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Hamsayeh Abbasi Niasar E, Brenneman Wilson EC, Quenneville CE, Maly MR, Li LP. Region partitioning of articular cartilage with streaming-potential-based parameters and indentation maps. J Mech Behav Biomed Mater 2024; 154:106534. [PMID: 38581961 DOI: 10.1016/j.jmbbm.2024.106534] [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: 11/10/2023] [Revised: 03/17/2024] [Accepted: 03/30/2024] [Indexed: 04/08/2024]
Abstract
Articular cartilage exhibits site-specific tissue inhomogeneity, for which the tissue properties may continuously vary across the articular surface. To facilitate practical applications such as studying site-specific cartilage degeneration, the inhomogeneity may be approximated with several distinct region-wise variations, with one set of tissue properties for one region. A clustering method was previously developed to partition such regions using cartilage indentation-relaxation and thickness mapping instead of simply using surface geometry. In the present study, a quantitative parameter based on streaming potential measurement was introduced as an additional feature to assess the applicability of the methodology with independent datasets. Experimental data were collected from 24 sets of femoral condyles, extracted from fresh porcine stifle joints, through streaming potential mapping, automated indentation, and needle penetration tests. K-means clustering and Elbow method were used to find optimal region partitions. Consistent with previous findings, three regions were suggested for either lateral or medial condyle regardless of left or right joint. The region shapes were approximately triangular or trapezoidal, which was similar to what was found previously. Streaming potentials were confirmed to be region-dependent, but not significantly different among joints. The cartilage was significantly thicker in the medial than lateral condyles. The region areas were consistent among joints, and comparable to that found in a previous study. The present study demonstrated the capability of region partitioning methods with different variables, which may facilitate new applications whenever site-specific tissue properties must be considered.
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Affiliation(s)
| | | | - C E Quenneville
- Department of Mechanical Engineering, McMaster University, Hamilton, ON, Canada
| | - M R Maly
- Department of Kinesiology and Health Sciences, University of Waterloo, ON, Canada
| | - L P Li
- Department of Mechanical and Manufacturing Engineering, University of Calgary, AB, Canada.
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2
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Men Y, Ren Y, Zhao Z, Wang X, Liu L. Numerical analysis of streaming potential induced by loads in micro-pores of articular cartilage. Comput Methods Biomech Biomed Engin 2023; 26:1761-1771. [PMID: 37902439 DOI: 10.1080/10255842.2022.2141570] [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: 05/23/2022] [Accepted: 09/19/2022] [Indexed: 11/06/2022]
Abstract
In order to understand the distribution of streaming potentials in cartilage pores, this paper established finite element model to analyze. The results showed that the streaming potential in cartilage micro-pores increased along the axis. The electric potential in 5 μm straight micro-pore was about 50 μV, and the electric potential of curved bifurcation model was about 30 μV. The pressure and Zeta potential had a linear growth relationship with the streaming potential. The streaming potential decreased with the increase of ion concentration until ion concentration was saturated. These results could provide a theoretical basis for cartilage research.
