Effect of contact stress in bones of the distal interphalangeal joint on microscopic changes in articular cartilage and ligaments

OBJECTIVE

To examine articular cartilage of the distal interphalangeal (DIP) joint and distal sesamoidean impar ligament (DSIL) as well as the deep digital flexor tendon (DDFT) for adaptive responses to contact stress.

SAMPLE POPULATION

Specimens from 21 horses.

PROCEDURE

Pressure-sensitive film was inserted between articular surfaces of the DIP joint. The digit was subjected to a load. Finite element models (FEM) were developed from the data. The navicular bone, distal phalanx, and distal attachments of the DSIL and DDFT were examined histologically.

RESULTS

Analysis of pressure-sensitive film revealed significant increases in contact area and contact load at dorsiflexion in the joints between the distal phalanx and navicular bone and between the middle phalanx and navicular bone. The FEM results revealed compressive and shear stresses. Histologic evaluation revealed loss of proteoglycans in articular cartilage from older horses (7 to 27 years old). Tidemark advancement (up to 14 tidemarks) was observed in articular cartilage between the distal phalanx and navicular bone in older clinically normal horses. In 2 horses with navicular syndrome, more tidemarks were evident. Clinically normal horses had a progressive increase in proteoglycans in the DSIL and DDFT.

CONCLUSIONS AND CLINICAL RELEVANCE

Load on the navicular bone and associated joints was highest during dorsiflexion. This increased load may be responsible for microscopic changes of tidemark advancement and proteoglycan depletion in the articular cartilage and of proteoglycan production in the DSIL and DDFT Such microscopic changes may represent adaptive responses to stresses that may progress and contribute to lameness.

[(3)H]-SB-269970--A selective antagonist radioligand for 5-HT(7) receptors

Binding of the 5-HT(7) receptor antagonist radioligand [(3)H]-SB-269970 to human 5-HT(7(a)) receptors expressed in HEK293 cell membranes (h5-HT(7(a))/293) and to guinea-pig cerebral cortex membranes, was characterized and compared with [(3)H]-5-CT binding. [(3)H]-SB-269970 (1 nM) showed full association with h5-HT(7(a))/293 membranes after 40 min. Specific binding at equilibrium represented >90% of total binding and was fully reversible by methiothepin (10 microM), full dissociation occurring by 100 min. The association (k(+1)) and dissociation (k(-1)) rate constants were 0.05 nM(-1)min(-1) and 0.05 min(-1) respectively, giving a K(D) (k(-1)/k(+1)) of 1.0 nM. [(3)H]-SB-269970 bound saturably and apparently monophasically to both h5-HT(7(a))/293 and guinea-pig cortex membranes, with K(D) values of 1.25+/-0.05 and 1.7+/-0.3 nM respectively. The B(max) for [(3)H]-SB-269970 to both h5-HT(7(a))/293 and guinea-pig cortex membranes (5780+/-380 and 125+/-8.2 fmoles mg protein(-1) respectively) was similar to that for [(3)H]-5-CT (6190+/-940 and 143+/-19 fmoles mg protein(-1) respectively). These data suggest that, in each tissue, both radioligands labelled the same population of receptors, which appear to be present in an agonist high affinity state. The profile of compound inhibition of [(3)H]-SB-269970 binding to h5-HT(7(a))/293 and guineapig cortex membranes correlated well (corr. coeff. 0.98) with those for [(3)H]-5-CT binding and were consistent with the profiles reported previously for the human 5-HT(7(a)) and guinea-pig cortex 5-HT(7) receptors using [(3)H]-5-CT. Hill slopes for inhibition of [(3)H]-SB-269970 and [(3)H]-5-CT binding were close to 1, consistent with binding to a single receptor population in both tissues. [(3)H]-SB-269970 represents the first selective 5-HT(7) antagonist radioligand, which should aid further characterization of 5-HT(7) receptors in recombinant and native tissues and help establish their role in brain function.

