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Davis-Wilson HC, Thoma LM, Franz JR, Blackburn JT, Longobardi L, Schwartz TA, Hackney AC, Pietrosimone B. Physical Activity Associates with T1rho MRI of Femoral Cartilage After Anterior Cruciate Ligament Reconstruction. Med Sci Sports Exerc 2024; 56:411-417. [PMID: 37796166 PMCID: PMC10922225 DOI: 10.1249/mss.0000000000003318] [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] [Indexed: 10/06/2023]
Abstract
PURPOSE Less physical activity has been associated with systemic biomarkers of cartilage breakdown after anterior cruciate ligament reconstruction (ACLR). However, previous research lacks analysis of deleterious cartilage compositional changes and objective physical activity after ACLR. The purpose of this study was to determine the association between physical activity quantified via accelerometer-based measures of daily steps and time in moderate-to-vigorous physical activity (MVPA), and T1rho magnetic resonance imaging (MRI) of the femoral articular cartilage, a marker of proteoglycan density in individuals with ACLR. METHODS Daily steps and MVPA were assessed over 7 d using an accelerometer worn on the hip in 26 individuals between 6 and 12 months after primary unilateral ACLR. Resting T1rho MRI was collected bilaterally, and T1rho MRI interlimb ratios (ILR: ACLR limb/contralateral limb) were calculated for lateral and medial femoral condyle regions of interest. We conducted univariate linear regression analyses to determine associations between T1rho MRI ILRs and daily steps and MVPA with and without controlling for sex. RESULTS Greater T1rho MRI ILR of the central lateral femoral condyle, indicative of less proteoglycan density in the ACLR limb, was associated with greater time in MVPA ( R2 = 0.178, P = 0.032). Sex-adjusted models showed significant interaction terms between daily steps and sex in the anterior ( P = 0.025), central ( P = 0.002), and posterior ( P = 0.002) medial femoral condyle. CONCLUSIONS Lesser physical activity may be a risk factor for maintaining cartilage health after ACLR; additionally, the relationship between physical activity and cartilage health may be different between males and females.
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Affiliation(s)
- Hope C. Davis-Wilson
- Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO
- VA Eastern Colorado Geriatric Research, Education, and Clinical Center, Rocky Mountain Regional VA Medical Center, Aurora, CO
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Louise M. Thoma
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Division of Physical Therapy, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Jason R. Franz
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC
| | - J. Troy Blackburn
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Department of Orthopaedics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Lara Longobardi
- Department of Medicine, Division of Rheumatology, Allergy, and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Todd A. Schwartz
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Department of Biostatistics, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Anthony C. Hackney
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Brian Pietrosimone
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Department of Orthopaedics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Patterson BE, Girdwood MA, West TJ, Bruder AM, Øiestad BE, Juhl C, Culvenor AG. Muscle strength and osteoarthritis of the knee: a systematic review and meta-analysis of longitudinal studies. Skeletal Radiol 2023; 52:2085-2097. [PMID: 36562820 DOI: 10.1007/s00256-022-04266-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 12/12/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To evaluate the sex-specific association between low knee extensor and flexor muscle strength and the risk of knee structural worsening. MATERIALS AND METHODS Systematic searches in five databases identified longitudinal studies (≥ 1 year follow-up) reporting an association between knee extensor or flexor strength and structural decline in individuals with, or at risk of, knee osteoarthritis. Results were pooled for tibiofemoral and patellofemoral osteoarthritis worsening (and stratified by sex/gender where possible) using a random-effects meta-analysis estimating the risk ratio and 95% confidence interval or a best-evidence synthesis. Risk of bias and overall certainty of evidence were assessed. RESULTS Fourteen studies were included with participants (mean age 27-72 years) with osteoarthritis (n = 8), at risk of osteoarthritis (n = 3), or a combination with, or at risk of, osteoarthritis (n = 3). Low knee extensor strength was associated with an increased risk of worsening tibiofemoral (12 studies: RR 1.18, 95% CI 1.04 to 1.35) and patellofemoral osteoarthritis (4 studies: RR 1.62, 95% CI 1.01 to 2.61). Significant associations between low knee extensor strength and worsening tibiofemoral osteoarthritis were observed for women (4 studies: RR 1.25, 95% CI 1.04 to 1.51) but not men (4 studies: RR 1.10, 95% CI 0.87 to 1.39). Low knee flexor strength increased the risk of worsening tibiofemoral osteoarthritis (5 studies: RR 1.16, 95% CI 1.07 to 1.26). Ten studies were high risk of bias, and all estimates were graded as very low certainty of evidence. CONCLUSION Low knee extensor and flexor strength increased the risk of worsening tibiofemoral osteoarthritis. Low knee extensor strength increased the risk of worsening patellofemoral osteoarthritis. The relationship between low knee extensor strength and worsening tibiofemoral osteoarthritis may be modified by sex/gender.
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Affiliation(s)
- Brooke E Patterson
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health Human Services and Sport, La Trobe University, Kingsbury Drive, Melbourne, VIC, 3086, Australia
- Australian IOC Research Centre, La Trobe University, Melbourne, VIC, Australia
| | - Michael A Girdwood
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health Human Services and Sport, La Trobe University, Kingsbury Drive, Melbourne, VIC, 3086, Australia
- Australian IOC Research Centre, La Trobe University, Melbourne, VIC, Australia
| | - Thomas J West
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health Human Services and Sport, La Trobe University, Kingsbury Drive, Melbourne, VIC, 3086, Australia
- Australian IOC Research Centre, La Trobe University, Melbourne, VIC, Australia
| | - Andrea M Bruder
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health Human Services and Sport, La Trobe University, Kingsbury Drive, Melbourne, VIC, 3086, Australia
- Australian IOC Research Centre, La Trobe University, Melbourne, VIC, Australia
| | - Britt Elin Øiestad
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | - Carsten Juhl
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Department of Physiotherapy and Occupational Therapy, University Hospital of Copenhagen, Herlev, and Gentofte, Capital Region of Denmark, Denmark
| | - Adam G Culvenor
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health Human Services and Sport, La Trobe University, Kingsbury Drive, Melbourne, VIC, 3086, Australia.
- Australian IOC Research Centre, La Trobe University, Melbourne, VIC, Australia.
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Liao TC, Bird A, Samaan MA, Pedoia V, Majumdar S, Souza RB. Persistent underloading of patellofemoral joint following hamstring autograft ACL reconstruction is associated with cartilage health. Osteoarthritis Cartilage 2023; 31:1265-1273. [PMID: 37116856 DOI: 10.1016/j.joca.2023.04.010] [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: 08/02/2022] [Revised: 03/31/2023] [Accepted: 04/14/2023] [Indexed: 04/30/2023]
Abstract
OBJECTIVE To determine the longitudinal changes of patellofemoral joint (PFJ) contact pressure following anterior cruciate ligament reconstruction (ACLR). To identify the associations between PFJ contact pressure and cartilage health. DESIGN Forty-nine subjects with hamstring autograft ACLR (27 males; age 28.8 [standard deviation, 8.3] years) and 19 controls (12 males; 30.7 [4.6] years) participated. A sagittal plane musculoskeletal model was used to estimate PFJ contact pressure. A combined T1ρ/T2 magnetic resonance sequence was obtained. Assessments were performed preoperatively, at 6 months, 1, 2, and 3 years postoperatively in ACLR subjects and once for controls. Repeated Analysis of Variance (ANOVA) was used to compare peak PFJ contact pressure between ACLR and contralateral knees, and t-tests to compare with control knees. Statistical parametric mapping was used to evaluate the associations between PFJ contact pressure and cartilage relaxation concurrently and longitudinally. RESULTS No changes in peak PFJ contact pressure were found within ACLR knees over 3 years (preoperative to 3 years, 0.36 [CI, -0.08, 0.81] MPa), but decreased over time in the contralateral knees (0.75 [0.32, 1.18] MPa). When compared to the controls, ACLR knees exhibited lower PFJ contact pressure at all time points (at baseline, -0.64 [-1.25, -0.03] MPa). Within ACLR knees, lower PFJ contact pressure at 6 months was associated with elevated T2 times (r = -0.47 to -0.49, p = 0.021-0.025). CONCLUSIONS Underloading of the PFJ following ACLR persists for up to 3 years and has concurrent and future consequences in cartilage health. The non-surgical knees exhibited normal contact pressure initially but decreased over time achieving limb symmetry.
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Affiliation(s)
- Tzu-Chieh Liao
- Department of Physical Therapy, University of Michigan-Flint, Flint, MI, USA; Department of Radiology, University of Michigan, Ann Arbor, MI, USA.
| | - Alyssa Bird
- Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, San Francisco, CA, USA
| | - Michael A Samaan
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY, USA
| | - Valentina Pedoia
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Sharmila Majumdar
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Richard B Souza
- Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, San Francisco, CA, USA; Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
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Voinier D, Neogi T, Arbeeva L, Voinier S, Master H, Thoma LM, Brunette M, Jakiela JT, White DK. Association of physical activity with loss of knee joint space width over two years: a compositional data analysis in the Osteoarthritis Initiative. Osteoarthritis Cartilage 2023; 31:1091-1100. [PMID: 36822497 PMCID: PMC10523474 DOI: 10.1016/j.joca.2022.12.012] [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: 07/01/2022] [Revised: 11/18/2022] [Accepted: 12/15/2022] [Indexed: 02/25/2023]
Abstract
OBJECTIVE There is continued debate as to how engaging in physical activity (PA), including moderate-to-vigorous PA (MVPA), light PA (LPA), and sedentary time (SED), affects one's risk for knee osteoarthritis (OA). Traditional regression methods do not account for the codependence of these categories of PA, whereby when one category increases, the others must decrease. Thus, we used compositional data analysis (CoDA) to examine time spent in each category of PA, or PA composition, and its association with loss of knee joint space width (JSW), a common indicator of knee OA progression. METHODS We performed a secondary analysis of data from a subset of participants in the Osteoarthritis Initiative. These participants had minute-by-minute activity data collected over 7 days at baseline; we then categorized each minute as MVPA, LPA, or SED. Our exposure, PA composition, represented min/day spent in each category. Our outcome, medial JSW loss, was the difference in medial tibiofemoral JSW from baseline to 2 years later. We employed CoDA, using an isometric log-ratio transformation, to examine the association of PA composition with medial JSW loss over 2 years, adjusting for potential confounders. RESULTS We included 969 participants (age: 64.5 years, 56% female, body mass index [BMI]: 28.8 kg/m2). Mean PA composition was: MVPA 9.1 min/day, LPA 278 min/day, SED 690 min/day. Per adjusted regression models, higher MVPA was not associated with greater medial JSW loss (β = -0.0005, P = 0.97), nor was LPA (β = 0.06, P = 0.27) or SED (β = -0.06, P = 0.21). CONCLUSION Using CoDA, PA composition was not associated with medial JSW loss over 2 years.
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Affiliation(s)
- D Voinier
- Department of Physical Therapy, University of Delaware, Newark, DE, USA.
| | - T Neogi
- Department of Medicine, Section of Rheumatology, Boston University School of Medicine, Boston, MA, USA.
| | - L Arbeeva
- University of North Carolina at Chapel Hill, Thurston Arthritis Research Center, Chapel Hill, NC, USA.
| | - S Voinier
- Department of Mechanical Engineering, University of Delaware, Newark, DE, USA.
| | - H Master
- Vanderbilt University Medical Center, Vanderbilt Institute for Clinical and Translational Research, Nashville, TN, USA.
| | - L M Thoma
- University of North Carolina at Chapel Hill, Division of Physical Therapy, Chapel Hill, NC, USA.
| | - M Brunette
- Evidation Health Inc, San Mateo, CA, USA.
| | - J T Jakiela
- Department of Physical Therapy, University of Delaware, Newark, DE, USA.
| | - D K White
- Department of Physical Therapy, University of Delaware, Newark, DE, USA.
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Coburn SL, Crossley KM, Kemp JL, Warden SJ, West TJ, Bruder AM, Mentiplay BF, Culvenor AG. Immediate and Delayed Effects of Joint Loading Activities on Knee and Hip Cartilage: A Systematic Review and Meta-analysis. SPORTS MEDICINE - OPEN 2023; 9:56. [PMID: 37450202 PMCID: PMC10348990 DOI: 10.1186/s40798-023-00602-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 06/19/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND The impact of activity-related joint loading on cartilage is not clear. Abnormal loading is considered to be a mechanical driver of osteoarthritis (OA), yet moderate amounts of physical activity and rehabilitation exercise can have positive effects on articular cartilage. Our aim was to investigate the immediate effects of joint loading activities on knee and hip cartilage in healthy adults, as assessed using magnetic resonance imaging. We also investigated delayed effects of activities on healthy cartilage and the effects of activities on cartilage in adults with, or at risk of, OA. We explored the association of sex, age and loading duration with cartilage changes. METHODS A systematic review of six databases identified studies assessing change in adult hip and knee cartilage using MRI within 48 h before and after application of a joint loading intervention/activity. Studies included adults with healthy cartilage or those with, or at risk of, OA. Joint loading activities included walking, hopping, cycling, weightbearing knee bends and simulated standing within the scanner. Risk of bias was assessed using the Newcastle-Ottawa Scale. Random-effects meta-analysis estimated the percentage change in compartment-specific cartilage thickness or volume and composition (T2 relaxation time) outcomes. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system evaluated certainty of evidence. RESULTS Forty studies of 653 participants were included after screening 5159 retrieved studies. Knee cartilage thickness or volume decreased immediately following all loading activities investigating healthy adults; however, GRADE assessment indicated very low certainty evidence. Patellar cartilage thickness and volume reduced 5.0% (95% CI 3.5, 6.4, I2 = 89.3%) after body weight knee bends, and tibial cartilage composition (T2 relaxation time) decreased 5.1% (95% CI 3.7, 6.5, I2 = 0.0%) after simulated standing within the scanner. Hip cartilage data were insufficient for pooling. Secondary outcomes synthesised narratively suggest knee cartilage recovers within 30 min of walking and 90 min of 100 knee bends. We found contrasting effects of simulated standing and walking in adults with, or at risk of, OA. An increase of 10 knee bend repetitions was associated with 2% greater reduction in patellar thickness or volume. CONCLUSION There is very low certainty evidence that minimal knee cartilage thickness and volume and composition (T2 relaxation time) reductions (0-5%) occur after weightbearing knee bends, simulated standing, walking, hopping/jumping and cycling, and the impact of knee bends may be dose dependent. Our findings provide a framework of cartilage responses to loading in healthy adults which may have utility for clinicians when designing and prescribing rehabilitation programs and providing exercise advice.
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Affiliation(s)
- Sally L. Coburn
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC Australia
| | - Kay M. Crossley
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC Australia
| | - Joanne L. Kemp
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC Australia
| | - Stuart J. Warden
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC Australia
- Department of Physical Therapy, School of Health & Human Sciences, Indiana University, Indianapolis, IN USA
| | - Tom J. West
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC Australia
| | - Andrea M. Bruder
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC Australia
| | - Benjamin F. Mentiplay
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC Australia
| | - Adam G. Culvenor
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC Australia
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Hu Y, Zhang H, Wang S, Cao L, Zhou F, Jing Y, Su J. Bone/cartilage organoid on-chip: Construction strategy and application. Bioact Mater 2023; 25:29-41. [PMID: 37056252 PMCID: PMC10087111 DOI: 10.1016/j.bioactmat.2023.01.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/15/2023] [Accepted: 01/16/2023] [Indexed: 01/21/2023] Open
Abstract
The necessity of disease models for bone/cartilage related disorders is well-recognized, but the barrier between ex-vivo cell culture, animal models and the real human body has been pending for decades. The organoid-on-a-chip technique showed opportunity to revolutionize basic research and drug screening for diseases like osteoporosis and arthritis. The bone/cartilage organoid on-chip (BCoC) system is a novel platform of multi-tissue which faithfully emulate the essential elements, biologic functions and pathophysiological response under real circumstances. In this review, we propose the concept of BCoC platform, summarize the basic modules and current efforts to orchestrate them on a single microfluidic system. Current disease models, unsolved problems and future challenging are also discussed, the aim should be a deeper understanding of diseases, and ultimate realization of generic ex-vivo tools for further therapeutic strategies of pathological conditions.