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Affiliation(s)
- Yutao Men
- Tianjin Key Laboratory for Advanced Mechatronic System Design and Intelligent Control, Tianjin University of Technology, Tianjin, China
- National Demonstration Center for Experimental Mechanical and Electrical Engineering Education, Tianjin University of Technology, Tianjin, China
| | - Yucheng Ren
- Tianjin Key Laboratory for Advanced Mechatronic System Design and Intelligent Control, Tianjin University of Technology, Tianjin, China
- National Demonstration Center for Experimental Mechanical and Electrical Engineering Education, Tianjin University of Technology, Tianjin, China
| | - Zhonghai Zhao
- Tianjin Key Laboratory for Advanced Mechatronic System Design and Intelligent Control, Tianjin University of Technology, Tianjin, China
- National Demonstration Center for Experimental Mechanical and Electrical Engineering Education, Tianjin University of Technology, Tianjin, China
| | - Xin Wang
- Tianjin Key Laboratory for Advanced Mechatronic System Design and Intelligent Control, Tianjin University of Technology, Tianjin, China
- National Demonstration Center for Experimental Mechanical and Electrical Engineering Education, Tianjin University of Technology, Tianjin, China
| | - Lu Liu
- Tianjin Key Laboratory of Bone Implant Interface Functionalization and Personality Research Enterprises, Just Huajian Medical Devices (Tianjin) Co., Ltd, Tianjin, China
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3
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Puhakka J, Salonius E, Paatela T, Muhonen V, Meller A, Vasara A, Kautiainen H, Kosola J, Kiviranta I. Comparison Between Arthroscopic and Histological International Cartilage Repair Society Scoring Systems in Porcine Cartilage Repair Model. Cartilage 2022; 13:19476035211069246. [PMID: 35098743 PMCID: PMC9137296 DOI: 10.1177/19476035211069246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE The arthroscopic and histological International Cartilage Repair Society (ICRS) scores are designed to evaluate cartilage repair quality. Arthroscopic ICRS score can give a maximum score of 12 and the histological score can give values between 0% and 100% for each of its 14 subscores. This study compares these methods in an animal cartilage repair model. This study hypothesizes that there is a significant correlation between these methods. DESIGN A chondral defect was made in the medial femoral condyle of 18 pigs. Five weeks later, 9 pigs were treated with a novel recombinant human type III collagen/polylactide scaffold and 9 were left untreated to heal spontaneously. After 4 months, the medial condyles were evaluated with a simulated arthroscopy using the ICRS scoring system followed by a histological ICRS scoring. RESULTS This porcine cartilage repair model produced repaired cartilage tissue ranging from good to poor repair tissue quality. The mean arthroscopic ICRS total score was 6.8 (SD = 2.2). Histological ICRS overall assessment subscore was 38.2 (SD = 31.1) and histological ICRS average points were 60.5 (SD = 19.5). Arthroscopic ICRS compared with histological ICRS average points or its overall assessment subscore showed moderate correlation (r = 0.49 and r = 0.50, respectively). The interrater reliability with the intraclass correlation coefficients for arthroscopic ICRS total scores, histological ICRS overall assessment subscore, and ICRS average points showed moderate to excellent reliability. CONCLUSIONS Arthroscopic and histological ICRS scoring methods for repaired articular cartilage show a moderate correlation in the animal cartilage repair model.
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Affiliation(s)
- Jani Puhakka
- University of Helsinki, Helsinki, Finland,Jani Puhakka, University of Helsinki, Topeliuksenkatu 5, Helsinki 00260, Finland.
| | | | | | | | | | - Anna Vasara
- Helsinki University Hospital, Helsinki, Finland
| | | | - Jussi Kosola
- Kanta-Hämeen keskussairaala, Hameenlinna, Finland
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Changoor A, Garon M, Quenneville E, Bull SB, Gordon K, Savard P, Buschmann MD, Hurtig MB. Non-invasive Electroarthrography Measures Load-Induced Cartilage Streaming Potentials via Electrodes Placed on Skin Surrounding an Articular Joint. Cartilage 2021; 13:375S-385S. [PMID: 32500724 PMCID: PMC8804767 DOI: 10.1177/1947603520928583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE We aimed to demonstrate that electroarthrography (EAG) measures streaming potentials originating in the cartilage extracellular matrix during load bearing through electrodes adhered to skin surrounding an articular joint. DESIGN Equine metacarpophalangeal joints were subjected to simulated physiological loads while (1) replacing synovial fluid with immersion buffers of different electrolyte concentrations and (2) directly degrading cartilage with trypsin. RESULTS An inverse relationship between ionic strength and EAG coefficient was detected. Compared to native synovial fluid, EAG coefficients increased (P < 0.05) for 5 of 6 electrodes immersed in 0.1X phosphate-buffered saline (PBS) (0.014 M NaCl), decreased (P < 0.05) for 4 of 6 electrodes in 1X PBS (0.14 M NaCl), and decreased (P < 0.05) for all 6 electrodes in 10X PBS (1.4 M NaCl). This relationship corresponds to similar studies where streaming potentials were directly measured on cartilage. EAG coefficients, obtained after trypsin degradation, were reduced (P < 0.05) in 6 of 8, and 7 of 8 electrodes, during simulated standing and walking, respectively. Trypsin degradation was confirmed by direct cartilage assessments. Streaming potentials, measured by directly contacting cartilage, indicated lower cartilage stiffness (P < 10-5). Unconfined compression data revealed reduced Em, representing proteoglycan matrix stiffness (P = 0.005), no change in Ef, representing collagen network stiffness (P = 0.15), and no change in permeability (P = 0.24). Trypsin depleted proteoglycan as observed by both dimethylmethylene blue assay (P = 0.0005) and safranin-O stained histological sections. CONCLUSION These data show that non-invasive EAG detects streaming potentials produced by cartilage during joint compression and has potential to become a diagnostic tool capable of detecting early cartilage degeneration.