Patellar tendon augmentation after removal of its central third limits joints tissue changes

The central third of the patellar tendon is commonly used to reconstruct the injured anterior cruciate ligament. Some studies have noted changes in joint tissues following this procedure. It has been postulated that these changes may be associated with increased stress on the remaining tendon following harvest of the graft. In our study, the central third of the patellar tendon was excised in three groups of rabbits. The central tendon defects in two of the three groups were fitted with different augmentation devices to augment the host tendon during the healing process. All rabbits followed a daily treadmill exercise regimen for 12 weeks following the operation. Biomechanical testing of the tendon revealed that in nonaugmented tendons the cross-sectional area and the length of the patellar tendon significantly increased 112 and 16%, respectively. There was histological evidence of host-tendon remodeling throughout the cross section and extensive fibrosis in the infrapatellar fat pad. Augmentation of the tendon significantly reduced these changes, with the least change noted in the group with the greatest augmentation. The rabbits with augmentation devices retained tendon dimensions similar to those of the contralateral intact tendon, and tendon remodeling occurred only in the defect area. The rabbits with augmentation devices exhibited little to no fibrosis of the fat pad. Structural properties of augmented and nonaugmented tendons were similar despite the size differences, indicating higher tissue quality in the augmented tendons. This study suggested that complications of the knee joint (i.e., tendon proliferation and fat pad fibrosis) noted after anterior cruciate-ligament reconstruction with the autogenous patellar tendon may be limited by the implantation of an augmentation device.

Detection of experimentally produced occult microfractures at the bone-cartilage interface in decalcified sections

We compared three histological preparation methods to detect experimentally produced occult microfractures in decalcified human patellae: a paraffin tape-transfer technique, a paraffin slab-cut method, and a paraffin method with methyl salicylate as the clearing agent. Microfractures were observed at the bone-cartilage interface and were oriented either parallel or perpendicular to the tidemark. Both types of microfractures were documented with each preparation method. The slab-cut method was time-consuming, but the section thickness allowed detailed analysis of the architecture of microcracks as they passed into the depth of the section. The methyl salicylate method was efficient and produced thin, serial sections with good morphological detail and minimal cutting artifact. Reliable histological data were also derived from the tape-transfer technique, but this method was inconsistent. The methods summarized here for processing decalcified human joint tissues provide a basis for future orthopaedic studies investigating occult microfractures at the bone-cartilage interface.

Patellar tendon and infrapatellar fat pad healing after harvest of an ACL graft

Clinical studies have documented proliferation of the host patellar tendon and fibrosis extending into adjacent tissues after reconstruction of the injured anterior cruciate ligament (ACL) using the central one-third of the patellar tendon (PT) as the graft. Such generalized arthrofibrosis has been implicated in knee locking and as possible source of anterior knee pain. However, it is not clinically feasible to measure changes in tendon morphology and mechanical properties and degeneration of peripheral tissues over time following graft harvest. In a rabbit experimental model proliferative changes in the tendon and the infrapatellar fat pad have been documented following harvest of a central third tendon graft without ACL reconstruction. Studies in larger animals have shown significant reductions in the strength and stiffness of the healing patellar tendon, but without assessment of the peripheral tissue response. In the current study an ACL reconstruction was performed in a goat model using an autogenous patellar tendon graft. Extensive tendon and fat pad proliferation were observed along with significant reductions in the biomechanical properties of the host tendon. Significant fat pad fibrosis was documented using biochemical methods. The current data confirm that harvest of an autogenous PT graft for reconstruction of the ACL results in significant changes in the PT and adjacent tissues. These data may help explain some of the clinical complications documented in the reconstructed joint.