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Transcriptomic response of bioengineered human cartilage to parabolic flight microgravity is sex-dependent. NPJ Microgravity 2023; 9:5. [PMID: 36658138 PMCID: PMC9852254 DOI: 10.1038/s41526-023-00255-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 01/10/2023] [Indexed: 01/20/2023] Open
Abstract
Spaceflight and simulated spaceflight microgravity induced osteoarthritic-like alterations at the transcriptomic and proteomic levels in the articular and meniscal cartilages of rodents. But little is known about the effect of spaceflight or simulated spaceflight microgravity on the transcriptome of tissue-engineered cartilage developed from human cells. In this study, we investigate the effect of simulated spaceflight microgravity facilitated by parabolic flights on tissue-engineered cartilage developed from in vitro chondrogenesis of human bone marrow mesenchymal stem cells obtained from age-matched female and male donors. The successful induction of cartilage-like tissue was confirmed by the expression of well-demonstrated chondrogenic markers. Our bulk transcriptome data via RNA sequencing demonstrated that parabolic flight altered mostly fundamental biological processes, and the modulation of the transcriptome profile showed sex-dependent differences. The secretome profile analysis revealed that two genes (WNT7B and WNT9A) from the Wnt-signaling pathway, which is implicated in osteoarthritis development, were only up-regulated for female donors. The results of this study showed that the engineered cartilage tissues responded to microgravity in a sex-dependent manner, and the reported data offers a strong foundation to further explore the underlying mechanisms.
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8
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Ma Z, Li DX, Chee RKW, Kunze M, Mulet-Sierra A, Sommerfeldt M, Westover L, Graf D, Adesida AB. Mechanical Unloading of Engineered Human Meniscus Models Under Simulated Microgravity: A Transcriptomic Study. Sci Data 2022; 9:736. [PMID: 36450785 PMCID: PMC9712603 DOI: 10.1038/s41597-022-01837-x] [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: 05/20/2022] [Accepted: 11/14/2022] [Indexed: 12/12/2022] Open
Abstract
Osteoarthritis (OA) primarily affects mechanical load-bearing joints, with the knee being the most common. The prevalence, burden and severity of knee osteoarthritis (KOA) are disproportionately higher in females, but hormonal differences alone do not explain the disproportionate incidence of KOA in females. Mechanical unloading by spaceflight microgravity has been implicated in OA development in cartilaginous tissues. However, the mechanisms and sex-dependent differences in OA-like development are not well explored. In this study, engineered meniscus constructs were generated from healthy human meniscus fibrochondrocytes (MFC) seeded onto type I collagen scaffolds and cultured under normal gravity and simulated microgravity conditions. We report the whole-genome sequences of constructs from 4 female and 4 male donors, along with the evaluation of their phenotypic characteristics. The collected data could be used as valuable resources to further explore the mechanism of KOA development in response to mechanical unloading, and to investigate the molecular basis of the observed sex differences in KOA.
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Affiliation(s)
- Zhiyao Ma
- grid.17089.370000 0001 2190 316XDepartment of Surgery, Division of Orthopaedic Surgery, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 2E1 Canada
| | - David Xinzheyang Li
- grid.17089.370000 0001 2190 316XDepartment of Surgery, Division of Orthopaedic Surgery, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 2E1 Canada ,grid.17089.370000 0001 2190 316XDepartment of Civil & Environmental Engineering, University of Alberta, Edmonton, AB Canada
| | - Ryan K. W. Chee
- grid.17089.370000 0001 2190 316XDepartment of Surgery, Division of Orthopaedic Surgery, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 2E1 Canada
| | - Melanie Kunze
- grid.17089.370000 0001 2190 316XDepartment of Surgery, Division of Orthopaedic Surgery, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 2E1 Canada
| | - Aillette Mulet-Sierra
- grid.17089.370000 0001 2190 316XDepartment of Surgery, Division of Orthopaedic Surgery, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 2E1 Canada
| | - Mark Sommerfeldt
- grid.17089.370000 0001 2190 316XDepartment of Surgery, Division of Orthopaedic Surgery, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 2E1 Canada
| | - Lindsey Westover
- grid.17089.370000 0001 2190 316XDepartment of Mechanical Engineering, University of Alberta, Edmonton, AB Canada
| | - Daniel Graf
- grid.17089.370000 0001 2190 316XSchool of Dentistry, University of Alberta, Edmonton, AB Canada
| | - Adetola B. Adesida
- grid.17089.370000 0001 2190 316XDepartment of Surgery, Division of Orthopaedic Surgery, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 2E1 Canada
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Study on the Role of MicroRNA-214 in the Rehabilitation of Cartilage in Mice with Exercise-Induced Traumatic Osteoarthritis. Curr Issues Mol Biol 2022; 44:4100-4117. [PMID: 36135193 PMCID: PMC9497662 DOI: 10.3390/cimb44090281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/01/2022] [Accepted: 09/02/2022] [Indexed: 01/17/2023] Open
Abstract
This study aimed to explore the possible relationship between the expression of Micro RNA-214 (miR-214) and the pathogenesis and recovery in mice with post-traumatic osteoarthritis (PTOA). In this study, 40 male C57BL/6 mice were randomly divided into five groups: model control (MC) group, model (M) group, rehabilitation control (RC) group, model + rehabilitation (M + R) group, and model + convalescent (M + C) group. Four weeks of high-intensity treadmill exercise (HITE) and 4 weeks of moderate-intensity treadmill exercise (MITE) were implemented for PTOA modeling and rehabilitation, respectively. In vitro, 10% elongation mechanical strain was used for IL-1β stimulated chondrocytes. We found that compared with the MC group, there was a significant increase in the aspect of inflammation and catabolism while a dramatic fall in miR-214 expression was observed in the M group. After the 4 weeks of MITE, the level of inflammation and metabolism, as well as miR-214 expression, was partially reversed in the M + R group compared with the M + C group. The expression of miR-214 decreased dramatically after chondrocyte stimulation by IL-1β and then increased significantly after 10% strain was applied to IL-1β-treated cells. These results suggest that a suitable mechanical load can increase the expression of miR-214, and that miR-214 may play a chondroprotective effect in the development of OA.
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Dahmen J, Stornebrink T, Smit TH, Kerkhoffs GMMJ. Comment on: Khan et al. "The Influence of Running on Lower Limb Cartilage: A Systematic Review and Meta-Analysis". Sports Med 2022; 52:3065-3066. [PMID: 35939210 DOI: 10.1007/s40279-022-01743-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2022] [Indexed: 10/15/2022]
Affiliation(s)
- Jari Dahmen
- Department of Orthopaedic Surgery, Amsterdam UMC, Location AMC, Amsterdam Movement Sciences, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.,Academic Center for Evidence Based Sports Medicine (ACES), Amsterdam, The Netherlands.,Amsterdam Collaboration for Health and Safety in Sports (ACHSS), International Olympic Committee (IOC) Research Center Amsterdam UMC, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Tobias Stornebrink
- Department of Orthopaedic Surgery, Amsterdam UMC, Location AMC, Amsterdam Movement Sciences, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.,Academic Center for Evidence Based Sports Medicine (ACES), Amsterdam, The Netherlands.,Amsterdam Collaboration for Health and Safety in Sports (ACHSS), International Olympic Committee (IOC) Research Center Amsterdam UMC, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Theodoor H Smit
- Department of Orthopaedic Surgery, Amsterdam UMC, Location AMC, Amsterdam Movement Sciences, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.,Academic Center for Evidence Based Sports Medicine (ACES), Amsterdam, The Netherlands.,Amsterdam Collaboration for Health and Safety in Sports (ACHSS), International Olympic Committee (IOC) Research Center Amsterdam UMC, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.,Department of Medical Biology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Gino M M J Kerkhoffs
- Department of Orthopaedic Surgery, Amsterdam UMC, Location AMC, Amsterdam Movement Sciences, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands. .,Academic Center for Evidence Based Sports Medicine (ACES), Amsterdam, The Netherlands. .,Amsterdam Collaboration for Health and Safety in Sports (ACHSS), International Olympic Committee (IOC) Research Center Amsterdam UMC, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
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Gatti AA, Keir PJ, Noseworthy MD, Maly MR. Investigating acute changes in osteoarthritic cartilage by integrating biomechanics and statistical shape models of bone: data from the osteoarthritis initiative. MAGNETIC RESONANCE MATERIALS IN PHYSICS, BIOLOGY AND MEDICINE 2022; 35:861-873. [PMID: 35286512 PMCID: PMC8919909 DOI: 10.1007/s10334-022-01004-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/06/2021] [Accepted: 12/30/2021] [Indexed: 11/25/2022]
Abstract
Objective Methods Results Discussion Supplementary Information
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Affiliation(s)
- Anthony A Gatti
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
- NeuralSeg Ltd., Hamilton, Canada
| | - Peter J Keir
- Department of Kinesiology, McMaster University, Hamilton, Canada
| | - Michael D Noseworthy
- School of Biomedical Engineering, McMaster University, Hamilton, Canada
- School of Electrical and Computer Engineering, McMaster University, Hamilton, Canada
| | - Monica R Maly
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada.
- Department of Kinesiology, McMaster University, Hamilton, Canada.
- Department of Kinesiology, University of Waterloo, Waterloo, Canada.
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12
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Ma Z, Li DX, Kunze M, Mulet-Sierra A, Westover L, Adesida AB. Engineered Human Meniscus in Modeling Sex Differences of Knee Osteoarthritis in Vitro. Front Bioeng Biotechnol 2022; 10:823679. [PMID: 35284415 PMCID: PMC8904202 DOI: 10.3389/fbioe.2022.823679] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/21/2022] [Indexed: 12/30/2022] Open
Abstract
Background: Osteoarthritis (OA) primarily affects mechanical load-bearing joints. The knee joint is the most impacted by OA. Knee OA (KOA) occurs in almost all demographic groups, but the prevalence and severity are disproportionately higher in females. The molecular mechanism underlying the pathogenesis and progression of KOA is unknown. The molecular basis of biological sex matters of KOA is not fully understood. Mechanical stimulation plays a vital role in modulating OA-related responses of load-bearing tissues. Mechanical unloading by simulated microgravity (SMG) induced OA-like gene expression in engineered cartilage, while mechanical loading by cyclic hydrostatic pressure (CHP), on the other hand, exerted a pro-chondrogenic effect. This study aimed to evaluate the effects of mechanical loading and unloading via CHP and SMG, respectively, on the OA-related profile changes of engineered meniscus tissues and explore biological sex-related differences.Methods: Tissue-engineered menisci were made from female and male meniscus fibrochondrocytes (MFCs) under static conditions of normal gravity in chondrogenic media and subjected to SMG and CHP culture. Constructs were assayed via histology, immunofluorescence, GAG/DNA assays, RNA sequencing, and testing of mechanical properties.Results: The mRNA expression of ACAN and COL2A1, was upregulated by CHP but downregulated by SMG. COL10A1, a marker for chondrocyte hypertrophy, was downregulated by CHP compared to SMG. Furthermore, CHP increased GAG/DNA levels and wet weight in both female and male donors, but only significantly in females. From the transcriptomics, CHP and SMG significantly modulated genes related to the ossification, regulation of ossification, extracellular matrix, and angiogenesis Gene Ontology (GO) terms. A clear difference in fold-change magnitude and direction was seen between the two treatments for many of the genes. Furthermore, differences in fold-change magnitudes were seen between male and female donors within each treatment. SMG and CHP also significantly modulated genes in OA-related KEGG pathways, such as mineral absorption, Wnt signalling pathway, and HIF-1 signalling pathway.Conclusion: Engineered menisci responded to CHP and SMG in a sex-dependent manner. SMG may induce an OA-like profile, while CHP promotes chondrogenesis. The combination of SMG and CHP could serve as a model to study the early molecular events of KOA and potential drug-targetable pathways.
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Affiliation(s)
- Zhiyao Ma
- Department of Surgery, Divisions of Orthopaedic Surgery, Surgical Research and Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - David Xinzheyang Li
- Department of Surgery, Divisions of Orthopaedic Surgery, Surgical Research and Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Department of Civil and Environmental Engineering, University of Alberta, Edmonton, AB, Canada
| | - Melanie Kunze
- Department of Surgery, Divisions of Orthopaedic Surgery, Surgical Research and Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Aillette Mulet-Sierra
- Department of Surgery, Divisions of Orthopaedic Surgery, Surgical Research and Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Lindsey Westover
- Department of Mechanical Engineering, University of Alberta, Edmonton, AB, Canada
| | - Adetola B. Adesida
- Department of Surgery, Divisions of Orthopaedic Surgery, Surgical Research and Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- *Correspondence: Adetola B. Adesida,
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13
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Bjornsen E, Schwartz TA, Lisee C, Blackburn T, Lalush D, Nissman D, Spang J, Pietrosimone B. Loading during Midstance of Gait Is Associated with Magnetic Resonance Imaging of Cartilage Composition Following Anterior Cruciate Ligament Reconstruction. Cartilage 2022; 13:19476035211072220. [PMID: 35098719 PMCID: PMC9137315 DOI: 10.1177/19476035211072220] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE A complex association exists between aberrant gait biomechanics and posttraumatic knee osteoarthritis (PTOA) development. Previous research has primarily focused on the link between peak loading during the loading phase of stance and joint tissue changes following anterior cruciate ligament reconstruction (ACLR). However, the associations between loading and cartilage composition at other portions of stance, including midstance and late stance, is unclear. The objective of this study was to explore associations between vertical ground reaction force (vGRF) at each 1% increment of stance phase and tibiofemoral articular cartilage magnetic resonance imaging (MRI) T1ρ relaxation times following ACLR. DESIGN Twenty-three individuals (47.82% female, 22.1 ±4.1 years old) with unilateral ACLR participated in a gait assessment and T1ρ MRI collection at 12.25 ± 0.61 months post-ACLR. T1ρ relaxation times were calculated for the articular cartilage of the weightbearing medial and lateral femoral (MFC, LFC) and tibial (MTC, LTC) condyles. Separate bivariate, Pearson product moment correlation coefficients (r) were used to estimate strength of associations between T1ρ MRI relaxation times in the medial and lateral tibiofemoral articular cartilage with vGRF across the entire stance phase. RESULTS Greater vGRF during midstance (46%-56% of stance phase) was associated with greater T1ρ MRI relaxation times in the MFC (r ranging between 0.43 and 0.46). CONCLUSIONS Biomechanical gait profiles that include greater vGRF during midstance are associated with MRI estimates of lesser proteoglycan density in the MFC. Inability to unload the ACLR limb during midstance may be linked to joint tissue changes associated with PTOA development.
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Affiliation(s)
- Elizabeth Bjornsen
- Human Movement Science Curriculum, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Elizabeth Bjornsen, Human Movement Science Curriculum, The University of North Carolina at Chapel Hill, Fetzer Hall, 210 South Road, Chapel Hill, NC 27599, USA.
| | - Todd A. Schwartz
- Department of Biostatistics, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Caroline Lisee
- Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Troy Blackburn
- Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - David Lalush
- Joint Department of Biomedical Engineering, North Carolina State University and The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Daniel Nissman
- Department of Radiology, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jeffrey Spang
- Department of Orthopaedics, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Brian Pietrosimone
- Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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14
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Schulz H, Strauch SM, Richter P, Wehland M, Krüger M, Sahana J, Corydon TJ, Wise P, Baran R, Lebert M, Grimm D. Latest knowledge about changes in the proteome in microgravity. Expert Rev Proteomics 2022; 19:43-59. [PMID: 35037812 DOI: 10.1080/14789450.2022.2030711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
INTRODUCTION : A long-term stay of humans in space causes a large number of well-known health problems and changes in protists and plants. Deep space exploration will increase the time humans or rodents will spend in microgravity (µg). Moreover, they are exposed to cosmic radiation, hypodynamia, and isolation. OMICS investigations will increase our knowledge of the underlying mechanisms of µg-induced alterations in vivo and in vitro. AREAS COVERED : We summarize the findings over the recent 3 years on µg-induced changes in the proteome of protists, plants, rodent and human cells. Considering the thematic orientation of microgravity-related publications in that time frame, we focus on medicine-associated findings such as the µg-induced antibiotic resistance of bacteria, the myocardial consequences of µg-induced calpain activation and the role of MMP13 in osteoarthritis. All these point to the fact that µg is an extreme stressor that could not be evolutionarily addressed on Earth. EXPERT COMMENTARY : In conclusion, when interpreting µg-experiments, the direct, mostly unspecific stress response, must be distinguished from specific µg-effects. For this reason, recent studies often do not consider single protein findings but place them in the context of protein-protein interactions. This enables an estimation of functional relationships, especially if these are supported by epigenetic and transcriptional data (multi-omics).
