (n = 7) from 2 to 13 N in 11 steps. Moreover, to determine mechanically induced collagen damage, Col2-3/4M (cumulative collagen damage) and Col2-3/4C(short) (only enzymatic damage) staining were compared.

RESULTS

The normalized peak and equilibrium reaction forces decreased in the groups that received increasing and 15 N peak loading. However, Col2-3/4M staining was negative in all samples, while enzymatic damage (Col2-3/4C(short)) appeared similar in experiments and in unloaded control groups.

CONCLUSION

It was shown that a loading magnitude threshold exists above which softening occurs in cartilage. However, in samples that did show softening, we were unable to detect collagen damage. Thus, our results demonstrate that cartilage softening most likely precedes collagen damage.

FREQUENCY CONTENT OF CARTILAGE IMPACT FORCE SIGNAL REFLECTS ACUTE HISTOLOGIC STRUCTURAL DAMAGE

OBJECTIVE

The objective of this study was to determine if acute cartilage impact damage could be predicted by a quantification of the frequency content of the impact force signal.

DESIGN

Osteochondral specimens excised from bovine lateral tibial plateaus were impacted with one of six impact energies. Each impact force signal underwent frequency analysis, with the amount of higher-frequency content (percent of frequency spectrum above 1 KHz) being registered. Specimens were histologically evaluated to assess acute structural damage (articular surface cracking and cartilage crushing) resulting from the impact.

RESULTS

Acute histologic structural damage to the cartilage had higher concordance with the high-frequency content measure than with other mechanical impact measures (delivered impact energy, impact maximum stress, and impact maximum stress rate of change).

CONCLUSIONS

This result suggests that the frequency content of an impact force signal, specifically the proportion of higher-frequency components, can be used as a quick surrogate measure for acute structural cartilage injury. Taking advantage of this relationship could reduce the time and expense of histological processing needed to morphologically assess cartilage damage, especially for purposes of initial screening when evaluating new impaction protocols.

Does prior sustained compression make cartilage-on-bone more vulnerable to trauma?

BACKGROUND

This study investigated how varying levels of prior creep deformation in cartilage-on-bone samples influences their mechanical response and vulnerability to structural damage following a single traumatic impact.

METHODS

Bovine patellae were subjected to varying intervals of prior creep loading at a constant stress of 4MPa. Immediately following removal of this stress the samples were impacted with a pendulum indenter system at a fixed energy of 2.2J.

FINDINGS

With increasing prior creep, the peak force on impact rose, the duration of impact and time to reach peak force both decreased, and both the energy dissipated during impact and the magnitude of impulse were both unchanged by the level of prior creep. With increasing prior creep, the severity of impact-induced osteochondral damage increased: articular cartilage cracks penetrated to a greater depth, extending to the calcified cartilage layer resulting in hairline fractures or articular cartilage delamination and associated secondary damage to the vascular channels in the subchondral bone.

INTERPRETATION

The study shows that exposure of the cartilage-on-bone system to prior creep can significantly influence its response to subsequent impact, namely force attenuation and severity of damage to the articular cartilage, calcified cartilage and vascular channel network in the subchondral bone.

Correlation of dynamic impact testing, histopathology and visual macroscopic assessment in human osteoarthritic cartilage

OBJECTIVE

Improved staging of cartilage degeneration is required, particularly during the early stages. We correlated mechanical properties with histological and macroscopic findings.

METHODS

One hundred and twenty cartilage samples were obtained during total knee arthroplasty. Two adjacent plugs were harvested--one for histological classification and one for macroscopic and biomechanical purposes. Dynamic impact testing was performed; normal stress, dissipated energy (∆E), tangent modulus and stiffness were evaluated.

RESULTS

Samples were classified according to six categories of the ICRS histological scale. Mechanical characteristics revealing significant differences between the groups (p < 0.01) were specific damping and related absolute ∆E. A significant correlation was found between the macroscopic score and specific damping, as well as absolute and relative ∆E (p < 0.01). A strong relation was revealed between relative ∆E and cartilage thickness (p < 0.001; R (2) = 0.69).

CONCLUSIONS

Only ∆E correlated with the condition of the cartilage--the value increased with decreasing quality-and is the most suitable characteristic. This change appears substantial in initial stages of cartilage deterioration.