A method to increase the sensitive range of pressure sensitive film

Pressure-sensitive film is frequently used in biomechanics to document intra- and extra-articular contact pressures. This often involves the contact of two surfaces of varying curvature producing non-uniform pressure distributions. The purpose of this study was to determine the feasibility of using multiple films in such experiments to yield accurate pressure and contact area data. A composite arrangement of film was dynamically loaded using cylindrical indenters of five radii. An analytical model of each indentation was constructed to provide a standard for error analysis. The study showed that several ranges of pressure sensitive film can be used simultaneously to accurately transduce contact pressures arising from loading scenarios that produce contact pressure gradients and contact pressures that involve suprathreshold loading of a given film range.

Evaluation of cannabinoid receptor agonists and antagonists using the guanosine-5'-O-(3-[35S]thio)-triphosphate binding assay in rat cerebellar membranes

Cannabinoid receptors are members of the superfamily of G protein-coupled receptors. Their activation has previously been shown to stimulate guanosine 5'-O-(3-[35S]thio)-triphosphate ([35S]GTP gamma S) binding in a range of brain regions using both membrane preparations and autoradiography. This study evaluates the activities of structurally diverse cannabinoid receptor ligands in the GTP gamma S binding assay, comparing the relationship between receptor binding and activation and also examining efficacy differences between compounds. Using rat cerebellar membrane preparations, the effects of GDP concentration on GTP gamma S binding and the activities of a range of cannabinoid receptor ligands, including the CB1 selective antagonist SR141716A, were investigated. GDP concentration was found to have differing effects on cannabinoid-stimulated [35S]GTP gamma S binding depending on the nature of the agonist used. The stimulation produced by high efficacy compounds, such as CP 55,940 and WIN 55212-2, was increased by raising the GDP concentration, but that of a low efficacy agonist, (-)-delta-tetrahydrocannabinol, was decreased. Of the cannabinoid compounds tested, a wide range of potencies (EC50) and levels of maximal stimulation (Emax) were observed. These ranged from CP 55,244 (Emax of 165, 148-183%, and an EC50 of 0.47, 0.22-0.96, nM) through (-)-delta-tetrahydrocannabinol, cannabinol and anandamide, which produced no concentration-dependent stimulation of [35S]GTP gamma S binding under the same conditions. SR141716A competitively antagonized all the agonists against which it was tested, providing equilibrium dissociation constants (Kd values) in the sub-nanomolar range (0.06-0.40 nM), implicating a CB1 receptor mediated response. These results provide a more detailed characterization of the cannabinoid-stimulated [35S]GTP gamma S binding assay than has previously been reported.

Predominant enteroviral serotypes causing meningitis

All enteroviral reports to the Public Health Laboratory Service from 1975 to 1994 which had been proved by culture were analysed. Of the 40,366 isolates, 5741 reports (14%) were from cultures of cerebrospinal fluid. The groups and serotypes accounting for the largest number of cerebrospinal fluid isolates were A9, E7, E9, E11, E19, and E30, accounting for 70% of all cultured isolates of cerebrospinal fluid. It may be possible to prevent most cases of viral meningitis in the UK with the development of an enteroviral vaccine.

Breaking strength retention and histologic effects around 1.3-mm. ORTHOSORB polydioxanone absorbable pins at various sites in the rabbit

Absorbable 1.3-mm polydioxanone (ORTHOSORB) pins were implanted in 75 New Zealand White rabbits in three sites: within the lateral subcutaneous tissue parallel to the femur, down the femoral intramedullary canal, and mediolaterally across the femoral condyles (transcondylar). Pins were harvested at periodic intervals up to 56 and 365 days for mechanical and histologic analyses, respectively. Mechanical analyses were performed by loading the pin in double shear. Histologic analyses were performed on the pin and surrounding tissue. Histologic observations revealed a typical nonspecific foreign-body reaction at all implant sites that resolved at 1 year after resorption of the pin. On histologic examination, there was complete resorption of the pin material in the subcutaneous site by day 182, and there was complete resolution of all response to the pin in six of nine rabbits by day 365. In the intramedullary site, pin material was completely resorbed, based on histologic examination, in five of six rabbits by day 182, and there was complete resolution of the response to the pin in eight of nine rabbits by day 365. The pin material was completely resorbed based on histologic examination of the transcondylar site by day 210, and there was complete resolution of the response to the pin in four of six rabbits by day 270 and in four of nine rabbits by day 365. No enlarged pin tracks or sinus formations were observed in or near the implants sites. The average initial shear strength as 171.4+/ 5.1 MPa, and the breaking strength retention decreased with increasing implantation time. Pins from the subcutaneous regions maintained above 97% of their initial strengths at 28 days, and those from the intramedullary canals maintained above 92%. At later times the strength of the pins implanted in the intramedullary canal decreased more rapidly than those from the subcutaneous region. Overall, the average breaking strength of the subcutaneous pins was significantly greater than that of the intramedullary pins at all time points beyond 14 days. These data indicate that the pins exhibited a strength retention profile sufficient to allow normal healing of bone without enlarged pin tracts, allergic reactions, or sinus formations.