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Affiliation(s)
- Herbert Schulz
- Department of Microgravity and Translational Regenerative Medicine, Clinic for Plastic, Aesthetic and Hand Surgery, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.,Research Group 'Magdeburger Arbeitsgemeinschaft für Forschung unter Raumfahrt- und Schwerelosigkeitsbedingungen' (MARS), Otto-von-Guericke University, Magdeburg, Germany
| | - Sebastian M Strauch
- Postgraduate Program in Health and Environment, University of Joinville Region, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, SC, CEP 89219-710, Brazil
| | - Peter Richter
- Gravitational Biology Group, Department of Biology, Friedrich-Alexander University, Staudtstraße 5, 91058 Erlangen, Germany
| | - Markus Wehland
- Department of Microgravity and Translational Regenerative Medicine, Clinic for Plastic, Aesthetic and Hand Surgery, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.,Research Group 'Magdeburger Arbeitsgemeinschaft für Forschung unter Raumfahrt- und Schwerelosigkeitsbedingungen' (MARS), Otto-von-Guericke University, Magdeburg, Germany
| | - Marcus Krüger
- Department of Microgravity and Translational Regenerative Medicine, Clinic for Plastic, Aesthetic and Hand Surgery, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.,Research Group 'Magdeburger Arbeitsgemeinschaft für Forschung unter Raumfahrt- und Schwerelosigkeitsbedingungen' (MARS), Otto-von-Guericke University, Magdeburg, Germany
| | | | - Thomas J Corydon
- Department of Biomedicine, Aarhus University, Aarhus C, Denmark.,Department of Ophthalmology, Aarhus University Hospital, Aarhus C, Denmark
| | - Petra Wise
- Department of Microgravity and Translational Regenerative Medicine, Clinic for Plastic, Aesthetic and Hand Surgery, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.,The Saban Research Institute, Children's Hospital Los Angeles, University of Southern California, Los Angeles, USA
| | - Ronni Baran
- Department of Biomedicine, Aarhus University, Aarhus C, Denmark
| | - Michael Lebert
- Gravitational Biology Group, Department of Biology, Friedrich-Alexander University, Staudtstraße 5, 91058 Erlangen, Germany.,Space Biology Unlimited SAS, 24 Cours de l'Intendance, 33000 Bordeaux, France
| | - Daniela Grimm
- Department of Microgravity and Translational Regenerative Medicine, Clinic for Plastic, Aesthetic and Hand Surgery, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.,Research Group 'Magdeburger Arbeitsgemeinschaft für Forschung unter Raumfahrt- und Schwerelosigkeitsbedingungen' (MARS), Otto-von-Guericke University, Magdeburg, Germany.,Department of Biomedicine, Aarhus University, Aarhus C, Denmark
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15
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Wellsandt E, Kallman T, Golightly Y, Podsiadlo D, Dudley A, Vas S, Michaud K, Tao M, Sajja B, Manzer M. Knee joint unloading and daily physical activity associate with cartilage T2 relaxation times 1 month after ACL injury. J Orthop Res 2022; 40:138-149. [PMID: 33783030 PMCID: PMC8478972 DOI: 10.1002/jor.25034] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 02/14/2021] [Accepted: 03/10/2021] [Indexed: 02/04/2023]
Abstract
Osteoarthritis (OA) is prevalent after anterior cruciate ligament (ACL) injury, but mechanismsunderlying its development are poorly understood. The purpose of this study was to determine if gait biomechanics and daily physical activity (PA) associate with cartilage T2 relaxation times, a marker of collagen organization and water content, 1 month after ACL injury. Twenty-seven participants (15-35 years old) without chondral lesions completed magnetic resonance imaging, three-dimensional gait analysis, and 1 week of PA accelerometry. Interlimb differences and ratios were calculated for gait biomechanics and T2 relaxation times, respectively. Multiple linear regression models adjusted for age, sex, and concomitant meniscus injury were used to determine the association between gait biomechanics and PA with T2 relaxation times, respectively. Altered knee adduction moment (KAM) impulse, less knee flexion excursion (kEXC) and higher daily step counts accounted for 35.8%-65.8% of T2 relaxation time variation in the weightbearing and posterior cartilage of the medial and lateral compartment (all p ≤ .011). KAM impulse was the strongest factor for T2 relaxation times in all models (all p ≤ .001). Lower KAM impulse associated with longer T2 relaxation times in the injured medial compartment (β = -.720 to -.901) and shorter T2 relaxation in the lateral compartment (β = .713 to .956). At 1 month after ACL injury, altered KAM impulse, less kEXC, and higher PA associated with longer T2 relaxation times, which may indicate poorer cartilage health. Statement of Clinical Significance: Gait biomechanics and daily PA are modifiable targets that may improve cartilage health acutely after ACL injury and slow progression to OA.
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Affiliation(s)
- Elizabeth Wellsandt
- Division of Physical Therapy Education, University of Nebraska Medical Center, Omaha, Nebraska, USA,Department of Orthopedic Surgery and Rehabilitation, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Tyler Kallman
- College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Yvonne Golightly
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA,Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA,Division of Physical Therapy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA,Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Daniel Podsiadlo
- Division of Physical Therapy Education, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Andrew Dudley
- Department of Genetics Cell Biology and Anatomy, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Stephanie Vas
- Department of Clinical Diagnostic and Therapeutic Sciences, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Kaleb Michaud
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA,Forward, The National Databank for Rheumatic Diseases, Wichita, Kansas, USA
| | - Matthew Tao
- Division of Physical Therapy Education, University of Nebraska Medical Center, Omaha, Nebraska, USA,Department of Orthopedic Surgery and Rehabilitation, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Balasrinivasa Sajja
- Department of Radiology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Melissa Manzer
- Department of Radiology, University of Nebraska Medical Center, Omaha, Nebraska, USA
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16
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Jerban S, Kasibhatla A, Ma Y, Wu M, Chen Y, Guo T, Wan L, Szeverenyi N, Chang EY, Du J. Detecting Articular Cartilage and Meniscus Deformation Effects Using Magnetization Transfer Ultrashort Echo Time (MT-UTE) Modeling during Mechanical Load Application: Ex Vivo Feasibility Study. Cartilage 2021; 13:665S-673S. [PMID: 33289401 PMCID: PMC8808840 DOI: 10.1177/1947603520976771] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Ultrashort echo time (UTE) magnetic resonance imaging (MRI) sequences have improved imaging of short T2 musculoskeletal (MSK) tissues. UTE-MRI combined with magnetization transfer modeling (UTE-MT) has demonstrated robust assessment of MSK tissues. This study aimed to investigate the variation of UTE-MT measures under mechanical loading in tibiofemoral cartilage and meniscus of cadaveric knee joints. DESIGN Fourteen knee joints from young (n = 8, 42 ± 12 years old) and elderly (n = 6, 89 ± 4 years old) donors were scanned on a 3-T scanner under 3 loading conditions: load = 300 N (Load1), load = 500 N (Load2), and load = 0 N (Unload). UTE-MT sequences were performed at each loading condition. Macromolecular proton fraction (MMF) was calculated from UTE-MT modeling. Wilcoxon rank sum test was used to examine the MRI data differences between loading conditions. RESULTS For young donors, MMF increased in all grouped regions of interest (meniscus [M], femoral articular cartilage [FAC], tibial articular cartilage [TAC], articular cartilage regions covered by meniscus [AC-MC], and articular cartilage regions uncovered by meniscus [AC-UC]) when the load increased from 300 to 500 N. The increases in MMF were significant for M (13.3%, P < 0.01) and AC-MC (9.2%, P = 0.04). MMF decreased in all studied regions after unloading, which was significant only for AC-MC (-8.9%, P = 0.01). For elderly donors, MRI parameters did not show significant changes by loading or unloading. CONCLUSION This study highlights the potential of the UTE-MT modeling combined with knee loading in differentiating between normal and abnormal knees. Average tissue deformation effects were likely higher and more uniformly distributed in the joints of young donors compared with elderly donors.
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Affiliation(s)
- Saeed Jerban
- Department of Radiology, University of
California, San Diego, CA, USA,Saeed Jerban, Department of Radiology,
University of California, 9500 Gilman Dr., San Diego, CA 92093, USA.
| | - Akhil Kasibhatla
- Department of Radiology, University of
California, San Diego, CA, USA
| | - Yajun Ma
- Department of Radiology, University of
California, San Diego, CA, USA
| | - Mei Wu
- Department of Radiology, University of
California, San Diego, CA, USA
| | - Yanjun Chen
- Department of Radiology, University of
California, San Diego, CA, USA
| | - Tan Guo
- Department of Radiology, University of
California, San Diego, CA, USA
| | - Lidi Wan
- Department of Radiology, University of
California, San Diego, CA, USA
| | | | - Eric Y. Chang
- Department of Radiology, University of
California, San Diego, CA, USA,Radiology Service, VA San Diego
Healthcare System, San Diego, CA, USA
| | - Jiang Du
- Department of Radiology, University of
California, San Diego, CA, USA
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17
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Wellsandt E, Emory J, Golightly YM, Dudley AT, Michaud K, Tao MA, Manzer MN, Sajja BR. Individual and cumulative measures of knee joint load associate with T2 relaxation times of knee cartilage in young, uninjured individuals: A pilot study. Knee 2021; 32:19-29. [PMID: 34371371 DOI: 10.1016/j.knee.2021.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 03/25/2021] [Accepted: 07/18/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Articular cartilage structure and chondrocyte health are sensitive and reliant on dynamic joint loading during activities. The purpose of this pilot study was to determine the association between measures of individual and cumulative knee joint loading with T2 relaxation times in the knee cartilage of young individuals without knee injury. METHODS Twelve participants (17-30 years old) without history of knee injury or surgery completed MRI, physical activity (PA), and biomechanical gait testing. T2 relaxation times were calculated in the cartilage within the patella and lateral and medial compartments. Accelerometry was used to measure mean daily step counts, minutes of PA, and % sedentary time over 7 days. Vertical ground reaction force, external knee joint moments and peak knee flexion angle were measured during stance phase of gait using three-dimensional motion capture. Cumulative knee joint loading was calculated as daily step count by external knee joint moment impulse. The relationship between measures of knee joint loading and T2 relaxation times was assessed using Pearson correlations. RESULTS Higher T2 relaxation times in the femoral and tibial cartilage were consistently correlated to greater body mass, daily step counts, moderate and vigorous PA, and peak knee joint moments (r = 0.10-0.84). Greater cumulative knee flexion and adduction loading was associated with higher T2 relaxation times in the femoral and tibial cartilage (r = 0.16-0.65). CONCLUSION Preliminary findings suggest that individual loading factors and cumulative knee joint loading are associated with higher T2 relaxation times in the articular cartilage of young, healthy knees.
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Affiliation(s)
- E Wellsandt
- Division of Physical Therapy Education, University of Nebraska Medical Center, 984420 Nebraska Medical Center, Omaha, NE 98198-4420, United States; Department of Orthopaedic Surgery and Rehabilitation, University of Nebraska Medical Center, 985640 Nebraska Medical Center, Omaha, NE 68198-5640, United States.
| | - J Emory
- College of Medicine, University of Nebraska Medical Center, 985520 Nebraska Medical Center, Omaha, NE 68198-5520, United States
| | - Y M Golightly
- Department of Epidemiology, Gillings School of Global Public Health at The University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC 27599-7400, United States; Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Thurston Bldg., CB#7280, Chapel Hill, NC 27599-7280, United States; Injury Prevention Research Center, University of North Carolina at Chapel Hill, 521 South Greensboro Street, Carboro, NC 27510, United States; Division of Physical Therapy, University of North Carolina at Chapel Hill, Bondurant Hall, CB #7135, Chapel Hill, NC 27599-7135, United States
| | - A T Dudley
- Department of Genetics, Cell Biology and Anatomy, University of Nebraska Medical Center, 985805 Nebraska Medical Center, Omaha, NE 68198-5805, United States
| | - K Michaud
- Department of Internal Medicine, University of Nebraska Medical Center, 983332 Nebraska Medical Center, Omaha, NE 68198-3332, United States; Forward, The National Databank for Rheumatic Diseases, 1035 North Emporia Avenue #288, Wichita, KS 67214, United States
| | - M A Tao
- Division of Physical Therapy Education, University of Nebraska Medical Center, 984420 Nebraska Medical Center, Omaha, NE 98198-4420, United States; Department of Orthopaedic Surgery and Rehabilitation, University of Nebraska Medical Center, 985640 Nebraska Medical Center, Omaha, NE 68198-5640, United States
| | - M N Manzer
- Department of Radiology, University of Nebraska Medical Center, 981045 Nebraska Medical Center, Omaha, NE 68198-1045, United States
| | - B R Sajja
- Department of Radiology, University of Nebraska Medical Center, 981045 Nebraska Medical Center, Omaha, NE 68198-1045, United States
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18
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Jogi SP, Thaha R, Rajan S, Mahajan V, Venugopal VK, Mehndiratta A, Singh A. Device for Assessing Knee Joint Dynamics During Magnetic Resonance Imaging. J Magn Reson Imaging 2021; 55:895-907. [PMID: 34369633 DOI: 10.1002/jmri.27877] [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: 02/25/2021] [Revised: 07/23/2021] [Accepted: 07/27/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Knee assessment with and without load using magnetic resonance imaging (MRI) can provide information on knee joint dynamics and improve the diagnosis of knee joint diseases. Performing such studies on a routine MRI-scanner require a load-exerting device during scanning. There is a need for more studies on developing loading devices and evaluating their clinical potential. PURPOSE Design and develop a portable and easy-to-use axial loading device to evaluate the knee joint dynamics during the MRI study. STUDY TYPE Prospective study. SUBJECTS Nine healthy subjects. FIELD STRENGTH/SEQUENCE A 0.25 T standing-open MRI and 3.0 T MRI. PD-T2 -weighted FSE, 3D-fast-spoiled-gradient-echo, FS-PD, and CartiGram sequences. ASSESSMENT Design and development of loading device, calibration of loads, MR safety assessment (using projectile angular displacement, torque, and temperature tests). Scoring system for ease of doing. Qualitative (by radiologist) and quantitative (using structural similarity index measure [SSIM]) image-artifact assessment. Evaluation of repeatability, comparison with various standing stances load, and loading effect on knee MR parameters (tibiofemoral bone gap [TFBG], femoral cartilage thickness [FCT], tibial cartilage thickness [TCT], femoral cartilage T2 -value [FCT2], and tibia cartilage T2 -value [TCT2]). The relative percentage change (RPC) in parameters due to the device load was computed. STATISTICAL TEST Pearson's correlation coefficient (r). RESULTS The developed device is conditional-MR safe (details in the manuscript and supplementary materials), 15 × 15 × 45 cm3 dimension, and <3 kg. The ease of using the device was 4.9/5. The device introduced no visible image artifacts, and SSIM of 0.9889 ± 0.0153 was observed. The TFBG intraobserver variability (absolute difference) was <0.1 mm. Interobserver variability of all regions of interest was <0.1 mm. The load exerted by the device was close to the load during standing on both legs in 0.25 T scanner with r > 0.9. Loading resulted in RPC of 1.5%-11.0%, 7.9%-8.5%, and -1.5% to 13.0% in the TFBG, FCT, and TCT, respectively. FCT2 and TCT2 were reduced in range of 1.5-2.7 msec and 0.5-2.3 msec due to load. DATA CONCLUSION The proposed device is conditionally MR safe, low cost (material cost < INR 6000), portable, and effective in loading the knee joint with up to 50% of body weight. EVIDENCE LEVEL 1 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Sandeep P Jogi
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, India.,Department of Biomedical Engineering, ASET, Amity University Haryana, Gurgaon, Haryana, India
| | - Rafeek Thaha
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, India
| | | | | | | | - Amit Mehndiratta
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, India.,Department of Biomedical Engineering, All India Institute of Medical Sciences, New Delhi, India
| | - Anup Singh
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, India.,Department of Biomedical Engineering, All India Institute of Medical Sciences, New Delhi, India
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19
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Jerban S, Ma Y, Kasibhatla A, Wu M, Szeverenyi N, Guma M, Covey D, D'lima D, Ward SR, Sah RL, Chang EY, Du J, Chung CB. Ultrashort echo time adiabatic T 1ρ (UTE-Adiab-T 1ρ) is sensitive to human cadaveric knee joint deformation induced by mechanical loading and unloading. Magn Reson Imaging 2021; 80:98-105. [PMID: 33945858 PMCID: PMC10858706 DOI: 10.1016/j.mri.2021.04.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 04/13/2021] [Accepted: 04/29/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE The development of ultrashort echo time (UTE) MRI sequences has led to improved imaging of tissues with short T2 relaxation times, such as the deep layer cartilage and meniscus. UTE combined with adiabatic T1ρ preparation (UTE-Adiab-T1ρ) is an MRI measure with low sensitivity to the magic angle effect. This study aimed to investigate the sensitivity of UTE-Adiab-T1ρ to mechanical load-induced deformations in the tibiofemoral cartilage and meniscus of human cadaveric knee joints. METHODS Eight knee joints from young (42 ± 12 years at death) donors were evaluated on a 3 T scanner using the UTE-Adiab-T1ρ sequence under four sequential loading conditions: load = 0 N (Load0), load = 300 N (Load1), load = 500 N (Load2), and load = 0 N (Unload). UTE-Adiab-T1ρ was measured in the meniscus (M), femoral articular cartilage (FAC), tibial articular cartilage (TAC), articular cartilage regions uncovered by meniscus (AC-UC), and articular cartilage regions covered by meniscus (AC-MC) within region of interests (ROIs) manually selected by an experienced MR scientist. The Kruskal-Wallis test, with corrected significance level for multiple comparisons, was used to examine the UTE-Adiab-T1ρ differences between different loading conditions. RESULTS UTE-Adiab-T1ρ decreased in all grouped ROIs under both Load1 and Load2 conditions (-18.7% and - 16.9% for M, -18.8% and - 12.6% for FAC, -21.4% and - 10.7% for TAC, -26.2% and - 13.9% for AC-UC, and - 16.9% and - 10.7% for AC-MC). After unloading, average UTE-Adiab-T1ρ increased across all ROIs and within a lower range compared with the average UTE-Adiab-T1ρ decreases induced by the two previous loading conditions. The loading-induced differences were statistically non-significant. CONCLUSIONS While UTE-Adiab-T1ρ reduction by loading is likely an indication of tissue deformation, the increase of UTE-Adiab-T1ρ within a lower range by unloading implies partial tissue restoration. This study highlights the UTE-Adiab-T1ρ technique as an imaging marker of tissue function for detecting deformation patterns under loading.