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Affiliation(s)
- Adele Changoor
- Lunenfeld-Tanenbaum Research Institute,
Sinai Health System, Toronto, Ontario, Canada
- Department of Surgery and Department of
Laboratory Medicine & Pathobiology, University of Toronto, Toronto, Ontario,
Canada
| | | | | | - Shelley B. Bull
- Lunenfeld-Tanenbaum Research Institute,
Sinai Health System, Toronto, Ontario, Canada
| | - Karen Gordon
- College of Engineering and Physical
Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Pierre Savard
- Biomedical and Electrical Engineering,
École Polytechnique, Montréal, Quebec, Canada
| | | | - Mark B. Hurtig
- Comparative Orthopaedic Research
Laboratory, Department of Clinical Studies, University of Guelph, Guelph, Ontario,
Canada
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5
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Ukai T, Sato M, Wasai S, Takahashi T, Omura H, Watanabe M. Comparison of properties determined using electromechanical assessment (Arthro-BST™) with macroscopic and histological properties in symptomatic human articular cartilage of the hip. Arthritis Res Ther 2021; 23:227. [PMID: 34465392 PMCID: PMC8406846 DOI: 10.1186/s13075-021-02611-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 08/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cartilage degeneration is assessed using various methods. Although macroscopic evaluation can directly measure cartilage degeneration, it cannot accurately assess cartilage properties. Histological examination is one of the most accurate methods for evaluating cartilage degeneration. However, it is invasive and requires collection of cartilage tissue. In contrast, the Arthro-BST™ probe can assess cartilage properties noninvasively. This study aimed to evaluate the effectiveness of the Arthro-BST in assessing cartilage degeneration by comparing macroscopic (International Cartilage Repair Society [ICRS] classification) and histological evaluations (modified Mankin score and Osteoarthritis Research Society International [OARSI] histological grade). METHODS Fourteen femoral heads were excised from 13 patients during surgery to treat hip osteoarthritis or femoral fracture. The ICRS score was used for macroscopic evaluation of cartilage degeneration. The Arthro-BST was applied at sites matching the areas of cartilage damage. The sites assessed using the ICRS classification and Arthro-BST were evaluated histologically (modified Mankin score and OARSI histological grade), and these were compared with the Arthro-BST results. RESULTS The ICRS classification identified significant differences between grades 1 and 3 (p < 0.01), between grades 1 and 4 (p < 0.01), between grades 2 and 3 (p < 0.01), and between grades 2 and 4 (p < 0.01). Significant correlations were observed between the Arthro-BST results and the ICRS score, modified Mankin score (structure, cellularity, matrix staining, total score), and OARSI histological grade. CONCLUSIONS In the assessment of hip osteoarthritis, the Arthro-BST results correlated with those of macroscopic and histological evaluations. The Arthro-BST is useful for assessing hip osteoarthritis and may be helpful for noninvasive assessment of cartilage degeneration.