Subfracture insult to the human cadaver patellofemoral joint produces occult injury

The current criterion used by the automotive industry for injury to the lower extremity is based on visible bone fracture. Studies suggest, however, that chronic joint degeneration may occur after subfracture impact loads on the knee. We hypothesized that subfracture loading of the patellofemoral joint could result in previously undocumented microtrauma in areas of high contact pressure. In the current study, seven patellofemoral joints from human cadavers were subjected to impact with successively greater energy until visible fracture was noted. Transverse and comminuted fractures of the patella were noted at 6.7 kN of load. Approximately 45% of the impact energy then was delivered to the contralateral joint. Subfracture loads of 5.2 kN resulted in no gross bone fracture in five of seven specimens. Histological examination of the patellae horizontal split fracture in the subchondral bone, at the tidemark, or at the interface of calcified cartilage and subchondral bone. The trauma appeared predominantly on the lateral facet, adjacent to or directly beneath preexisting fibrillation of the articular surface. Surface fibrillation was noted in histological sections of control patellae (not subjected to impact loading), but occult damages were not observed. Although the mechanism of this occult trauma is unknown, similar damage has been shown to occur from direct shear loading. As these microcracks can potentiate a disease process in the joint, this study may suggest that the current criterion for injury, based on bone fracture alone, is not sufficiently conservative.

Investigation of the effects of transport and lairage on hydration state and resting behaviour of calves for export

Plasma sodium concentrations, packed cell volume, total plasma protein concentration and dermal skinfold thickness were used to assess the state of hydration of 113 transported calves before and after lairage and in 30 control calves on the farm of origin. Skin thickness increased significantly (P less than 0.05) and total protein increased slightly during transport and decreased during lairage. These changes suggest that transport may cause dehydration and lairage may help in recovery. Plasma potassium concentration decreased during transport, but the effect was inversely related to the distance travelled, and the concentration increased during lairage. These changes are consistent with recovery from initially high cortisol levels at loading. The resting behaviour of 150 transported calves was recorded hourly for six hours. More time was spent resting and sleeping by the transported calves than has been reported for non-transported calves and more still by small transported calves, suggesting that transport is exhausting, that lairage helps recovery and that small calves are more adversely affected. During lairage the numbers of calves asleep decreased to values reported for normal calves, suggesting that 10 hours lairage was adequate. However, small calves did not return to their normal rest patterns within the observation period.

A controlled trial of nandrolone decanoate in the treatment of rheumatoid arthritis in postmenopausal women