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Affiliation(s)
- Saeed Jerban
- Department of Radiology, University of California, San Diego, CA, USA.
| | - Yajun Ma
- Department of Radiology, University of California, San Diego, CA, USA
| | - Akhil Kasibhatla
- Department of Radiology, University of California, San Diego, CA, USA
| | - Mei Wu
- Department of Radiology, University of California, San Diego, CA, USA
| | | | - Monica Guma
- Department of Medicine, School of Medicine, University of California, San Diego, CA, USA
| | - Dana Covey
- Orthopaedic Service, VA San Diego Healthcare System, San Diego, CA, USA; Department of Orthopedic Surgery, University of California, San Diego, CA, USA
| | - Darryl D'lima
- Shiley Center for Orthopedic Research and Education at Scripps Clinic, CA, USA
| | - Samuel R Ward
- Department of Orthopedic Surgery, University of California, San Diego, CA, USA; Department of Bioengineering, University of California, San Diego, CA, USA
| | - Robert L Sah
- Department of Orthopedic Surgery, University of California, San Diego, CA, USA; Department of Bioengineering, University of California, San Diego, CA, USA
| | - Eric Y Chang
- Department of Radiology, University of California, San Diego, CA, USA; Research Service, VA San Diego Healthcare System, San Diego, La Jolla, CA, USA
| | - Jiang Du
- Department of Radiology, University of California, San Diego, CA, USA
| | - Christine B Chung
- Department of Radiology, University of California, San Diego, CA, USA
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20
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Kwok AT, Mohamed NS, Plate JF, Yammani RR, Rosas S, Bateman TA, Livingston E, Moore JE, Kerr BA, Lee J, Furdui CM, Tan L, Bouxsein ML, Ferguson VL, Stodieck LS, Zawieja DC, Delp MD, Mao XW, Willey JS. Spaceflight and hind limb unloading induces an arthritic phenotype in knee articular cartilage and menisci of rodents. Sci Rep 2021; 11:10469. [PMID: 34006989 PMCID: PMC8131644 DOI: 10.1038/s41598-021-90010-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 04/15/2021] [Indexed: 11/18/2022] Open
Abstract
Reduced knee weight-bearing from prescription or sedentary lifestyles are associated with cartilage degradation; effects on the meniscus are unclear. Rodents exposed to spaceflight or hind limb unloading (HLU) represent unique opportunities to evaluate this question. This study evaluated arthritic changes in the medial knee compartment that bears the highest loads across the knee after actual and simulated spaceflight, and recovery with subsequent full weight-bearing. Cartilage and meniscal degradation in mice were measured via microCT, histology, and proteomics and/or biochemically after: (1) ~ 35 days on the International Space Station (ISS); (2) 13-days aboard the Space Shuttle Atlantis; or (3) 30 days of HLU, followed by a 49-day weight-bearing readaptation with/without exercise. Cartilage degradation post-ISS and HLU occurred at similar spatial locations, the tibial-femoral cartilage-cartilage contact point, with meniscal volume decline. Cartilage and meniscal glycosaminoglycan content were decreased in unloaded mice, with elevated catabolic enzymes (e.g., matrix metalloproteinases), and elevated oxidative stress and catabolic molecular pathway responses in menisci. After the 13-day Shuttle flight, meniscal degradation was observed. During readaptation, recovery of cartilage volume and thickness occurred with exercise. Reduced weight-bearing from either spaceflight or HLU induced an arthritic phenotype in cartilage and menisci, and exercise promoted recovery.
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Affiliation(s)
- Andy T Kwok
- Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA
| | - Nequesha S Mohamed
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Johannes F Plate
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Raghunatha R Yammani
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Department of Internal Medicine, Section of Molecular Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Samuel Rosas
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Ted A Bateman
- Department of Biomedical Engineering, University of North Carolina, Chapel Hill, NC, USA
| | - Eric Livingston
- Department of Biomedical Engineering, University of North Carolina, Chapel Hill, NC, USA
| | - Joseph E Moore
- Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA
| | - Bethany A Kerr
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jingyun Lee
- Department of Internal Medicine, Section of Molecular Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Proteomics and Metabolomics Shared Resource, Comprehensive Cancer Center, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Cristina M Furdui
- Department of Internal Medicine, Section of Molecular Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Proteomics and Metabolomics Shared Resource, Comprehensive Cancer Center, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Li Tan
- Department of Internal Medicine, Section of Molecular Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Mary L Bouxsein
- Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Virginia L Ferguson
- Department of Mechanical Engineering, University of Colorado At Boulder, Boulder, CO, USA
| | - Louis S Stodieck
- BioServe Space Technologies, Aerospace Engineering Sciences, University of Colorado At Boulder, Boulder, CO, USA
| | - David C Zawieja
- Department of Medical Physiology, Texas A&M University Medical School, Bryan, TX, USA
| | - Michael D Delp
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL, USA
| | - Xiao W Mao
- Division of Biomedical Engineering Sciences (BMES), Department of Basic Sciences, Loma Linda University, Loma Linda, CA, USA
| | - Jeffrey S Willey
- Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA. .,Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA.
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21
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Subchondral bone microenvironment in osteoarthritis and pain. Bone Res 2021; 9:20. [PMID: 33731688 PMCID: PMC7969608 DOI: 10.1038/s41413-021-00147-z] [Citation(s) in RCA: 159] [Impact Index Per Article: 53.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 01/20/2021] [Accepted: 02/01/2021] [Indexed: 01/31/2023] Open
Abstract
Osteoarthritis comprises several joint disorders characterized by articular cartilage degeneration and persistent pain, causing disability and economic burden. The incidence of osteoarthritis is rapidly increasing worldwide due to aging and obesity trends. Basic and clinical research on osteoarthritis has been carried out for decades, but many questions remain unanswered. The exact role of subchondral bone during the initiation and progression osteoarthritis remains unclear. Accumulating evidence shows that subchondral bone lesions, including bone marrow edema and angiogenesis, develop earlier than cartilage degeneration. Clinical interventions targeting subchondral bone have shown therapeutic potential, while others targeting cartilage have yielded disappointing results. Abnormal subchondral bone remodeling, angiogenesis and sensory nerve innervation contribute directly or indirectly to cartilage destruction and pain. This review is about bone-cartilage crosstalk, the subchondral microenvironment and the critical role of both in osteoarthritis progression. It also provides an update on the pathogenesis of and interventions for osteoarthritis and future research targeting subchondral bone.
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22
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Non-anatomical placement adversely affects the functional performance of the meniscal implant: a finite element study. Biomech Model Mechanobiol 2021; 20:1167-1185. [PMID: 33661440 DOI: 10.1007/s10237-021-01440-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 02/17/2021] [Indexed: 01/14/2023]
Abstract
Non-anatomical placement may occur during the surgical implantation of the meniscal implant, and its influence on the resulting biomechanics of the knee joint has not been systematically studied. The purpose of this study was to evaluate the biomechanical effects of non-anatomical placement of the meniscal implant on the knee joint during a complete walking cycle. Three-dimensional finite element (FE) analyses of the knee joint were performed, based on the model developed from magnetic resonance images and the loading conditions derived from the gait pattern of a healthy male subject, for the following physiological conditions: (i) knee joint with intact native meniscus, (ii) medial meniscectomized knee joint, (iii) knee joint with anatomically placed meniscal implant, and (iv) knee joint with the meniscal implant placed in four different in vitro determined non-anatomical locations. While the native menisci were modeled using the nonlinear hyperelastic Holzapfel-Gasser-Ogden (HGO) constitutive model, the meniscal implant was modeled using the isotropic hyperelastic neo-Hookean model. Placement of the meniscal implant in the non-anatomical lateral-posterior and lateral-anterior locations significantly increased the peak contact pressure in the medial compartment. Placement of the meniscal implant in non-anatomical locations significantly altered the tibial rotational kinematics and increased the total force acting at the meniscal horns. Results suggest that placement of the meniscal implant in non-anatomical locations may restrain its ability to be chondroprotective and may initiate or accelerate cartilage degeneration. In conclusion, clinicians should endeavor to place the implant as closest as possible to the anatomical location to restore the normal knee biomechanics.
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23
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Lawrence EA, Aggleton J, van Loon J, Godivier J, Harniman R, Pei J, Nowlan N, Hammond C. Exposure to hypergravity during zebrafish development alters cartilage material properties and strain distribution. Bone Joint Res 2021; 10:137-148. [PMID: 33560137 DOI: 10.1302/2046-3758.102.bjr-2020-0239.r1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
AIMS Vertebrates have adapted to life on Earth and its constant gravitational field, which exerts load on the body and influences the structure and function of tissues. While the effects of microgravity on muscle and bone homeostasis are well described, with sarcopenia and osteoporosis observed in astronauts returning from space, the effects of shorter exposures to increased gravitational fields are less well characterized. We aimed to test how hypergravity affects early cartilage and skeletal development in a zebrafish model. METHODS We exposed zebrafish to 3 g and 6 g hypergravity from three to five days post-fertilization, when key events in jaw cartilage morphogenesis occur. Following this exposure, we performed immunostaining along with a range of histological stains and transmission electron microscopy (TEM) to examine cartilage morphology and structure, atomic force microscopy (AFM) and nanoindentation experiments to investigate the cartilage material properties, and finite element modelling to map the pattern of strain and stress in the skeletal rudiments. RESULTS We did not observe changes to larval growth, or morphology of cartilage or muscle. However, we observed altered mechanical properties of jaw cartilages, and in these regions we saw changes to chondrocyte morphology and extracellular matrix (ECM) composition. These areas also correspond to places where strain and stress distribution are predicted to be most different following hypergravity exposure. CONCLUSION Our results suggest that altered mechanical loading, through hypergravity exposure, affects chondrocyte maturation and ECM components, ultimately leading to changes to cartilage structure and function. Cite this article: Bone Joint Res 2021;10(2):137-148.
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Affiliation(s)
| | - Jessye Aggleton
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK.,School of Anthropology and Archaeology, University of Bristol, Bristol, UK
| | - Jack van Loon
- European Space Agency (ESA) Technology Center (ESTEC), TEC-MMG, Noordwijk, The Netherlands.,Department Oral & Maxillofacial Surgery/Pathology, Amsterdam Movement Sciences & Amsterdam Bone Center (ABC), Amsterdam University Medical Center Location VUmc & Academic Center for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Josepha Godivier
- Department of Bioengineering, Imperial College London, London, UK
| | | | - Jiaxin Pei
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK
| | - Niamh Nowlan
- Department of Bioengineering, Imperial College London, London, UK
| | - Chrissy Hammond
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK
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24
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Boling MC, Dupell M, Pfeiffer SJ, Wallace K, Lalush D, Spang JT, Nissman D, Pietrosimone B. In vivo Compositional Changes in the Articular Cartilage of the Patellofemoral Joint following Anterior Cruciate Ligament Reconstruction. Arthritis Care Res (Hoboken) 2021; 74:1172-1178. [PMID: 33460530 PMCID: PMC8286261 DOI: 10.1002/acr.24561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 11/16/2020] [Accepted: 01/12/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To compare T1ρ relaxation times of the medial and lateral regions of the patella and femoral trochlea at 6 and 12 months post-anterior cruciate ligament reconstruction (ACLR) on the ACLR and contralateral limb. Greater T1ρ relaxation times are associated with a lesser proteoglycan density of articular cartilage. METHODS Twenty individuals (11 males, 9 females; age=22±3.9yrs; mass=76.11±13.48kg; height=178.32±12.32) who underwent a previous unilateral ACLR using a patellar tendon autograft. Magnetic resonance images from both limbs were acquired at 6 and 12 months post-ACLR. Voxel by voxel T1ρ relaxation times were calculated using a five-image sequence. The medial and lateral regions of the femoral trochlea and patellar articular cartilage were manually segmented on both limbs. Separate limb (ACLR and contralateral limb) by time (6-months and 12-months) ANOVAs were performed for each region (P<0.05). RESULTS For the medial patella and lateral trochlea, T1ρ relaxation times increased in both limbs between 6 and 12-months post-ACLR (medial patella: P=0.012; lateral trochlea: P=0.043). For the lateral patella, T1ρ relaxation times were significantly greater on the contralateral limb compared to the ACLR limb (P=0.001). The T1ρ relaxation times of the medial trochlea on the ACLR limb were significantly greater at 6 (P=0.005) and 12-months (P<0.001) compared to the contralateral limb. T1ρ relaxation times of the medial trochlea significantly increased from 6 to 12-months on the ACLR limb (P=0.003). CONCLUSION Changes in T1ρ relaxation times occur within the first 12 months following ACLR in specific regions of the patellofemoral joint on the ACLR and contralateral limb.