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Affiliation(s)
- Taku Ukai
- Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Bohseidai, Isehara, Kanagawa, 259-1193, Japan.,Center for Musculoskeletal Innovative Research and Advancement (C-MiRA), Tokai University Graduate School, Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Masato Sato
- Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Bohseidai, Isehara, Kanagawa, 259-1193, Japan. .,Center for Musculoskeletal Innovative Research and Advancement (C-MiRA), Tokai University Graduate School, Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
| | - Shiho Wasai
- Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Bohseidai, Isehara, Kanagawa, 259-1193, Japan.,Center for Musculoskeletal Innovative Research and Advancement (C-MiRA), Tokai University Graduate School, Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Takumi Takahashi
- Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Bohseidai, Isehara, Kanagawa, 259-1193, Japan.,Center for Musculoskeletal Innovative Research and Advancement (C-MiRA), Tokai University Graduate School, Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Haruka Omura
- Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Bohseidai, Isehara, Kanagawa, 259-1193, Japan.,Center for Musculoskeletal Innovative Research and Advancement (C-MiRA), Tokai University Graduate School, Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Masahiko Watanabe
- Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Bohseidai, Isehara, Kanagawa, 259-1193, Japan.,Center for Musculoskeletal Innovative Research and Advancement (C-MiRA), Tokai University Graduate School, Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
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6
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Puhakka J, Paatela T, Salonius E, Muhonen V, Meller A, Vasara A, Kautiainen H, Kosola J, Kiviranta I. Arthroscopic International Cartilage Repair Society Classification System Has Only Moderate Reliability in a Porcine Cartilage Repair Model. Am J Sports Med 2021; 49:1524-1529. [PMID: 33733882 DOI: 10.1177/0363546521998006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The International Cartilage Repair Society (ICRS) score was designed for arthroscopic use to evaluate the quality of cartilage repair. PURPOSE To evaluate the reliability of the ICRS scoring system using an animal cartilage repair model. STUDY DESIGN Controlled laboratory study. METHODS A chondral defect with an area of 1.5 cm2 was made in the medial femoral condyle of 18 domestic pigs. Five weeks later, 9 pigs were treated using a novel recombinant human type III collagen/polylactide scaffold, and 9 were left to heal spontaneously. After 4 months, the pigs were sacrificed, then 3 arthroscopic surgeons evaluated the medial femoral condyles via video-recorded simulated arthroscopy using the ICRS scoring system. The surgeons repeated the evaluation twice within a 9-month period using their recorded arthroscopy. RESULTS The porcine cartilage repair model produced cartilage repair tissue of poor to good quality. The mean ICRS total scores for all observations were 6.6 (SD, 2.6) in arthroscopy, 5.9 (SD, 2.7) in the first reevaluation, and 6.2 (SD, 2.8) in the second reevaluation. The interrater reliability with the intraclass correlation coefficient (ICC) for the ICRS total scores (ICC, 0.46-0.60) and for each individual subscore (ICC, 0.26-0.71) showed poor to moderate reliability. The intrarater reliability with the ICC also showed poor to moderate reliability for ICRS total scores (ICC, 0.52-0.59) and for each individual subscore (ICC, 0.29-0.58). A modified Bland-Altman plot for the initial arthroscopy and for the 2 reevaluations showed an evident disagreement among the observers. CONCLUSION In an animal cartilage repair model, the ICRS scoring system seems to have poor to moderate reliability. CLINICAL RELEVANCE Arthroscopic assessment of cartilage repair using the ICRS scoring method has limited reliability. We need more objective methods with acceptable reliability to evaluate cartilage repair outcomes.