The effects of hammer pressure on cellular response in a porcine heart valve tissue

Our objective was to design, develop, characterize and validate a prototype device for testing the response of aortic valve tissue to impact forces. With each cardiac cycle, the aortic valve, on closure, is subjected to a substantial impact force and the ability of valvular interstitial cells to withstand such forces without apoptosis has not been examined. Our aim was to correlate impact force with apoptosis, identifying the latter using a terminal transferase dUTP nick end-labelling (Tunel) assay. With our drop tower design, we created reproducible impact forces on heart valve tissue resulting in cellular trauma. The reliability of the impact tester design were verified and results showed that normal tissue can withstand impact forces more than 30× greater than the physiological forces to which the tissue is normally exposed. This provides a wide safety margin and indicates that bioengineered aortic valve tissue should have similar properties if it is to withstand physiologic forces long term.

How subtle structural changes associated with maturity and mild degeneration influence the impact-induced failure modes of cartilage-on-bone

BACKGROUND

Implicit structural changes in the joint tissues, not apparent in gross appearance and related to age and mild degeneration, represent potentially important biomechanical factors that could influence the vulnerability of the joint to trauma. The hypothesis of this study was that micro-level structural differences in the cartilage tissue matrix, and its interface with the underlying bone, would result in different fracture responses to single impact loading.

METHODS

For this study a range of cartilage-on-bone samples, from intact to mildly degenerate, were obtained from bovine patellae. These samples were subjected to a single impact, via a cylindrical 6-mm diameter plane-ended indenter, sufficient to create a visible fracture on the articular surface. Microstructural assessment of the region of failure was carried out using differential interference contrast optical imaging. Distinct differences in the modes of fracture propagation were correlated with microstructural changes.

FINDINGS

It was found that the intact tissues required impact energies of approximately 2.3J to induce surface rupture. These ruptures advanced to a variable radial depth that depended on the age of the animal from which the tissue was obtained. In the intact tissues from adult animals, the ruptures were largely confined to the upper third of the cartilage thickness. In the intact tissues from adolescent animals the ruptures progressed into the deep matrix zone and crossed the underdeveloped calcified cartilage region and underlying bone. For the mildly degenerate tissue cohort, lower impact energies of approximately 1.6J was sufficient to cause extensive detachment of the articular cartilage at or near the osteochondral junction.

INTERPRETATION

The subtle microstructural differences in intact cartilage-bone tissue obtained from adolescent versus mature animals are important as they correlate with the observed differences in impact response. Any mechanical model or structural analogue of cartilage should consider such implicit structural variations and their implications for overall joint function during weight-bearing.

Reliability and validity of a novel muscle contusion device

CONTEXT

Many models have been employed to replicate skeletal muscle injury associated with trauma; however, most are restricted to 1 level of severity.

OBJECTIVE

To create and validate an injury-producing device that could generate multiple levels of injury severity.

DESIGN

Validation study.

PATIENTS OR OTHER PARTICIPANTS

Twenty-six male Wistar rats, 3 to 4 months old.

INTERVENTION(S)

A contusion device was developed and its ability to deliver consistent impacts was validated alone and in the presence of an experimental animal. A free-falling mass (267 g) was adjusted to the desired height (40, 50, 60, or 70 cm) and then dropped.

MAIN OUTCOME MEASURE(S)

Peak load, peak displacement, impulse, energy, and velocity peak were measured. Injury severity was determined using magnetic resonance imaging.

RESULTS

Outcome measures observed from the device alone were different by height (F(18,136) = 21.807, P < .001, 1-beta = 1.0). Outcomes using the experimental animals were also dependent on height (F(14,102) = 68.679, P < .001, 1-beta = 1.0). Linear regression analyses indicated that height accounted for 17% to 89% of the variance.

CONCLUSIONS

Mild to moderate and moderate to severe injuries can be replicated with this device, which will be useful in evaluating clinical treatments on acute muscle injury.

Cyclooxygenase inhibition lowers prostaglandin E2 release from articular cartilage and reduces apoptosis but not proteoglycan degradation following an impact load in vitro

This study investigated the release of prostaglandin E₂ (PGE₂) from cartilage following an impact load in vitro and the possible chondroprotective effect of cyclooxygenase-2 (COX-2) inhibition using non-steroidal anti-inflammatory drugs (NSAIDs).