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Affiliation(s)
- Michelle C Boling
- University of North Florida, 1 UNF Drive, Jacksonville, FL, 32224, USA
| | - Matthew Dupell
- University of North Florida, 1 UNF Drive, Jacksonville, FL, 32224, USA
| | - Steven J Pfeiffer
- University of North Florida, 1 UNF Drive, Jacksonville, FL, 32224, USA
| | - Kyle Wallace
- University of North Florida, 1 UNF Drive, Jacksonville, FL, 32224, USA
| | - David Lalush
- University of North Florida, 1 UNF Drive, Jacksonville, FL, 32224, USA
| | - Jeffrey T Spang
- University of North Florida, 1 UNF Drive, Jacksonville, FL, 32224, USA
| | - Daniel Nissman
- University of North Florida, 1 UNF Drive, Jacksonville, FL, 32224, USA
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25
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Ikuta F, Takahashi K, Kiuchi S, Watanabe A, Okuaki T, Oshima Y, Watanabe H, Hashimoto S. Effects of repeated intra-articular hyaluronic acid on cartilage degeneration evaluated by T1ρ mapping in knee osteoarthritis. Mod Rheumatol 2020; 31:912-918. [PMID: 32990487 DOI: 10.1080/14397595.2020.1830483] [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] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Intra-articular injection of hyaluronic acid (IAHA) has been used for the treatment of knee osteoarthritis (OA), but its effectiveness remains controversial. This study analyzed knee OA over time by magnetic resonance imaging (MRI) T1ρ mapping to objectively evaluate whether long-term repeated administration of IAHA influences cartilage degeneration. METHODS Sixty knees of 60 patients [58.3 ± 12.5 years (mean ± standard deviation)] who had multiple T1ρ mapping images were retrospectively analyzed. We calculated the T1ρ values of the medial femorotibial cartilage and classified changes in degenerative areas over time into 3 groups: Improvement, No Change, and Deterioration. RESULTS Average time between 2 MRI scans was 7.6 ± 1.2 months. The number of IAHA administrations was 15.5 ± 21.3, 8.39 ± 7.19, and 5.80 ± 7.49 in the Improvement, No Change, and Deterioration groups, respectively. Body mass index and number of IAHA administrations were significant factors causing change in the area of degeneration (p < .05) independent of age, sex, Kellgren-Lawrence grade, and posterior horn meniscus tears. CONCLUSION Cartilage degeneration may be improved with a higher number of administrations of IAHA, based on T1ρ mapping results. This highlights the possibility of increased treatment effectiveness of IAHA for knee OA with repeated administrations.
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Affiliation(s)
- Futoshi Ikuta
- Department of Orthopaedic Surgery, Nippon Medical School, Tokyo, Japan.,Inanami Spine and Joint Hospital, Tokyo, Japan
| | - Kenji Takahashi
- Department of Orthopaedics, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | - Atsuya Watanabe
- Department of General Medical Services, Graduate School of Medicine, Chiba University, Chiba, Japan
| | | | - Yasushi Oshima
- Department of Orthopaedic Surgery, Nippon Medical School, Tokyo, Japan
| | - Hiroshi Watanabe
- Department of Orthopaedic Surgery, Nippon Medical School, Tokyo, Japan
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26
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Lee D, Hong KT, Lim TS, Lee E, Lee YH, Park JS, Kim W, Oh JH, Choi JA, Song Y. Alterations in articular cartilage T2 star relaxation time following mechanical disorders: in vivo canine supraspinatus tendon resection models. BMC Musculoskelet Disord 2020; 21:424. [PMID: 32615950 PMCID: PMC7331159 DOI: 10.1186/s12891-020-03447-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 06/23/2020] [Indexed: 11/10/2022] Open
Abstract
Background The role of altered joint mechanics on cartilage degeneration in in vivo models has not been studied successfully due to a lack of pre-injury information. We aimed 1) to develop an accurate in vivo canine model to measure the changes in joint loading and T2 star (T2*) relaxation time before and after unilateral supraspinatus tendon resections, and 2) to find the relationship between regional variations in articular cartilage loading patterns and T2* relaxation time distributions. Methods Rigid markers were implanted in the scapula and humerus of tested dogs. The movement of the shoulder bones were measured by a motion tracking system during normal gaits. In vivo cartilage contact strain was measured by aligning 3D shoulder models with the motion tracking data. Articular cartilage T2* relaxation times were measured by quantitative MRI scans. Articular cartilage contact strain and T2* relaxation time were compared in the shoulders before and 3 months after the supraspinatus tendon resections. Results Excellent accuracy and reproducibility were found in our in vivo contact strain measurements with less than 1% errors. Changes in articular cartilage contact strain exhibited similar patterns with the changes in the T2* relaxation time after resection surgeries. Regional changes in the articular cartilage T2* relaxation time exhibited positive correlations with regional contact strain variations 3 months after the supraspinatus resection surgeries. Conclusion This is the first study to measure in vivo articular cartilage contact strains with high accuracy and reproducibility. Positive correlations between contact strain and T2* relaxation time suggest that the articular cartilage extracellular matrix may responds to mechanical changes in local areas.
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Affiliation(s)
- Dokwan Lee
- Department of Mechanical Engineering, Korea University Engineering Campus, Innovation Hall, Room 306, Anam-dong, Seongbuk-gu, Seoul, 02841, South Korea
| | - Ki-Taek Hong
- Department of Mechanical Engineering, Korea University Engineering Campus, Innovation Hall, Room 306, Anam-dong, Seongbuk-gu, Seoul, 02841, South Korea
| | - Tae Seong Lim
- Department of Radiology, Gachon University Gil Medical Center, Incheon, South Korea
| | - Eugene Lee
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Ye Hyun Lee
- Department of Orthopedic Surgery, National Police Hospital, Seoul, South Korea
| | - Ji Soon Park
- Department of Orthopedic Surgery, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, United Arab Emirates
| | - Woo Kim
- Seoul Kiwoonchan Orthopedics Clinic, Seoul, South Korea
| | - Joo Han Oh
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jung-Ah Choi
- Department of Radiology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, South Korea
| | - Yongnam Song
- Department of Mechanical Engineering, Korea University Engineering Campus, Innovation Hall, Room 306, Anam-dong, Seongbuk-gu, Seoul, 02841, South Korea.
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27
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Voinier D, Neogi T, Stefanik JJ, Guermazi A, Roemer FW, Thoma LM, Master H, Nevitt MC, Lewis CE, Torner J, White DK. Using Cumulative Load to Explain How Body Mass Index and Daily Walking Relate to Worsening Knee Cartilage Damage Over Two Years: The MOST Study. Arthritis Rheumatol 2020; 72:957-965. [PMID: 31785075 DOI: 10.1002/art.41181] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 11/26/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Knee cartilage damage is often linked to mechanical overloading. However, cartilage requires mechanical load to remain healthy, suggesting that underloading may be detrimental. This study was undertaken to examine knee overloading and underloading by defining cumulative load as the joint effects of body mass index (BMI) and daily walking, and examine the relationship between cumulative load and worsening cartilage damage over 2 years. METHODS We used data from the Multicenter Osteoarthritis Study. Steps/day, measured by accelerometry, and BMI were calculated at the 60-month visit. Cartilage damage on magnetic resonance imaging was semiquantitatively scored using the Whole-Organ Magnetic Resonance Imaging Score (WORMS) at the 60-month and 84-month visits; worsening damage was defined as increased WORMS between visits. Risk ratios (RRs) and 95% confidence intervals (95% CIs) were calculated using binomial regression, with adjustment for potential confounders. RESULTS Our study included 964 participants, 62% of whom were female, with a mean ± SD age of 66.9 ± 7.5 years. Participants had a mean ± SD BMI of 29.7 ± 4.8 kg/m2 and walked a mean ± SD of 7,153 ± 2,591 steps/day. Participants who walked a moderate number of steps/day (6,000-7,900) or a high number of steps/day (>7,900) and had a high BMI (>31 kg/m2 ) had a greater risk of worsening medial tibiofemoral (TF) damage (RR 2.83 [95% CI 1.46-5.48] and RR 2.61 [95% CI 1.50-4.54], respectively) compared with those who walked similar steps/day and had a low BMI (18-27 kg/m2 ). Participants with a low number of steps/day (<6,000) and a low BMI had a greater risk of worsening medial TF and lateral patellofemoral (PF) damage (RR 2.03 [95% CI 1.06-3.92] and RR 2.28 [95% CI 1.06-4.85], respectively) compared with those who walked a high number of steps/day and had a low BMI. Effect estimates for other compartments of the knee did not reach statistical significance. CONCLUSION This study provides preliminary evidence that both overloading and underloading may be detrimental to medial TF cartilage, and underloading may be detrimental to lateral PF cartilage.
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Affiliation(s)
| | - Tuhina Neogi
- Boston University School of Medicine, Boston, Massachusetts
| | | | - Ali Guermazi
- Boston University School of Medicine, Boston, Massachusetts
| | - Frank W Roemer
- Boston University School of Medicine, Boston, Massachusetts
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28
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Capin JJ, Williams JR, Neal K, Khandha A, Durkee L, Ito N, Stefanik JJ, Snyder-Mackler L, Buchanan TS. Slower Walking Speed Is Related to Early Femoral Trochlear Cartilage Degradation After ACL Reconstruction. J Orthop Res 2020; 38:645-652. [PMID: 31710115 PMCID: PMC7028512 DOI: 10.1002/jor.24503] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 10/14/2019] [Indexed: 02/04/2023]
Abstract
Post-traumatic patellofemoral osteoarthritis (OA) is prevalent after anterior cruciate ligament reconstruction (ACLR) and early cartilage degradation may be especially common in the femoral trochlear cartilage. Determining the presence of and factors associated with early femoral trochlear cartilage degradation, a precursor to OA, is a critical preliminary step in identifying those at risk for patellofemoral OA development and designing interventions to combat the disease. Early cartilage degradation can be detected using quantitative magnetic resonance imaging measures, such as tissue T2 relaxation time. The purposes of this study were to (i) compare involved (ACLR) versus uninvolved (contralateral) femoral trochlear cartilage T2 relaxation times 6 months after ACLR, and (ii) determine the relationship between walking speed and walking mechanics 3 months after ACLR and femoral trochlear cartilage T2 relaxation times 6 months after ACLR. Twenty-six individuals (age 23 ± 7 years) after primary, unilateral ACLR participated in detailed motion analyses 3.3 ± 0.6 months after ACLR and quantitative magnetic resonance imaging 6.3 ± 0.5 months after ACLR. There were no limb differences in femoral trochlear cartilage T2 relaxation times. Slower walking speed was related to higher (worse) femoral trochlear cartilage T2 relaxation times in the involved limb (Pearson's r: -0.583, p = 0.002) and greater interlimb differences in trochlear T2 relaxation times (Pearson's r: -0.349, p = 0.080). Walking mechanics were weakly related to trochlear T2 relaxation times. Statement of clinical significance: Slower walking speed was by far the strongest predictor of worse femoral trochlear cartilage health, suggesting slow walking speed may be an early clinical indicator of future patellofemoral OA after ACLR. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:645-652, 2020.
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Affiliation(s)
- Jacob J. Capin
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO,Eastern Colorado VA Geriatric Research Education and Clinical Center (GRECC), Aurora, CO
| | - Jack R. Williams
- Mechanical Engineering Department, University of Delaware, Newark, DE, USA
| | - Kelsey Neal
- Mechanical Engineering Department, University of Delaware, Newark, DE, USA
| | - Ashutosh Khandha
- Biomedical Engineering Department, University of Delaware, Newark, DE, USA
| | - Laura Durkee
- Athletic Training Education Program, University of Delaware, Newark, DE, USA
| | - Naoaki Ito
- Biomechanics and Movement Science Program, University of Delaware, Newark, DE, USA,Physical Therapy Department, University of Delaware, Newark, DE, USA
| | - Joshua J. Stefanik
- Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, Boston, MA, USA
| | - Lynn Snyder-Mackler
- Biomedical Engineering Department, University of Delaware, Newark, DE, USA,Biomechanics and Movement Science Program, University of Delaware, Newark, DE, USA,Physical Therapy Department, University of Delaware, Newark, DE, USA,Delaware Rehabilitation Institute, University of Delaware, Newark, DE, USA
| | - Thomas S. Buchanan
- Mechanical Engineering Department, University of Delaware, Newark, DE, USA,Biomedical Engineering Department, University of Delaware, Newark, DE, USA,Delaware Rehabilitation Institute, University of Delaware, Newark, DE, USA
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Heilmeier U, Mamoto K, Amano K, Eck B, Tanaka M, Bullen JA, Schwaiger BJ, Huebner JL, Stabler TV, Kraus VB, Ma CB, Link TM, Li X. Infrapatellar fat pad abnormalities are associated with a higher inflammatory synovial fluid cytokine profile in young adults following ACL tear. Osteoarthritis Cartilage 2020; 28:82-91. [PMID: 31526878 PMCID: PMC6935420 DOI: 10.1016/j.joca.2019.09.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 08/08/2019] [Accepted: 09/03/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate the degree of knee fat pad abnormalities after acute anterior cruciate ligament (ACL) tear via magnetic resonance fat pad scoring and to assess cross-sectionally its association with synovial fluid biomarkers and with early cartilage damage as quantified via T1ρ and T2 relaxation time measurements. DESIGN 26 patients with acute ACL tears underwent 3T MR scanning of the injured knee prior to ACL reconstruction. The presence and degree of abnormalities of the infrapatellar (IPFP) and the suprapatellar (SPFP) fat pads were scored on MR images along with grading of effusion-synovitis and synovial proliferations. Knee cartilage composition was assessed by 3T MR T1ρ and T2 mapping in six knee compartments. We quantified concentrations of 20 biomarkers in synovial fluid aspirated at the time of ACL reconstruction. Spearman rank partial correlations with adjustments for age and gender were employed to evaluate correlations of MR, particularly cartilage composition and fat pad abnormalities, and biomarker data. RESULTS The degree of IPFP abnormality correlated positively with the synovial levels of the inflammatory cytokine markers IFN-γ (ρpartial = 0.64, 95% CI (0.26-0.85)), IL-10 (ρpartial = 0.47, 95% CI (0.04-0.75)), IL-6 (ρpartial = 0.56, 95% CI (0.16-0.81)), IL-8 (ρpartial = 0.49, 95% CI (0.06-0.76)), TNF-α (ρpartial = 0.55, 95% CI (0.14-0.80)) and of the chondrodestructive markers MMP-1 and -3 (MMP-1: ρpartial = 0.57, 95% CI (0.17-0.81); MMP-3: ρpartial = 0.60, 95% CI (0.21-0.83)). IPFP abnormalities were significantly associated with higher T1ρ and T2 values in the trochlear cartilage (T1ρ: ρpartial = 0.55, 95% CI (0.15-0.80); T2: ρpartial = 0.58, 95% CI (0.18-0.81)) and with higher T2 values in the medial femoral, medial tibial as well as in patellar cartilage (0.45 ≤ ρpartial ≤ 0.59). Correlations between SPFP abnormalities and synovial markers were not significant except for IL-6 (ρpartial = 0.57, 95% CI (0.17-0.81)). CONCLUSIONS This exploratory study suggests that acute ACL rupture can be associated with damage to knee tissues such as the inferior fat pad of the knee. Such fat pad injury could be partially responsible for the apparent post-injury pro-inflammatory response noted in ACL-injured individuals. However, future longitudinal studies are needed to link ACL-rupture associated fat pad injury with important patient outcomes such as the development of posttraumatic osteoarthritis.