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Affiliation(s)
- Jani Puhakka
- Department of Orthopaedics and Traumatology, Helsinki University Hospital, Helsinki, Finland.,Department of Orthopaedics and Traumatology, University of Helsinki, Helsinki, Finland
| | - Teemu Paatela
- Department of Orthopaedics and Traumatology, Helsinki University Hospital, Helsinki, Finland.,Department of Orthopaedics and Traumatology, University of Helsinki, Helsinki, Finland
| | - Eve Salonius
- Department of Orthopaedics and Traumatology, Helsinki University Hospital, Helsinki, Finland.,Department of Orthopaedics and Traumatology, University of Helsinki, Helsinki, Finland
| | - Virpi Muhonen
- Department of Orthopaedics and Traumatology, University of Helsinki, Helsinki, Finland
| | - Anna Meller
- University of Helsinki, Helsinki Institute of Life Science (HiLIFE), Laboratory Animal Center, Helsinki, Finland
| | - Anna Vasara
- Department of Orthopaedics and Traumatology, Helsinki University Hospital, Helsinki, Finland
| | - Hannu Kautiainen
- Folkhälsan Research Center, Helsinki, Finland.,Kuopio University Hospital, Primary Health Care Unit, Kuopio, Finland
| | - Jussi Kosola
- Department of Orthopaedics and Traumatology, University of Helsinki, Helsinki, Finland.,Department of Orthopaedics and Traumatology, Kanta-Häme Hospital, Hämeenlinna, Finland
| | - Ilkka Kiviranta
- Department of Orthopaedics and Traumatology, Helsinki University Hospital, Helsinki, Finland.,Department of Orthopaedics and Traumatology, University of Helsinki, Helsinki, Finland
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7
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Mickevicius T, Pockevicius A, Kucinskas A, Gudas R, Maciulaitis J, Usas A. Nondestructive Assessment of Articular Cartilage Electromechanical Properties after Osteochondral Autologous and Allogeneic Transplantation in a Goat Model. Cartilage 2020; 11:348-357. [PMID: 29998744 PMCID: PMC7298600 DOI: 10.1177/1947603518786543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To determine the applicability of a minimally invasive diagnostic device to evaluate the quality of articular cartilage following autologous (OAT) and allogeneic (OCA) osteochondral graft transplantation in goat model. DESIGN OAT grafts were harvested from lateral femoral condyles (LFCs) and transplanted into osteochondral defects created in medial femoral condyles (MFCs) of contralateral knees. OCA grafts were transplanted into MFC condyles after in vitro storage. Autologous platelet-rich plasma (PRP) was administered intraarticularly after the surgery and at 1 and 2 months postoperatively. OAT and OCA grafts were evaluated macroscopically (Oswestry arthroscopy score [OAS]), electromechanically (quantitative parameter, QP), and histologically (O'Driscoll score, safranin O staining intensity) at 3 and 6 months after transplantation. Results were compared with preoperative graft evaluation. RESULTS Transplanted cartilage deteriorated within 6 months in all groups. Cartilage quality was better retained in OAT group compared with a decline in OCA group. QP and OAS scores were comparable in OAT and OCA groups at 3 months, but superior in OAT group at 6 months, according to all the methods applied. PRP injections significantly improved QP and OAS score at 6 months compared with 3 months in OAT group. QP moderately correlated with OAS, O'Driscoll score, and safranin O staining intensity. CONCLUSIONS Grafts did not retain preoperative quality parameters at 6 months follow-up; however, OAT were superior to OCA grafts. PRP may have a beneficial effect on macroscopic and electromechanical properties of cartilage; however, histological improvement is yet to be proved. Electromechanical diagnostic device enables reliable assessment of transplanted cartilage.