Explants of human articular cartilage were subjected to a single impact load in a drop tower, and then cultured for 6 days in the presence of either a selective COX-2 inhibitor (celecoxib; 0.01, 0.1, 1.0 and 10 μM) or a non-selective COX inhibitor (indomethacin; 0.1 and 10 μM). The concentrations of PGE₂ and glycosaminoglycans (GAGs), a measure of cartilage breakdown, were measured in the explant culture medium at 3 and 6 days post-impact. Apoptotic cell death was measured in frozen explant sections by the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labelling (TUNEL) method.

PGE₂ levels were increased by more than 20-fold in the medium of explants at both 3 (p = 0.012) and 6 days (p = 0.004) following impact, compared with unloaded controls. In the presence of celecoxib and indomethacin, the PGE₂ levels were reduced in a dose-related manner. These inhibitors, however, had no effect in reducing the impact-induced release of GAGs from the cartilage matrix. Addition of celecoxib and indomethacin significantly reduced the number of trauma-induced apoptotic chondrocytes in cartilage explant sections.

In this study, a marked increase in PGE₂ was measured in the medium following an impact load on articular cartilage, which was abolished by the selective COX-2 inhibitor, celecoxib, and non-selective indomethacin. These inhibitors reduced chondrocyte apoptosis but no change was observed in the release of GAGs from the explants, suggesting that the COX/PGE₂ pathway is not directly responsible for cartilage breakdown following traumatic injury. Our in vitro study demonstrates that it is unlikely that COX-2 inhibition alone would slow down or prevent the development of secondary osteoarthritis.

Impact testing to determine the mechanical properties of articular cartilage in isolation and on bone

The biomechanical response of cartilage to impact loads, both in isolation and in situ on its bone substrate, has been little studied despite the common occurrence of osteoarthritis subsequent to cartilage injury. An instrumented drop tower was used to apply controlled impact loads of different energies to explants of bovine articular cartilage. Results were compared with a conventional slow stress-strain test. The effects of the underlying bone were investigated by progressively shortening a core of bone removed with the cartilage, and by gluing cartilage samples to substrates of different moduli. The maximum dynamic modulus of isolated samples of bovine articular cartilage, at strain rates between 1100 and 1500 s(-1), was approximately two orders of magnitude larger than the quasistatic modulus and varied non-linearly with applied stress. When attached to a substrate of higher modulus, increasing the thickness of the substrate increased the effective modulus of the combination until a steady value was achieved. A lower modulus substrate reduced the effective modulus of the combination. Severe impacts resulted in damage to the bone rather than to the cartilage. The modulus of cartilage rises rapidly and non-linearly with strain rate, giving the tissue a remarkable ability to withstand impact loads. The presence of cartilage attenuated the peak force experienced by the bone and spread the impact loading period over a longer time.

Effect of a single impact loading on the structure and mechanical properties of articular cartilage

AIM

To study the effect of a single impact on the structure and mechanical properties of cartilage.

MATERIALS AND METHOD

Osteochondral plugs harvested from bovine femora were subjected each to a single impact using an in-house designed drop-tower. Impact masses of different values were released from different drop heights in selected combinations to apply stresses at strain rates and impact energies within specific ranges. Changes in the storage and loss moduli were estimated from cyclic compressive loading test undertaken before and after impact. The conditions of these tests were set to those occurring during walking and running. The extent of the damage on cartilage surface and depth was assessed using optical and confocal microscopy.

RESULTS

The storage modulus varied slightly at level walking and running after performing impact tests up to the impact energy of 0.736 J. However, the decrease in the storage modulus was considerable at the impact energy of 1.962 J for test conditions representing both walking and running. This impact energy resulted in strain rate of 1500 s(-1), stress of 25 MPa and energy absorbed per unit volume of 12.79 mJ/mm(3). After impact the loss modulus increased over the loading cycles at all energies. Severe fissures were observed across the cartilage surface and through its thickness at levels of impact energy equal or greater than 1.472 J.

CONCLUSIONS

This study identified thresholds for the strain rate, impact stress and impact energy, which caused permanent changes in the mechanical properties and damage to structure of cartilage.