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Affiliation(s)
- U Heilmeier
- Department of Radiology and Biomedical Imaging, Musculoskeletal Quantitative Imaging Research, University of California San Francisco, San Francisco, CA, USA.
| | - K Mamoto
- Department of Radiology and Biomedical Imaging, Musculoskeletal Quantitative Imaging Research, University of California San Francisco, San Francisco, CA, USA; Department of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA; Department of Orthopaedic Surgery, Osaka City University Medical School, Osaka, Japan.
| | - K Amano
- Department of Radiology and Biomedical Imaging, Musculoskeletal Quantitative Imaging Research, University of California San Francisco, San Francisco, CA, USA.
| | - B Eck
- Department of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA.
| | - M Tanaka
- Department of Radiology and Biomedical Imaging, Musculoskeletal Quantitative Imaging Research, University of California San Francisco, San Francisco, CA, USA.
| | - J A Bullen
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA.
| | - B J Schwaiger
- Department of Radiology and Biomedical Imaging, Musculoskeletal Quantitative Imaging Research, University of California San Francisco, San Francisco, CA, USA.
| | - J L Huebner
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA.
| | - T V Stabler
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA.
| | - V B Kraus
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA.
| | - C B Ma
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA, USA.
| | - T M Link
- Department of Radiology and Biomedical Imaging, Musculoskeletal Quantitative Imaging Research, University of California San Francisco, San Francisco, CA, USA.
| | - X Li
- Department of Radiology and Biomedical Imaging, Musculoskeletal Quantitative Imaging Research, University of California San Francisco, San Francisco, CA, USA; Department of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA.
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Jerban S, Chang EY, Du J. Magnetic resonance imaging (MRI) studies of knee joint under mechanical loading: Review. Magn Reson Imaging 2019; 65:27-36. [PMID: 31670237 DOI: 10.1016/j.mri.2019.09.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 08/17/2019] [Accepted: 09/15/2019] [Indexed: 02/07/2023]
Abstract
Osteoarthritis (OA) is a very common disease that affects the human knee joint, particularly the articular cartilage and meniscus components which are regularly under compressive mechanical loads. Early-stage OA diagnosis is essential as it allows for timely intervention. The primary non-invasive approaches currently available for OA diagnosis include magnetic resonance imaging (MRI), which provides excellent soft tissue contrast at high spatial resolution. MRI-based knee investigation is usually performed on joints at rest or in a non-weight-bearing condition that does not mimic the actual physiological condition of the joint. This discrepancy may lead to missed detections of early-stage OA or of minor lesions. The mechanical properties of degenerated musculoskeletal (MSK) tissues may vary markedly before any significant morphological or structural changes detectable by MRI. Recognizing distinct deformation characteristics of these tissues under known mechanical loads may reveal crucial joint lesions or mechanical malfunctions which result from early-stage OA. This review article summarizes the large number of MRI-based investigations on knee joints under mechanical loading which have been reported in the literature including the corresponding MRI measures, the MRI-compatible devices employed, and potential challenges due to the limitations of clinical MRI sequences.
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Affiliation(s)
- Saeed Jerban
- Department of Radiology, University of California, San Diego, CA, USA.
| | - Eric Y Chang
- Department of Radiology, University of California, San Diego, CA, USA; Radiology Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Jiang Du
- Department of Radiology, University of California, San Diego, CA, USA
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Abstract
Cumulative load reflects the total accumulated load across a loading exposure. Estimated cumulative load can identify individuals with or at risk for pathology. However, there is no research into the accuracy of the estimated cumulative load. This study determined: (1) which impulses, from a 500 revolution bicycling activity, accurately estimate cumulative pedal reaction force; and (2) how many impulses are required to accurately estimate cumulative pedal reaction force over 500 revolutions. Twenty-four healthy adults (mean 23.4 [SD 3.1] years; 11 men) participated. Participants performed three bicycling bouts of 10-min in duration and were randomized to one of two groups (group 1 = self-selected power and prescribed cadence of 80 revolutions per minute; group 2 = prescribed power of 100 W and self-selected cadence). The first 10 revolutions (2%) of the normal pedal reaction force (PRFN) and resultant pedal reaction force (PRFR), and the first five revolutions (1%) of the anterior-posterior reaction force (PRFAP) over-estimated cumulative load. The PRFN, PRFAP, and PRFR required 80 revolutions (16%), 320 revolutions (64%) and 65 revolutions (13%), respectively, to accurately estimate cumulative load across 500 cycles. These findings highlight that the context and amount of data collected are important in producing accurate estimates of cumulative load.
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Affiliation(s)
- Anthony A Gatti
- School of Rehabilitation Sciences, McMaster University; 1280 Main St. W., Hamilton, Ontario, Canada
| | - Monica R Maly
- Department of Kinesiology, University of Waterloo; 200 University Ave, Waterloo, Ontario, Canada
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Abstract
OBJECTIVE To study the experimental influences to the measurement of cartilage thickness by magnetic resonance imaging (MRI). DESIGN The complete thicknesses of healthy and trypsin-degraded cartilage were measured at high-resolution MRI under different conditions, using two intensity-based imaging sequences (ultra-short echo [UTE] and multislice-multiecho [MSME]) and 3 quantitative relaxation imaging sequences (T1, T2, and T1ρ). Other variables included different orientations in the magnet, 2 soaking solutions (saline and phosphate buffered saline [PBS]), and external loading. RESULTS With cartilage soaked in saline, UTE and T1 methods yielded complete and consistent measurement of cartilage thickness, while the thickness measurement by T2, T1ρ, and MSME methods were orientation dependent. The effect of external loading on cartilage thickness is also sequence and orientation dependent. All variations in cartilage thickness in MRI could be eliminated with the use of a 100 mM PBS or imaged by UTE sequence. CONCLUSIONS The appearance of articular cartilage and the measurement accuracy of cartilage thickness in MRI can be influenced by a number of experimental factors in ex vivo MRI, from the use of various pulse sequences and soaking solutions to the health of the tissue. T2-based imaging sequence, both proton-intensity sequence and quantitative relaxation sequence, similarly produced the largest variations. With adequate resolution, the accurate measurement of whole cartilage tissue in clinical MRI could be utilized to detect differences between healthy and osteoarthritic cartilage after compression.
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Affiliation(s)
- Nian Wang
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, MI, USA,Center for In Vivo Microscopy, Department of Radiology, Duke University, Durham, NC, USA
| | - Farid Badar
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, MI, USA
| | - Yang Xia
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, MI, USA,Yang Xia, PhD, Department of Physics, Oakland University, 276 Hannah Hall, Rochester, MI 48309, USA.
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33
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Kwok AT, Moore JE, Rosas S, Kerr BA, Andrews RN, Nguyen CM, Lee J, Furdui CM, Collins BE, Munley MT, Willey JS. Knee and Hip Joint Cartilage Damage from Combined Spaceflight Hazards of Low-Dose Radiation Less than 1 Gy and Prolonged Hindlimb Unloading. Radiat Res 2019; 191:497-506. [PMID: 30925135 DOI: 10.1667/rr15216.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Reduced weight bearing, and to a lesser extent radiation, during spaceflight have been shown as potential hazards to astronaut joint health. These hazards combined effect to the knee and hip joints are not well defined, particularly with low-dose exposure to radiation. In this study, we examined the individual and combined effects of varying low-dose radiation (≤1 Gy) and reduced weight bearing on the cartilage of the knee and hip joints. C57BL/6J mice (n = 80) were either tail suspended via hindlimb unloading (HLU) or remained full-weight bearing (ground). On day 6, each group was divided and irradiated with 0 Gy (sham), 0.1 Gy, 0.5 Gy or 1.0 Gy (n = 10/group), yielding eight groups: ground-sham; ground-0.1 Gy; ground-0.5 Gy; ground-1.0 Gy; HLU-sham; HLU-0.1 Gy; HLU-0.5 Gy; and HLU-1.0 Gy. On day 30, the hindlimbs, hip cartilage and serum were collected from the mice. Significant differences were identified statistically between treatment groups and the ground-sham control group, but no significant differences were observed between HLU and/or radiation groups. Contrast-enhanced micro-computed tomography (microCECT) demonstrated decrease in volume and thickness at the weight-bearing femoral-tibial cartilage-cartilage contact point in all treatment groups compared to ground-sham. Lower collagen was observed in all groups compared to ground-sham. Circulating serum cartilage oligomeric matrix protein (sCOMP), a biomarker for ongoing cartilage degradation, was increased in all of the irradiated groups compared to ground-sham, regardless of unloading. Mass spectrometry of the cartilage lining the femoral head and subsequent Ingenuity Pathway Analysis (IPA) identified a decrease in cartilage compositional proteins indicative of osteoarthritis. Our findings demonstrate that both individually and combined, HLU and exposure to spaceflight relevant radiation doses lead to cartilage degradation of the knee and hip with expression of an arthritic phenotype. Moreover, early administration of low-dose irradiation (0.1, 0.5 or 1.0 Gy) causes an active catabolic response in cartilage 24 days postirradiation. Further research is warranted with a focus on the prevention of cartilage degradation from long-term periods of reduced weight bearing and spaceflight-relevant low doses and qualities of radiation.
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Affiliation(s)
| | | | - Samuel Rosas
- Departments of a Radiation Oncology.,b Departments of Orthopaedic Surgery
| | | | | | | | - Jingyun Lee
- e Departments of Proteomics and Metabolomics Shared Resource, Comprehensive Cancer Center
| | - Cristina M Furdui
- f Departments of Internal Medicine, Section on Molecular Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Boyce E Collins
- g Engineering Research Center for Revolutionizing Metallic Biomaterials, North Carolina A&T State University, Greensboro, North Carolina
| | | | - Jeffrey S Willey
- Departments of a Radiation Oncology.,b Departments of Orthopaedic Surgery
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Rossi-deVries J, Pedoia V, Samaan MA, Ferguson AR, Souza RB, Majumdar S. Using multidimensional topological data analysis to identify traits of hip osteoarthritis. J Magn Reson Imaging 2018; 48:1046-1058. [PMID: 29734501 DOI: 10.1002/jmri.26029] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 03/01/2018] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Osteoarthritis (OA) is a multifaceted disease with many variables affecting diagnosis and progression. Topological data analysis (TDA) is a state-of-the-art big data analytics tool that can combine all variables into multidimensional space. TDA is used to simultaneously analyze imaging and gait analysis techniques. PURPOSE To identify biochemical and biomechanical biomarkers able to classify different disease progression phenotypes in subjects with and without radiographic signs of hip OA. STUDY TYPE Longitudinal study for comparison of progressive and nonprogressive subjects. POPULATION In all, 102 subjects with and without radiographic signs of hip osteoarthritis. FIELD STRENGTH/SEQUENCE 3T, SPGR 3D MAPSS T1ρ /T2 , intermediate-weighted fat-suppressed fast spin-echo (FSE). ASSESSMENT Multidimensional data analysis including cartilage composition, bone shape, Kellgren-Lawrence (KL) classification of osteoarthritis, scoring hip osteoarthritis with MRI (SHOMRI), hip disability and osteoarthritis outcome score (HOOS). STATISTICAL TESTS Analysis done using TDA, Kolmogorov-Smirnov (KS) testing, and Benjamini-Hochberg to rank P-value results to correct for multiple comparisons. RESULTS Subjects in the later stages of the disease had an increased SHOMRI score (P < 0.0001), increased KL (P = 0.0012), and older age (P < 0.0001). Subjects in the healthier group showed intact cartilage and less pain. Subjects found between these two groups had a range of symptoms. Analysis of this subgroup identified knee biomechanics (P < 0.0001) as an initial marker of the disease that is noticeable before the morphological progression and degeneration. Further analysis of an OA subgroup with femoroacetabular impingement (FAI) showed anterior labral tears to be the most significant marker (P = 0.0017) between those FAI subjects with and without OA symptoms. DATA CONCLUSION The data-driven analysis obtained with TDA proposes new phenotypes of these subjects that partially overlap with the radiographic-based classical disease status classification and also shows the potential for further examination of an early onset biomechanical intervention. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;48:1046-1058.
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Affiliation(s)
- Jasmine Rossi-deVries
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Valentina Pedoia
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Michael A Samaan
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA.,Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, California, USA
| | - Adam R Ferguson
- Weill Institute for Neurosciences, Department of Neurological Surgery, Brain and Spinal Injury Center, University of California, San Francisco, California, USA.,San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
| | - Richard B Souza
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA.,Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, California, USA
| | - Sharmila Majumdar
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
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35
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Grimm D, Egli M, Krüger M, Riwaldt S, Corydon TJ, Kopp S, Wehland M, Wise P, Infanger M, Mann V, Sundaresan A. Tissue Engineering Under Microgravity Conditions-Use of Stem Cells and Specialized Cells. Stem Cells Dev 2018; 27:787-804. [PMID: 29596037 DOI: 10.1089/scd.2017.0242] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Experimental cell research studying three-dimensional (3D) tissues in space and on Earth using new techniques to simulate microgravity is currently a hot topic in Gravitational Biology and Biomedicine. This review will focus on the current knowledge of the use of stem cells and specialized cells for tissue engineering under simulated microgravity conditions. We will report on recent advancements in the ability to construct 3D aggregates from various cell types using devices originally created to prepare for spaceflights such as the random positioning machine (RPM), the clinostat, or the NASA-developed rotating wall vessel (RWV) bioreactor, to engineer various tissues such as preliminary vessels, eye tissue, bone, cartilage, multicellular cancer spheroids, and others from different cells. In addition, stem cells had been investigated under microgravity for the purpose to engineer adipose tissue, cartilage, or bone. Recent publications have discussed different changes of stem cells when exposed to microgravity and the relevant pathways involved in these biological processes. Tissue engineering in microgravity is a new technique to produce organoids, spheroids, or tissues with and without scaffolds. These 3D aggregates can be used for drug testing studies or for coculture models. Multicellular tumor spheroids may be interesting for radiation experiments in the future and to reduce the need for in vivo experiments. Current achievements using cells from patients engineered on the RWV or on the RPM represent an important step in the advancement of techniques that may be applied in translational Regenerative Medicine.
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Affiliation(s)
- Daniela Grimm
- 1 Department of Biomedicine, Aarhus University , Aarhus C, Denmark .,2 Clinic for Plastic, Aesthetic and Hand Surgery, Otto-von-Guericke University , Magdeburg, Germany
| | - Marcel Egli
- 3 Institute of Medical Engineering, Lucerne University of Applied Sciences and Arts , Hergiswil, Switzerland
| | - Marcus Krüger
- 2 Clinic for Plastic, Aesthetic and Hand Surgery, Otto-von-Guericke University , Magdeburg, Germany
| | - Stefan Riwaldt
- 1 Department of Biomedicine, Aarhus University , Aarhus C, Denmark
| | - Thomas J Corydon
- 1 Department of Biomedicine, Aarhus University , Aarhus C, Denmark .,4 Department of Ophthalmology, Aarhus University Hospital , Aarhus, Denmark
| | - Sascha Kopp
- 2 Clinic for Plastic, Aesthetic and Hand Surgery, Otto-von-Guericke University , Magdeburg, Germany
| | - Markus Wehland
- 2 Clinic for Plastic, Aesthetic and Hand Surgery, Otto-von-Guericke University , Magdeburg, Germany
| | - Petra Wise
- 5 Hematology/Oncology, University of Southern California , Children's Hospital Los Angeles, Los Angeles, California
| | - Manfred Infanger
- 2 Clinic for Plastic, Aesthetic and Hand Surgery, Otto-von-Guericke University , Magdeburg, Germany
| | - Vivek Mann
- 6 Department of Biology, Texas Southern University , Houston, Texas
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36
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Cartilage breakdown in microgravity-a problem for long-term spaceflight? NPJ Regen Med 2017; 2:10. [PMID: 29302346 PMCID: PMC5677769 DOI: 10.1038/s41536-017-0016-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 02/13/2017] [Accepted: 03/06/2017] [Indexed: 12/02/2022] Open
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37
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Maher SA, Wang H, Koff MF, Belkin N, Potter HG, Rodeo SA. Clinical platform for understanding the relationship between joint contact mechanics and articular cartilage changes after meniscal surgery. J Orthop Res 2017; 35:600-611. [PMID: 27410773 DOI: 10.1002/jor.23365] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 07/02/2016] [Indexed: 02/04/2023]
Abstract
Injury to the meniscus of the knee has been implicated as a significant risk factor for the subsequent development of osteoarthritis, but the mechanisms of joint degeneration are unclear. Our objective was to develop a clinically applicable methodology to evaluate the relationship of joint contact mechanics at the time of surgery to biological changes of articular cartilage as a function of time following surgery. A series of pre-, intra-, and post-operative protocols were developed which utilized electronic sensors for the direct measurement of contact mechanics, and advanced imaging to assess cartilage health. The tests were applied to a pilot cohort of young active patients undergoing meniscus allograft transplantation. Our study demonstrated significant variability across patients in terms of contact area and peak contact stress, both before and after transplantation. Nonetheless, the majority of patients exhibited decreased peak contact stress and increased contact area after graft implantation. MR scans at 3-6 months showed decreased T1ρ values in tibial articular cartilage, suggesting an increase in proteoglycan content or concomitant decrease in water content. Prolongation of T2 values was found primarily within the central, cartilage-cartilage contact region of the tibial plateau suggested disruption of the collagen network. Minimal differences were found in cartilage thickness over the short time frame of this preliminary study. With longer clinical follow-up, our platform of clinical tests can be used to better understand the patient-specific mechanical factors that are related to increased risk of OA after meniscus injury and surgery. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:600-611, 2017.