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Affiliation(s)
- Tomas Mickevicius
- Department of Orthopaedics and
Traumatology, Hospital of Lithuanian University of Health Sciences Kaunas Clinics,
Kaunas, Lithuania
| | - Alius Pockevicius
- Pathology Center, Department of
Veterinary Pathobiology, Veterinary Academy, Lithuanian University of Health
Sciences, Kaunas, Lithuania
| | - Audrius Kucinskas
- Biological Research Center Lithuanian
University of Health Sciences, Kaunas, Lithuania
| | - Rimtautas Gudas
- Department of Orthopaedics and
Traumatology, Hospital of Lithuanian University of Health Sciences Kaunas Clinics,
Kaunas, Lithuania,Institute of Sports, Lithuanian
University of Health Sciences, Kaunas, Lithuania
| | - Justinas Maciulaitis
- Department of Orthopaedics and
Traumatology, Hospital of Lithuanian University of Health Sciences Kaunas Clinics,
Kaunas, Lithuania,Institute of Sports, Lithuanian
University of Health Sciences, Kaunas, Lithuania
| | - Arvydas Usas
- Institute of Physiology and
Pharmacology, Lithuanian University of Health Sciences, Kaunas, Lithuania,Arvydas Usas, Institute of Physiology and
Pharmacology, Lithuanian University of Health Sciences, Mickeviciaus 9, Kaunas,
LT-44307, Lithuania.
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8
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Hadjab I, Sim S, Karhula SS, Kauppinen S, Garon M, Quenneville E, Lavigne P, Lehenkari PP, Saarakkala S, Buschmann MD. Electromechanical properties of human osteoarthritic and asymptomatic articular cartilage are sensitive and early detectors of degeneration. Osteoarthritis Cartilage 2018; 26:405-413. [PMID: 29229562 DOI: 10.1016/j.joca.2017.12.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 11/18/2017] [Accepted: 12/04/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate cross-correlations of ex vivo electromechanical properties with cartilage and subchondral bone plate thickness, as well as their sensitivity and specificity regarding early cartilage degeneration in human tibial plateau. METHOD Six pairs of tibial plateaus were assessed ex vivo using an electromechanical probe (Arthro-BST) which measures a quantitative parameter (QP) reflecting articular cartilage compression-induced streaming potentials. Cartilage thickness was then measured with an automated thickness mapping technique using Mach-1 multiaxial mechanical tester. Subsequently, a visual assessment was performed by an experienced orthopedic surgeon using the International Cartilage Repair Society (ICRS) grading system. Each tibial plateau was finally evaluated with μCT scanner to determine the subchondral-bone plate thickness over the entire surface. RESULTS Cross-correlations between assessments decreased with increasing degeneration level. Moreover, electromechanical QP and subchondral-bone plate thickness increased strongly with ICRS grade (ρ = 0.86 and ρ = 0.54 respectively), while cartilage thickness slightly increased (ρ = 0.27). Sensitivity and specificity analysis revealed that the electromechanical QP is the most performant to distinguish between different early degeneration stages, followed by subchondral-bone plate thickness and then cartilage thickness. Lastly, effect sizes of cartilage and subchondral-bone properties were established to evaluate whether cartilage or bone showed the most noticeable changes between normal (ICRS 0) and each early degenerative stage. Thus, the effect sizes of cartilage electromechanical QP were almost twice those of the subchondral-bone plate thickness, indicating greater sensitivity of electromechanical measurements to detect early osteoarthritis. CONCLUSION The potential of electromechanical properties for the diagnosis of early human cartilage degeneration was highlighted and supported by cartilage thickness and μCT assessments.
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Affiliation(s)
- I Hadjab
- Biomedical Engineering Institute, Polytechnique Montreal, Montreal, QC, Canada; Biomomentum Inc., 970 Michelin St., Suite 200, Laval, QC H7L 5C1, Canada.
| | - S Sim
- Biomedical Engineering Institute, Polytechnique Montreal, Montreal, QC, Canada; Biomomentum Inc., 970 Michelin St., Suite 200, Laval, QC H7L 5C1, Canada.
| | - S S Karhula
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Finland; Infotech Oulu, University of Oulu, Finland.
| | - S Kauppinen
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Finland.
| | - M Garon
- Biomomentum Inc., 970 Michelin St., Suite 200, Laval, QC H7L 5C1, Canada.
