A novel rat model for subchondral microdamage in acute knee injury: a potential mechanism in post-traumatic osteoarthritis

OBJECTIVE

Subchondral microdamage may play an important role in post-traumatic osteoarthritis (PTOA) development following anterior cruciate ligament (ACL) rupture. It remains unknown whether this injury mechanism causes subchondral microdamage, or whether its repair occurs by targeted osteoclast-mediated remodeling. If so these events may represent a mechanism by which subchondral bone is involved in PTOA. Our objective was to test the hypothesis that subchondral microdamage occurs, and is co-localized with remodeling, in a novel rat model of ACL rupture.

DESIGN

We developed a novel non-invasive rat animal model for ACL rupture and subchondral microdamage generation. By inducing ACL rupture noninvasively rather than surgically, this more closely mimics the clinical injury. MicroCT, MRI and histological methods were used to measure microstructural changes, ligament damage, and cellular/matrix degeneration, respectively.

RESULTS

We reproducibly generated ACL rupture without damage to other soft joint tissues. Immediately after injury, increased microdamage was found in the postero-medial aspect of the tibia. Microstructural parameters showed increased resorption at 2 weeks, which returned to baseline. Dynamic histomorphometry showed increased calcein label uptake in the same region at 4 and 8 weeks. Chondrocyte death and protease activity in cartilage was also noted, however whether this was directly linked to subchondral changes is not yet known. Similarly, cartilage scoring showed degradation at 4 and 8 weeks post-injury.

CONCLUSIONS

This study shows that our novel model can be used to study subchondral microdamage after ACL-rupture, and its association with localized remodeling. Cartilage degeneration, on a similar time-scale to other models, is also a feature of this system.

Feasibility of a RARE-based sequence for quantitative diffusion-weighted MRI of the spine

The feasibility of a diffusion-weighted single-shot fast-spin-echo sequence for the diagnostic work-up of bone marrow diseases was assessed. Twenty healthy controls and 16 patients with various bone marrow pathologies of the spine (bone marrow edema, tumor and inflammation) were examined with a diffusion-weighted single-shot sequence based on a modified rapid acquisition with relaxation enhancement (mRARE) technique; four diffusion weightings (b-values: 50, 250, 500 and 750 s/mm(2)) in three orthogonal orientations were applied. Apparent diffusion coefficients (ADCs) were determined in the bone marrow and in the intervertebral discs of healthy volunteers and in diseased bone marrow. Ten of the 20 volunteers were repeatedly scanned within 30 min to examine short-time reproducibility. Spatial reproducibility was assessed by measuring ADCs in two different slices including the same lesion in 12 patients. The ADCs of the lesions exhibited significantly higher values, (1.27 +/- 0.32)x10(-3) mm(2)/s, compared with healthy bone marrow, (0.21 +/- 0.10)x10(-3) mm(2)/s. Short-time and spatial reproducibility had a mean coefficient of variation of 2.1% and 6.4%, respectively. The diffusion-weighted mRARE sequence provides a reliable tool for determining quantitative ADCs in vertebral bone marrow with adequate image quality.

T2-Relaxationszeit am Patellaknorpel - Globale und regionale Reproduzierbarkeit bei 1,5 Tesla und 3 Tesla

PURPOSE

Evaluation of the global and regional reproducibility of T2 relaxation time in patellar cartilage at 1.5 T and 3 T.

MATERIALS AND METHODS

6 left patellae of 6 healthy volunteers (aged 25 - 30, 3 female, 3 male) were examined using a fat-saturated multiecho sequence and a T1-w 3D-FLASH sequence with water excitation at 1.5 Tesla and 3 Tesla. Three consecutive data sets were acquired within one MRI session with the examined knee being repositioned in the coil and scanner between each data set. The segmented cartilage (FLASH sequence) was overlaid on the multiecho data and T2 values were calculated for the total cartilage, 3 horizontal layers consisting of a superficial, intermedial and deep layer, 3 facets consisting of a medial, median (ridge) and lateral facet (global T2 values) and 27 ROIs/MRI slices (regional T2 value). The reproducibility (precision error) was calculated as the root mean square average of the individual standard deviations [ms] and coefficients of variation (COV) [%].

RESULTS

The mean global reproducibility error for T2 was 3.53 % (+/- 0.38 %) at 1.5 Tesla and 3.25 % (+/- 0.61 %) at 3 Tesla. The mean regional reproducibility error for T2 was 8.62 % (+/- 2.61 %) at 1.5 Tesla and 9.66 % (+/- 3.37 %) at 3 Tesla. There was no significant difference with respect to absolute reproducibility errors between 1.5 Tesla and 3 Tesla at a constant spatial resolution. However, different reproducibility errors were found between the cartilage layers. One third of the data variability could be attributed to the influence of the different cartilage layers, and another 10 % to the influence of the separate MRI slices.

CONCLUSION

Our data provides an estimation of the global and regional reproducibility errors of T2 in healthy cartilage. In the analysis of small subregions, an increase in the regional reproducibility error must be accepted. The data may serve as a basis for sample size calculations of study populations and may contribute to the decision regarding the level of detail of an evaluation of study data.