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Affiliation(s)
- Suzanne A Maher
- Tissue Engineering Regeneration and Repair Program, Hospital for Special Surgery, 535 East 70th Street, New York, 10021
| | - Hongsheng Wang
- Tissue Engineering Regeneration and Repair Program, Hospital for Special Surgery, 535 East 70th Street, New York, 10021
| | - Matthew F Koff
- Magnetic Resonance Imaging Laboratory, Hospital for Special Surgery, 535 East 70th Street, New York, 10021
| | - Nicole Belkin
- Sports Medicine and Shoulder Service, Hospital for Special Surgery, 535 East 70th Street, New York, 10021
| | - Hollis G Potter
- Magnetic Resonance Imaging Laboratory, Hospital for Special Surgery, 535 East 70th Street, New York, 10021
| | - Scott A Rodeo
- Tissue Engineering Regeneration and Repair Program, Hospital for Special Surgery, 535 East 70th Street, New York, 10021.,Sports Medicine and Shoulder Service, Hospital for Special Surgery, 535 East 70th Street, New York, 10021
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Miller RH, Krupenevich RL, Pruziner AL, Wolf EJ, Schnall BL. Medial knee joint contact force in the intact limb during walking in recently ambulatory service members with unilateral limb loss: a cross-sectional study. PeerJ 2017; 5:e2960. [PMID: 28168120 PMCID: PMC5292027 DOI: 10.7717/peerj.2960] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 01/05/2017] [Indexed: 01/04/2023] Open
Abstract
Background Individuals with unilateral lower limb amputation have a high risk of developing knee osteoarthritis (OA) in their intact limb as they age. This risk may be related to joint loading experienced earlier in life. We hypothesized that loading during walking would be greater in the intact limb of young US military service members with limb loss than in controls with no limb loss. Methods Cross-sectional instrumented gait analysis at self-selected walking speeds with a limb loss group (N = 10, age 27 ± 5 years, 170 ± 36 days since last surgery) including five service members with transtibial limb loss and five with transfemoral limb loss, all walking independently with their first prosthesis for approximately two months. Controls (N = 10, age 30 ± 4 years) were service members with no overt demographical risk factors for knee OA. 3D inverse dynamics modeling was performed to calculate joint moments and medial knee joint contact forces (JCF) were calculated using a reduction-based musculoskeletal modeling method and expressed relative to body weight (BW). Results Peak JCF and maximum JCF loading rate were significantly greater in limb loss (184% BW, 2,469% BW/s) vs. controls (157% BW, 1,985% BW/s), with large effect sizes. Results were robust to probabilistic perturbations to the knee model parameters. Discussion Assuming these data are reflective of joint loading experienced in daily life, they support a “mechanical overloading” hypothesis for the risk of developing knee OA in the intact limb of limb loss subjects. Examination of the evolution of gait mechanics, joint loading, and joint health over time, as well as interventions to reduce load or strengthen the ability of the joint to withstand loads, is warranted.
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Affiliation(s)
- Ross H Miller
- Department of Kinesiology, University of Maryland, College Park, MD, United States; Neuroscience & Cognitive Science Program, University of Maryland, College Park, MD, United States
| | - Rebecca L Krupenevich
- Department of Kinesiology, University of Maryland , College Park , MD , United States
| | - Alison L Pruziner
- Department of Kinesiology, University of Maryland, College Park, MD, United States; Walter Reed National Military Medical Center, Bethesda, MD, United States; DoD-VA Extremity Trauma and Amputation Center of Excellence, Bethesda, MD, United States; Department of Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Erik J Wolf
- Walter Reed National Military Medical Center, Bethesda, MD, United States; DoD-VA Extremity Trauma and Amputation Center of Excellence, Bethesda, MD, United States; Department of Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Barri L Schnall
- Walter Reed National Military Medical Center , Bethesda , MD , United States
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Gatti AA, Noseworthy MD, Stratford PW, Brenneman EC, Totterman S, Tamez-Peña J, Maly MR. Acute changes in knee cartilage transverse relaxation time after running and bicycling. J Biomech 2017; 53:171-177. [DOI: 10.1016/j.jbiomech.2017.01.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 01/11/2017] [Accepted: 01/13/2017] [Indexed: 11/25/2022]
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40
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Xie R, Ruan L, Chen L, Zhou K, Yuan J, Ji W, Jing G, Huang X, Shi Q, Chen C. T2 relaxation time for intervertebral disc degeneration in patients with upper back pain: initial results on the clinical use of 3.0 Tesla MRI. BMC Med Imaging 2017; 17:9. [PMID: 28143419 PMCID: PMC5282844 DOI: 10.1186/s12880-017-0182-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Accepted: 01/23/2017] [Indexed: 12/20/2022] Open
Abstract
Background Magnetic resonance imaging (MRI) is a useful non-invasive tool for evaluating abnormalities of intervertebral discs. However, there are few studies which applied functional MRI techniques to investigate degenerative changes in cervical and cervicothoracic junction (CTJ) spine among adults. The aim of this study was to compare T2 relaxation time measurement evaluation with morphological grading for assessing cervical and CTJ intervertebral discs (IVD) in the patients suffering neck, shoulder, and upper back pain. Methods Sixty-three patients (378 IVDs) and 60 asymptomatic volunteers (360 IVDs) of the cervical and CTJ discs were assessed using a 3.0 T magnetic resonance imaging (MRI) protocol, including an sagittal T2 relaxation time protocol. The relaxation time values of the nucleus pulposus (NP) were recorded and all discs were visually graded according to Pfirrman’s grading system. The correlation between T2 relaxation time values and qualitative clinical grading of degeneration, patient age, sex and anatomic level were analyzed Results There is a clear trend of decreasing mean T2 values of the NP associate with increasing Pfirrmann grades (C2-T1) for both patients and asymptotic volunteers. Significant T2 differences were seen among grades I-V (P < 0.05). However, grade V was not observed in the CTJ. Linear correlation analysis revealed a strong negative association between T2 values of the NP and Pfirrmann grade (r = −0.588, r = −0.808) of C2-7 and C7T1. Age were also significantly correlated NP T2 values (r = −0.525, r = −0.723) for patients and volunteers. Moreover, the receiver operating characteristic analysis for average measures in a range from 0.70-0.79 (C2-7) to 0.84-0.89 (C7T1) for patients. Conclusions T2 quantitation provides a more sensitive and robust approach for detecting and characterizing the early stage of IVD degeneration and age-associated disc changes. Electronic supplementary material The online version of this article (doi:10.1186/s12880-017-0182-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Raoying Xie
- Department of Orthopaedics, the First Affiliated Hospital, Wenzhou Medical University, Nan baixiang Road, Shangcai Village, Wenzhou, 325000, Zhejiang, People's Republic of China.,Department of Radiation and chemotherapy division, the First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Linhui Ruan
- Department of Neurosurgery, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Lei Chen
- Department of Orthopaedics, the First Affiliated Hospital, Wenzhou Medical University, Nan baixiang Road, Shangcai Village, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Kai Zhou
- Department of Orthopaedics, the First Affiliated Hospital, Wenzhou Medical University, Nan baixiang Road, Shangcai Village, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Jiandong Yuan
- Department of Orthopaedics, the First Affiliated Hospital, Wenzhou Medical University, Nan baixiang Road, Shangcai Village, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Wei Ji
- Department of Orthopaedics, Navy General Hospital, Beijing, People's Republic of China
| | - Guangjian Jing
- Department of Orthopaedics, the First Affiliated Hospital, Wenzhou Medical University, Nan baixiang Road, Shangcai Village, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Xiaojing Huang
- Department of Orthopaedics, the First Affiliated Hospital, Wenzhou Medical University, Nan baixiang Road, Shangcai Village, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Qinglei Shi
- Siemens Ltd, China Healthcare Sector MR Business Group, Beijing, People's Republic of China
| | - Chun Chen
- Department of Orthopaedics, the First Affiliated Hospital, Wenzhou Medical University, Nan baixiang Road, Shangcai Village, Wenzhou, 325000, Zhejiang, People's Republic of China.
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Van Rossom S, Smith CR, Zevenbergen L, Thelen DG, Vanwanseele B, Van Assche D, Jonkers I. Knee Cartilage Thickness, T1ρ and T2 Relaxation Time Are Related to Articular Cartilage Loading in Healthy Adults. PLoS One 2017; 12:e0170002. [PMID: 28076431 PMCID: PMC5226797 DOI: 10.1371/journal.pone.0170002] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 12/27/2016] [Indexed: 11/19/2022] Open
Abstract
Cartilage is responsive to the loading imposed during cyclic routine activities. However, the local relation between cartilage in terms of thickness distribution and biochemical composition and the local contact pressure during walking has not been established. The objective of this study was to evaluate the relation between cartilage thickness, proteoglycan and collagen concentration in the knee joint and knee loading in terms of contact forces and pressure during walking. 3D gait analysis and MRI (3D-FSE, T1ρ relaxation time and T2 relaxation time sequence) of fifteen healthy subjects were acquired. Experimental gait data was processed using musculoskeletal modeling to calculate the contact forces, impulses and pressure distribution in the tibiofemoral joint. Correlates to local cartilage thickness and mean T1ρ and T2 relaxation times of the weight-bearing area of the femoral condyles were examined. Local thickness was significantly correlated with local pressure: medial thickness was correlated with medial condyle contact pressure and contact force, and lateral condyle thickness was correlated with lateral condyle contact pressure and contact force during stance. Furthermore, average T1ρ and T2 relaxation time correlated significantly with the peak contact forces and impulses. Increased T1ρ relaxation time correlated with increased shear loading, decreased T1ρ and T2 relaxation time correlated with increased compressive forces and pressures. Thicker cartilage was correlated with higher condylar loading during walking, suggesting that cartilage thickness is increased in those areas experiencing higher loading during a cyclic activity such as gait. Furthermore, the proteoglycan and collagen concentration and orientation derived from T1ρ and T2 relaxation measures were related to loading.
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Affiliation(s)
- Sam Van Rossom
- Human movement biomechanics research group, Department of kinesiology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Colin Robert Smith
- Department of mechanical engineering, University of Wisconsin-Madison, Madison, United States of America
| | - Lianne Zevenbergen
- Human movement biomechanics research group, Department of kinesiology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Darryl Gerard Thelen
- Department of mechanical engineering, University of Wisconsin-Madison, Madison, United States of America
- Department of biomedical engineering, University of Wisconsin-Madison, Madison, United States of America
- Department of orthopedics and rehabilitation, University of Wisconsin-Madison, Madison, United States of America
| | - Benedicte Vanwanseele
- Human movement biomechanics research group, Department of kinesiology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Dieter Van Assche
- Musculoskeletal rehabilitation research group, Department of rehabilitation sciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Ilse Jonkers
- Human movement biomechanics research group, Department of kinesiology, Katholieke Universiteit Leuven, Leuven, Belgium
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Kwee RM, Wirth W, Hafezi-Nejad N, Zikria BA, Guermazi A, Demehri S. Role of physical activity in cartilage damage progression of subjects with baseline full-thickness cartilage defects in medial tibiofemoral compartment: data from the Osteoarthritis Initiative. Osteoarthritis Cartilage 2016; 24:1898-1904. [PMID: 27327782 DOI: 10.1016/j.joca.2016.06.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 05/21/2016] [Accepted: 06/11/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess the association between physical activity and cartilage damage progression in medial tibiofemoral compartment (MTFC) using 2-year follow-up magnetic resonance imaging (MRI) in subjects with denuded areas of subchondral bone (dABs) at the central weight-bearing medial femur (cMF) at baseline MRI examination. METHODS One hundred subjects from the Osteoarthritis Initiative (OAI) progression cohort with dABs at the cMF at 3T MRI at baseline (51% men; mean age 62.2 years, range 45-79) were included. Sagittal 3D dual-echo steady-state with water excitation images were used to assess 2-year MTFC cartilage change. Associations between 2-year average Physical Activity Scale for the Elderly (PASE) and 2-year MTFC cartilage change were assessed by linear regression analysis. Subgroup analyses were performed. RESULTS No associations between PASE and 2-year MTFC cartilage change were observed in the entire cohort. Similarly, in the subgroup with cartilage loss during the 2 years, the non-refuted confidence intervals for the regression coefficients were tightly clustered around the null value (regression coefficients for: mean cMF.ThCtAB = -0.00059; 98.75% CI: -0.00130 to 0.00012), cMF.dAB% = 0.02176; 98.75% CI: -0.02514 to 0.06865, Mean MT.ThCtAB = -0.00013; 98.75% CI: -0.00064 to 0.00038, MT.dAB% = 0.02543; 98.75% CI: -0.01485 to 0.06571. CONCLUSION In the entire group of subjects with dABs at the cMF at baseline, no association between physical activity and 2-year MTFC cartilage change was detected. Due to the limited sample size of our study, small-sized effects may not have been detected in our study.
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Affiliation(s)
- R M Kwee
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Radiology, Zuyderland Medical Center, Heerlen, The Netherlands
| | - W Wirth
- Institute of Anatomy, Paracelsus Medical University, Salzburg, Austria; Chondrometrics GmbH, Ainring, Germany
| | - N Hafezi-Nejad
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - B A Zikria
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - A Guermazi
- Department of Radiology, Boston University School of Medicine, Boston, MA, USA
| | - S Demehri
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Behzadi C, Welsch GH, Laqmani A, Henes FO, Kaul MG, Schoen G, Adam G, Regier M. Comparison of T2* relaxation times of articular cartilage of the knee in elite professional football players and age-and BMI-matched amateur athletes. Eur J Radiol 2016; 86:105-111. [PMID: 28027735 DOI: 10.1016/j.ejrad.2016.10.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 09/26/2016] [Accepted: 10/26/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Recent investigation has underlined the potential of quantitative MR imaging to be used as a complementary tool for the diagnosis of cartilage degeneration at an early state. The presented study analyses T2* relaxation times of articular cartilage of the knee in professional athletes and compares the results to age- and BMI (Body Mass Index)-matched healthy amateur athletes. MATERIALS AND METHODS 22 professional football players and 22 age- and BMI-matched individuals were underwent knee Magnetic Resonance Imaging (MRI) at 3T including qualitative and quantitative analysis. Qualitative analysis included e.g. meniscal tears, joint effusion and bone edema. For quantitative analysis T2* (22 ET: 4.6-53.6ms) measurements in 3D data acquisition were performed. Deep and superficial layers of 22 predefined cartilage segments were analysed. All data sets were postprocessed using a dedicated software tool. Statistical analysis included Student t-test, confidence intervals and a random effects model. RESULTS In both groups, T2* relaxation times were significantly higher in the superficial compared to the deep layers (p<0.001). Professional athletes had significantly higher relaxation times in eight superficial and three deep cartilage layers in the predefined cartilage segments (p<0.05). Highly significant differences were found in the weight-bearing segments of the lateral superficial femoral condyle (p<0.001). CONCLUSION Elevated T2* values in cartilage layers of professional football players compared to amateur athletes were noted. The effects seem to predominate in superficial cartilage layers.