| | - E Quenneville
- Biomomentum Inc., 970 Michelin St., Suite 200, Laval, QC H7L 5C1, Canada.
| | - P Lavigne
- Department of Surgery, University of Montreal, Montreal, QC, Canada.
| | - P P Lehenkari
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Finland; Department of Surgery and Intensive Care, University of Oulu and Oulu University Hospital, Finland.
| | - S Saarakkala
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Finland; Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland.
| | - M D Buschmann
- Biomedical Engineering Institute, Polytechnique Montreal, Montreal, QC, Canada.
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9
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Sim S, Hadjab I, Garon M, Quenneville E, Lavigne P, Buschmann MD. Development of an Electromechanical Grade to Assess Human Knee Articular Cartilage Quality. Ann Biomed Eng 2017; 45:2410-2421. [PMID: 28653292 DOI: 10.1007/s10439-017-1879-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 06/21/2017] [Indexed: 10/19/2022]
Abstract
Quantitative assessments of articular cartilage function are needed to aid clinical decision making. Our objectives were to develop a new electromechanical grade to assess quantitatively cartilage quality and test its reliability. Electromechanical properties were measured using a hand-held electromechanical probe on 200 human articular surfaces from cadaveric donors and osteoarthritic patients. These data were used to create a reference electromechanical property database and to compare with visual arthroscopic International Cartilage Repair Society (ICRS) grading of cartilage degradation. The effect of patient-specific and location-specific characteristics on electromechanical properties was investigated to construct a continuous and quantitative electromechanical grade analogous to ICRS grade. The reliability of this novel grade was assessed by comparing it with ICRS grades on 37 human articular surfaces. Electromechanical properties were not affected by patient-specific characteristics for each ICRS grade, but were significantly different across the articular surface. Electromechanical properties varied linearly with ICRS grade, leading to a simple linear transformation from one scale to the other. The electromechanical grade correlated strongly with ICRS grade (r = 0.92, p < 0.0001). Additionally, the electromechanical grade detected lesions that were not found visually. This novel grade can assist the surgeon in assessing human knee cartilage by providing a quantitative and reliable grading system.
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Affiliation(s)
- Sotcheadt Sim
- Department of Chemical Engineering and Institute of Biomedical Engineering, Polytechnique Montreal, P.O. Box 6079, Station Centre-Ville, 2900 Boul. Edouard-Montpetit, Montreal, QC, H3C 3A7, Canada.,Biomomentum Inc., 970 Michelin St. Suite 200, Laval, QC, H7L 5C1, Canada
| | - Insaf Hadjab
- Department of Chemical Engineering and Institute of Biomedical Engineering, Polytechnique Montreal, P.O. Box 6079, Station Centre-Ville, 2900 Boul. Edouard-Montpetit, Montreal, QC, H3C 3A7, Canada.,Biomomentum Inc., 970 Michelin St. Suite 200, Laval, QC, H7L 5C1, Canada
| | - Martin Garon
- Biomomentum Inc., 970 Michelin St. Suite 200, Laval, QC, H7L 5C1, Canada
| | - Eric Quenneville
- Biomomentum Inc., 970 Michelin St. Suite 200, Laval, QC, H7L 5C1, Canada
| | - Patrick Lavigne
- Department of Surgery, University of Montreal, P.O. Box 6128, Station Centre-Ville, Montreal, QC, H3C 3J7, Canada
| | - Michael D Buschmann
- Department of Chemical Engineering and Institute of Biomedical Engineering, Polytechnique Montreal, P.O. Box 6079, Station Centre-Ville, 2900 Boul. Edouard-Montpetit, Montreal, QC, H3C 3A7, Canada. .,Groupe de Recherche en Sciences et Technologies Biomédicales, Polytechnique Montreal, P.O. Box 6079, Station Centre-Ville, Montreal, QC, H3C 3A7, Canada.