Techniques for diffusion-weighted imaging of bone marrow

Diffusion-weighted magnetic resonance imaging (DWI) is an imaging technique which is sensitive to random water movements in spatial scales far below those typically accessible by magnetic resonance imaging (MRI). This property makes DWI a powerful tool for diagnosis of diseases which involve alterations in water mobility, such as acute stroke. In bone marrow, DWI has been proven to be a highly useful method for the differential diagnosis of benign and malignant compression fractures. Unfortunately, the application of DWI sequences to the bone marrow frequently suffers from artifacts, which in some cases seriously restrict the diagnostic utility of the image. This requires the introduction of additional correction techniques, or even the development of new sequences. Thus, the selection of an adequate imaging technique for DWI of the bone marrow is a very important issue. In this article the most important sequences for DWI of the bone marrow are reviewed. Special attention is paid to the problems associated with these sequences, as well as their possible solutions.

Sustained firing of alpha and gamma hind limb motoneurons induced by stimulation of the pudendal nerve

Axons from receptors in the cat vaginal wall run in the sensory pudendal nerve (SPN), and brief (<10 s) vaginal probing (VP) in the decerebrate cat produces a long-lasting (>1 min) contraction of the triceps surae (TS) muscles. The aim of the present project was to find out whether brief SPN stimulation also produces sustained TS response and, eventually, to study the mechanisms involved in it. Decerebrate female cats were used. In some cats, TS electromyography (EMG) and tension response were recorded; stimulation of left SPN with single or repetitive trains of shocks produced a bilateral TS response that outlasted the stimulus >1 min as VP did. In paralyzed cats (pancuronium; Panc), intracellular recordings were made from hind limb motoneurons (MNs). SPN stimulation produced a depolarization <or=5 s long and occasional cell firing only lasting <2.5 s; this is in contrast with the prolonged TS postdischarge seen in nonparalyzed cats. If MNs were depolarized below the firing threshold by current injection, about half of them showed bistable firing that could last several minutes in response to SPN train. It is suggested that MNs might hyperpolarize after Panc injection. Before Panc injection, SPN train produced long-lasting (>1 min) electroneurographic (ENG) postdischarge in a small filament of the medial gastrocnemius (MG) nerve; the MG EMG postdischarge was also recorded. Large spikes (LS) and small spikes (SS) were distinguished in the ENG. During the postdischarge, LS frequency and the integrated EMG activity correlated well (r > 0.9); no correlation was found between SS and EMG. After Panc injection, LS postdischarge was absent but the SS postdischarge remained. LS followed by EMG potential were also evoked by brief TS stretch (reflex LS); single shocks to SPN only elicited SS that were not followed by EMG potential. It is concluded that alpha axons and gamma axons produced LS and SS, respectively, and that SPN activates gamma axons. It is proposed that, in the nonparalyzed cats, the stimulation of SPN with trains of shocks might cause an increase in the afferent inflow from muscle spindles to alpha MNs through the sustained firing of gamma MNs. The increased excitatory inflow would depolarize alpha MNs and allow bistable MN firing; Panc would decrease this inflow by blocking transmission to the spindle fibers.

Methods to find aponeurosis and tendon stiffness and the onset of muscle contraction

A method to measure small movements of living tissues either large or small is presented. The method is based on the detection of changes in reflected infrared light. An optocoupler (coupled photodiode and photodetector) and a small (< 1 cm2) mirror were used. The optocoupler (OC) has a low cost and it can be calibrated easily. It can be also used as the transducer of a strain-gage. Three different uses are shown: (a) as a strain-gage transducer; (b) detection of tendon and aponeurosis movements in large muscles (cat soleus); (c) detection of the onset of muscle contraction. Movements of less than 1 microm can be detected with the aid of automatic averaging of the signals. Concerning the second use (b), it permits the estimation of tendon stretch. Concerning the third use, the onset of muscle movement precedes by at least 2 ms that of the force recorded at the tendon.

The cat pudendal nerve: afferent fibers responding to mechanical stimulation of the perineal skin, the vagina or the uterine cervix

Some afferent fibers from the pudendal nerve of the female cat were stimulated by pressing on the perineal skin, the vagina or the uterine cervix. Three different types of skin mechanoreceptors were found: (1) with low threshold (< 20 mg) and slow-adapting discharges; (2) with high threshold (0.1-0.5 g) and slow-adapting discharges; and (3) with low threshold and fast-adapting discharges. Most of these receptors increased their firing frequency as the velocity of skin indentation was increased (velocity detectors). The average conduction velocity of the skin afferents was 29 +/- 9 m/s. The receptors located at the vagina showed a fast-adapting response to probing and were sensitive to the velocity of the probe movement. Most of these receptors, however, showed a slow adaptation when the vaginal wall was distended with a balloon. The conduction velocity in vaginal afferents was 37 +/- 16 m/s. Those receptors responding to pressure on the uterine cervix adapted slowly to constant pressure but were sensitive to the velocity of the pressure pulses. The conduction velocity in the afferents from the uterine cervix was 31 +/- 9 m/s.

Sustained activation of the triceps surae muscles produced by mechanical stimulation of the genital tract of the female cat

In decerebrate cats, controlled mechanical stimulation of the perivulvar skin, the vaginal wall or the cervix uteri induced visible hind limb extension. Pressing on the cervix uteri produced the greater response. To quantify these responses, the EMG activity and the tension developed by the normally inserted triceps surae muscles were recorded. The activity induced in these muscles by stimulation of the genital canal outlasted the stimulus by many seconds or a few minutes. These effects disappeared after spinalization at the T12 level. We propose that stimulation of the vaginal canal in the female cat may induce bistability of triceps surae motoneurones.