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Affiliation(s)
- C Behzadi
- Department of Diagnostic and Interventional Radiology and Nuclearmedicine, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany.
| | - G H Welsch
- Department of Sports Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany
| | - A Laqmani
- Department of Diagnostic and Interventional Radiology and Nuclearmedicine, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany
| | - F O Henes
- Department of Diagnostic and Interventional Radiology and Nuclearmedicine, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany
| | - M G Kaul
- Department of Diagnostic and Interventional Radiology and Nuclearmedicine, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany
| | - G Schoen
- Department of Medical Biometry and Epidemiology, University Medical Center, Hamburg-Eppendorf, Hamburg, 20246, Germany
| | - G Adam
- Department of Diagnostic and Interventional Radiology and Nuclearmedicine, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany
| | - M Regier
- Department of Diagnostic and Interventional Radiology and Nuclearmedicine, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany
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Munukka M, Waller B, Rantalainen T, Häkkinen A, Nieminen MT, Lammentausta E, Kujala UM, Paloneva J, Sipilä S, Peuna A, Kautiainen H, Selänne H, Kiviranta I, Heinonen A. Efficacy of progressive aquatic resistance training for tibiofemoral cartilage in postmenopausal women with mild knee osteoarthritis: a randomised controlled trial. Osteoarthritis Cartilage 2016; 24:1708-1717. [PMID: 27211862 DOI: 10.1016/j.joca.2016.05.007] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 04/19/2016] [Accepted: 05/09/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To study the efficacy of aquatic resistance training on biochemical composition of tibiofemoral cartilage in postmenopausal women with mild knee osteoarthritis (OA). DESIGN Eighty seven volunteer postmenopausal women, aged 60-68 years, with mild knee OA (Kellgren-Lawrence grades I/II and knee pain) were recruited and randomly assigned to an intervention (n = 43) and control (n = 44) group. The intervention group participated in 48 supervised aquatic resistance training sessions over 16 weeks while the control group maintained usual level of physical activity. The biochemical composition of the medial and lateral tibiofemoral cartilage was estimated using single-slice transverse relaxation time (T2) mapping and delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC index). Secondary outcomes were cardiorespiratory fitness, isometric knee extension and flexion force and knee injury and OA outcome (KOOS) questionnaire. RESULTS After 4-months aquatic training, there was a significant decrease in both T2 -1.2 ms (95% confidence interval (CI): -2.3 to -0.1, P = 0.021) and dGEMRIC index -23 ms (-43 to -3, P = 0.016) in the training group compared to controls in the full thickness posterior region of interest (ROI) of the medial femoral cartilage. Cardiorespiratory fitness significantly improved in the intervention group by 9.8% (P = 0.010). CONCLUSIONS Our results suggest that, in postmenopausal women with mild knee OA, the integrity of the collagen-interstitial water environment (T2) of the tibiofemoral cartilage may be responsive to low shear and compressive forces during aquatic resistance training. More research is required to understand the exact nature of acute responses in dGEMRIC index to this type of loading. Further, aquatic resistance training improves cardiorespiratory fitness. TRIAL REGISTRATION NUMBER ISRCTN65346593.
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Affiliation(s)
- M Munukka
- Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
| | - B Waller
- Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
| | - T Rantalainen
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia.
| | - A Häkkinen
- Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland; Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Jyväskylä, Finland.
| | - M T Nieminen
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland; Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Medical Research Center, University of Oulu and Oulu University Hospital.
| | - E Lammentausta
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.
| | - U M Kujala
- Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
| | - J Paloneva
- Department of Surgery, Central Finland Central Hospital, Jyväskylä, Finland.
| | - S Sipilä
- Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland; Gerontology Research Center, University of Jyväskylä, Finland.
| | - A Peuna
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland; Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland.
| | - H Kautiainen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland; Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland.
| | - H Selänne
- Mehiläinen Sports Medical Clinic, Jyväskylä, Finland.
| | - I Kiviranta
- Department of Orthopaedics and Traumatology, University of Helsinki, and Helsinki University Hospital, Helsinki, Finland.
| | - A Heinonen
- Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
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Willey JS, Kwok AT, Moore JE, Payne V, Lindburg CA, Balk SA, Olson J, Black PJ, Walb MC, Yammani RR, Munley MT. Spaceflight-Relevant Challenges of Radiation and/or Reduced Weight Bearing Cause Arthritic Responses in Knee Articular Cartilage. Radiat Res 2016; 186:333-344. [PMID: 27602483 DOI: 10.1667/rr14400.1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
There is little known about the effect of both reduced weight bearing and exposure to radiation during spaceflight on the mechanically-sensitive cartilage lining the knee joint. In this study, we characterized cartilage damage in rat knees after periods of reduced weight bearing with/without exposure to solar-flare-relevant radiation, then cartilage recovery after return to weight bearing. Male Sprague Dawley rats (n = 120) were either hindlimb unloaded (HLU) via tail suspension or remained weight bearing in cages (GROUND). On day 5, half of the HLU and GROUND rats were 1 Gy total-body X-ray irradiated during HLU, and half were sham irradiated (SHAM), yielding 4 groups: GROUND-SHAM; GROUND-IR; HLU-SHAM; and HLU-IR. Hindlimbs were collected from half of each group of rats on day 13. The remaining rats were then removed from HLU or remained weight bearing, and hindlimbs from these rats were collected on day 62. On day 13, glycosaminoglycan (GAG) content in cartilage lining the tibial plateau and femoral condyles of HLU rats was lower than that of the GROUND animals. Likewise, on day 13, immunoreactivity of the collagen type II-degrading matrix metalloproteinase-13 (MMP-13) and of a resultant metalloproteinase-generated neoepitope VDIPEN was increased in all groups versus GROUND-SHAM. Clustering of chondrocytes indicating cartilage damage was present in all HLU and IR groups versus GROUND-SHAM on day 13. On day 62, after 49 days of reloading, the loss of GAG content was attenuated in the HLU-SHAM and HLU-IR groups, and the increased VDIPEN staining in all treatment groups was attenuated. However, the increased chondrocyte clustering remained in all treatment groups on day 62. MMP-13 activity also remained elevated in the GROUND-IR and HLU-IR groups. Increased T2 relaxation times, measured on day 62 using 7T MRI, were greater in GROUND-IR and HLU-IR knees, indicating persistent cartilage damage in the irradiated groups. Both HLU and total-body irradiation resulted in acute degenerative and pre-arthritic changes in the knee articular cartilage of rats. A return to normal weight bearing resulted in some recovery from cartilage degradation. However, radiation delivered as both a single challenge and when combined with HLU resulted in chronic cartilage damage. These findings suggest that radiation exposure during spaceflight leads to and/or impairs recovery of cartilage upon return to reloading, generating long-term joint problems for astronauts.
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Affiliation(s)
- J S Willey
- a Department of Radiation Oncology, Wake Forest School of Medicine Comprehensive Cancer Center, Winston-Salem, North Carolina
| | - A T Kwok
- a Department of Radiation Oncology, Wake Forest School of Medicine Comprehensive Cancer Center, Winston-Salem, North Carolina
| | - J E Moore
- a Department of Radiation Oncology, Wake Forest School of Medicine Comprehensive Cancer Center, Winston-Salem, North Carolina
| | - V Payne
- a Department of Radiation Oncology, Wake Forest School of Medicine Comprehensive Cancer Center, Winston-Salem, North Carolina
| | - C A Lindburg
- a Department of Radiation Oncology, Wake Forest School of Medicine Comprehensive Cancer Center, Winston-Salem, North Carolina
| | - S A Balk
- b Transportation Solutions and Technology Applications Division, Leidos, Reston, Virginia; and
| | - J Olson
- a Department of Radiation Oncology, Wake Forest School of Medicine Comprehensive Cancer Center, Winston-Salem, North Carolina
| | - P J Black
- a Department of Radiation Oncology, Wake Forest School of Medicine Comprehensive Cancer Center, Winston-Salem, North Carolina
| | - M C Walb
- a Department of Radiation Oncology, Wake Forest School of Medicine Comprehensive Cancer Center, Winston-Salem, North Carolina
| | - R R Yammani
- c Department of Internal Medicine, Sections of Molecular Medicine and Rheumatology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - M T Munley
- a Department of Radiation Oncology, Wake Forest School of Medicine Comprehensive Cancer Center, Winston-Salem, North Carolina
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Calixto NE, Kumar D, Subburaj K, Singh J, Schooler J, Nardo L, Li X, Souza RB, Link TM, Majumdar S. Zonal differences in meniscus MR relaxation times in response to in vivo static loading in knee osteoarthritis. J Orthop Res 2016; 34. [PMID: 26223430 PMCID: PMC6714045 DOI: 10.1002/jor.23004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This study assessed the effects of static loading on MRI relaxation times of menisci in individuals with and without radiographic knee OA. High-resolution fast spin-echo (FSE) and T(1ρ)/T(2) relaxation time MR sequences were obtained with and without loading at 50% body weight in 124 subjects. T(1ρ)/T(2) relaxation times were calculated in menisci, and meniscus lesions were assessed through clinical grading. Student's t-test compared OA and control unloaded relaxation times as well as within-group changes with loading, Generalized Linear Models evaluated zonal variation, and ANCOVA compared loading response between groups. Unloaded T(1ρ) and T(2) in the middle and inner zones of the lateral anterior horn and outer zone of the medial posterior horn were significantly higher in OA and suggest that meniscal OA change occurs unevenly. Zonal T(1ρ) and T(2) showed differing patterns between anterior and posterior horns, suggesting differences in macromolecular organization. Significant increases with loading were seen largely in the T(2) of controls and less frequently in subjects with OA. In the medial posterior horn, T(1ρ) and T(2) decreased with loading in OA but changed negligibly in controls; these significantly different loading responses between groups may indicate load transmission failure in OA menisci.
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Affiliation(s)
- Nathaniel E. Calixto
- Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Deepak Kumar
- Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California,,Division of Physical Therapy, College of Health Professions, Medical University of South Carolina, Charleston, South Carolina
| | - Karupppasamy Subburaj
- Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California,,Engineering Product Development, Singapore University of Technology and Design, Singapore
| | - Justin Singh
- Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Joseph Schooler
- Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Lorenzo Nardo
- Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Xiaojuan Li
- Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Richard B. Souza
- Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California,,Department of Physical Therapy, University of California, San Francisco, California
| | - Thomas M. Link
- Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Sharmila Majumdar
- Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
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Inter- and intra-rater reliability of patellofemoral kinematic and contact area quantification by fast spin echo MRI and correlation with cartilage health by quantitative T1ρ MRI. Knee 2016; 23:13-9. [PMID: 26746045 PMCID: PMC4762728 DOI: 10.1016/j.knee.2015.08.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 08/11/2015] [Accepted: 08/20/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND Patellar maltracking is a leading cause of patellofemoral pain syndrome (PFPS). The aim of this study was to determine the inter- and intra-rater reliability of a semi-automated program for magnetic resonance imaging (MRI) based patellofemoral kinematics. METHODS Sixteen subjects (10 with PFPS [mean age 32.3; SD 5.2; eight females] and six controls without PFPS 19 [mean age 28.6; SD 2.8; three females]) participated in the study. One set of T2-weighted, fat-saturated fast spin-echo (FSE) MRIs were acquired from each subject in full extension and 30° of knee flexion. MRI including axial T1ρ relaxation time mapping sequences was also performed on each knee. Following image acquisitions, regions of interest for kinematic MRI, and patellar and trochlear cartilage were segmented and quantified with in-house designed spline- based MATLAB semi-automated software. RESULTS Intraclass Correlations Coefficients (ICC) of calculated kinematic parameters were good to excellent, ICC > 0.8 in patellar flexion, rotation, tilt, and translation (anterior -posterior, medial -lateral, and superior -inferior), and contact area translation. Only patellar tilt in the flexed position and motion from extended to flexed state was significantly different between PFPS and control patients (p=0.002 and p=0.006, respectively). No significant correlations were identified between patellofemoral kinematics and contact area with T1ρ relaxation times. CONCLUSIONS A semi-automated, spline-based kinematic MRI technique for patellofemoral kinematic and contact area quantification is highly reproducible with the potential to help better understand the role of patellofemoral maltracking in PFPS and other knee disorders. LEVEL OF EVIDENCE Level IV.
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48
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Wang N, Badar F, Xia Y. MRI properties of a unique hypo-intense layer in degraded articular cartilage. Phys Med Biol 2015; 60:8709-21. [PMID: 26509475 DOI: 10.1088/0031-9155/60/22/8709] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
To investigate the characteristics of a hypo-intense laminar appearance in articular cartilage under external loading, microscopic magnetic resonance imaging (μMRI) T1, T2 and T1ρ experiments of a total of 15 specimens of healthy and trypsin-degraded cartilage were performed at different soaking solutions (saline and 100 mM phosphate buffered saline (PBS)). T2 and T1ρ images of the healthy tissue in saline showed no load-induced laminar appearance, while a hypo-intense layer was clearly visible in the deep part of the degraded tissue at the magic angle. A significant difference was found between T2 values at 0° and 55° (from 16.5 ± 2.8 ms to 20.2 ± 2.7 ms, p = 0.0005), and at 0° and 90° (16.5 ± 2.8 ms to 21.3 ± 2.6 ms, p < 0.0001) in saline solution. In contrast, this hypo-intense laminar appearance largely disappeared when tissue was soaked in PBS. The visualization of this hypo-intensity appearance in different soaking mediums calls for caution in interpreting the data of relaxation times, chemical exchange and collagen fiber deformation.
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Affiliation(s)
- Nian Wang
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, MI 48309, USA
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Ploutz-Snyder L, Bloomfield S, Smith SM, Hunter SK, Templeton K, Bemben D. Effects of sex and gender on adaptation to space: musculoskeletal health. J Womens Health (Larchmt) 2015; 23:963-6. [PMID: 25401942 DOI: 10.1089/jwh.2014.4910] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
There is considerable variability among individuals in musculoskeletal response to long-duration spaceflight. The specific origin of the individual variability is unknown but is almost certainly influenced by the details of other mission conditions such as individual differences in exercise countermeasures, particularly intensity of exercise, dietary intake, medication use, stress, sleep, psychological profiles, and actual mission task demands. In addition to variations in mission conditions, genetic differences may account for some aspect of individual variability. Generally, this individual variability exceeds the variability between sexes that adds to the complexity of understanding sex differences alone. Research specifically related to sex differences of the musculoskeletal system during unloading is presented and discussed.
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Affiliation(s)
- Lori Ploutz-Snyder
- 1 Exercise Physiology and Countermeasures, University Space Research Association , Houston, Texas
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OARSI Clinical Trials Recommendations: Hip imaging in clinical trials in osteoarthritis. Osteoarthritis Cartilage 2015; 23:716-31. [PMID: 25952344 PMCID: PMC4430132 DOI: 10.1016/j.joca.2015.03.004] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 03/01/2015] [Accepted: 03/09/2015] [Indexed: 02/02/2023]
Abstract
Imaging of hip in osteoarthritis (OA) has seen considerable progress in the past decade, with the introduction of new techniques that may be more sensitive to structural disease changes. The purpose of this expert opinion, consensus driven recommendation is to provide detail on how to apply hip imaging in disease modifying clinical trials. It includes information on acquisition methods/techniques (including guidance on positioning for radiography, sequence/protocol recommendations/hardware for magnetic resonance imaging (MRI)); commonly encountered problems (including positioning, hardware and coil failures, artifacts associated with various MRI sequences); quality assurance/control procedures; measurement methods; measurement performance (reliability, responsiveness, and validity); recommendations for trials; and research recommendations.
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