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10
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Sim S, Chevrier A, Garon M, Quenneville E, Lavigne P, Yaroshinsky A, Hoemann CD, Buschmann MD. Electromechanical probe and automated indentation maps are sensitive techniques in assessing early degenerated human articular cartilage. J Orthop Res 2017; 35:858-867. [PMID: 27279435 DOI: 10.1002/jor.23330] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 06/02/2016] [Indexed: 02/04/2023]
Abstract
Recent advances in the development of new drugs to halt or even reverse the progression of Osteoarthritis at an early-stage requires new tools to detect early degeneration of articular cartilage. We investigated the ability of an electromechanical probe and an automated indentation technique to characterize entire human articular surfaces for rapid non-destructive discrimination between early degenerated and healthy articular cartilage. Human cadaveric asymptomatic articular surfaces (four pairs of distal femurs and four pairs of tibial plateaus) were used. They were assessed ex vivo: macroscopically, electromechanically, (maps of the electromechanical quantitative parameter, QP, reflecting streaming potentials), mechanically (maps of the instantaneous modulus, IM), and through cartilage thickness. Osteochondral cores were also harvested from healthy and degenerated regions for histological assessment, biochemical analyses, and unconfined compression tests. The macroscopic visual assessment delimited three distinct regions on each articular surface: Region I was macroscopically degenerated, region II was macroscopically normal but adjacent to regions I and III was the remaining normal articular surface. Thus, each extracted core was assigned to one of the three regions. A mixed effect model revealed that only the QP (p < 0.0001) and IM (p < 0.0001) were able to statistically discriminate the three regions. Effect size was higher for QP and IM than other assessments, indicating greater sensitivity to distinguish early degeneration of cartilage. When considering the mapping feature of the QP and IM techniques, it also revealed bilateral symmetry in a moderately similar distribution pattern between bilateral joints. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:858-867, 2017.
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Affiliation(s)
- Sotcheadt Sim
- Department of Chemical Engineering and Institute of Biomedical Engineering, Polytechnique Montreal, P.O. Box 6079, Station Centre-Ville, Montreal, Quebec H3C 3A7, Canada.,Biomomentum Inc., 970 Michelin St., Suite 200, Laval, Quebec H7L 5C1, Canada
| | - Anik Chevrier
- Department of Chemical Engineering and Institute of Biomedical Engineering, Polytechnique Montreal, P.O. Box 6079, Station Centre-Ville, Montreal, Quebec H3C 3A7, Canada
| | - Martin Garon
- Biomomentum Inc., 970 Michelin St., Suite 200, Laval, Quebec H7L 5C1, Canada
| | - Eric Quenneville
- Biomomentum Inc., 970 Michelin St., Suite 200, Laval, Quebec H7L 5C1, Canada
| | - Patrick Lavigne
- Department of Surgery, University of Montreal, P.O. Box 6128, Station Centre-Ville, Quebec H3C 3J7, Canada
| | - Alex Yaroshinsky
- Vital Systems, Inc., 3701 Algonquin Rd, Suite 360 Rolling Meadows, Illinois, 60008
| | - Caroline D Hoemann
- Department of Chemical Engineering and Institute of Biomedical Engineering, Polytechnique Montreal, P.O. Box 6079, Station Centre-Ville, Montreal, Quebec H3C 3A7, Canada.,Groupe de Recherche en Sciences et Technologies Biomédicales, Polytechnique Montreal, P.O. Box 6079, Station Centre-Ville, Montreal, Quebec H3C 3A7, Canada
| | - Michael D Buschmann
- Department of Chemical Engineering and Institute of Biomedical Engineering, Polytechnique Montreal, P.O. Box 6079, Station Centre-Ville, Montreal, Quebec H3C 3A7, Canada.,Groupe de Recherche en Sciences et Technologies Biomédicales, Polytechnique Montreal, P.O. Box 6079, Station Centre-Ville, Montreal, Quebec H3C 3A7, Canada
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