To determine whether an anabolic steroid had any benefit in the treatment of rheumatoid arthritis 47 patients entered a parallel group study. Twenty four received nandrolone decanoate 50 mg intramuscularly every third week for two years and 23 patients received no anabolic steroids. Other therapy was unaltered. Patients attended for clinical and biochemical assessments as well as the objective assessments of elementary body composition by in vivo neutron activation analysis and measurement of the mineral content of the distal femur by single photon absorptiometry on five occasions. A modest clinical deterioration (except for grip strength) was seen in both groups. No significant changes in calcium or alkaline phosphatase were seen. There was no significant change in total body calcium, total body phosphorus, body weight, or bone index/bone width measurements in either group. Significant increases occurred in total body nitrogen, total body potassium, haemoglobin, and packed cell volume (by six months) in the group treated with nandrolone decanoate. Comparison of 10 patients in the group treated with nandrolone decanoate also receiving oral steroid therapy with 14 patients in this group not receiving oral steroid therapy showed no significant differences. The main side effect of nandrolone decanoate was hoarseness. No radiological changes were seen. Nandrolone decanoate, in a dose that produces a significant anabolic effect, has no demonstrable action on bone metabolism in rheumatoid arthritis but may improve the chronic anaemia by six months.

Skeletal and blood biochemical characteristics of sheep during growth and breeding: a comparison of flocks with and without broken mouth

Two-hundred female Scottish Blackface sheep ranging in age from 3 months to 5 1/2 years were used to investigate the relationships between blood biochemical characteristics, skeletal metabolism and dental health on 5 farms, 3 with broken mouth and 2 with no incidence of the disease. Skeletal growth to 6 months of age was faster in lambs from control flocks than in lambs from affected farms although growth thereafter was slower in the control group. A generally lower protein intake on control farms may account for this reduced growth rate. In general, adult dimensions of bones were attained between 14 and 30 months of age but age of maturation varied between bones; tibial endochondral growth ended after 14 to 21 months while the rib still showed evidence of endochondral growth at 70 months of age. This growth was episodic, being maximal during lactation and possible causes are discussed. There was no significant differences in calcium or phosphorus status between control and affected populations, an inadequate phosphorus intake during pregnancy was common to both groups. Lower serum magnesium concentration in affected than in control sheep was a consistent finding and is discussed.

The shear strength between bone and porous ceramic root implants in the guinea pig incisor socket

Porous alumina and apatite implants have been placed in 67 guinea pig incisor tooth sockets after tooth extraction under anaesthetic. Bone readily grew into the spaces of the implant, and reduced the fibrous connective tissue between implant and bone. 'Pushout' tests have monitored the shear strength of the interlock between bone and implant. Despite considerable variation in the interlock strength, apatite produced the strongest bone interlock. The interlock with alumina tended to be more fibrous. The relative merits of fibrous and bone interlocks in immediate root implants are considered for the augmentation of the alveolar ridge and prosthetic treatment.

Changes in the protein components of rat incisor enamel during tooth development

Enamel-matrix components from rat incisor enamel were extracted from tissue at different stages of development on single teeth. Separations of proteins using urea and SDS acrylamide gel electrophoresis were compared. The bulk of the matrix exhibited SDS mol. wt of 25-30,000 with smaller amounts at approximately 18,000 and about 10-12,000. Trace amounts of material at -50,000 and 70,000 were detected. These were presumably associated with the mineral phase as their yield increased after demineralization. The proportion of small molecular weight components increased with tissue age. Using urea, many more proteins were separated (up to 20) into fast, intermediate and slowly-migrating components. Disappearance of small bands of intermediate mobility at the end of matrix secretion suggested that they were early ameloblast products which were rapidly degraded after secretion. Both slowly- and rapidly-migrating components increased with tissue age indicating progressive degradation of parent molecules of intermediate mobility into highly charged and relatively uncharged molecules.

Histology of enamel organ and chemical composition of adjacent enamel in rat incisors

By avoiding chemical fixation and using a freeze-drying technique, it proved possible to examine the enamel organ of rat mandibular incisors histologically while retaining the adjacent enamel of the same tooth for chemical analysis. The dramatic alterations which occur in enamel organ histology, such as ameloblast shortening and the development of hte papillary layer, could then be compared directly with mineral uptake and mineral content of the adjacent enamel. Both enamel and adjacent enamel organ were sampled as a continuous series of pieces, 0.5 mm in width, from youngest (apical) to oldest (incisal) tissue. Short ameloblasts were associated directly with the beginning of a rapid uptake of phosphate ions during the maturation phase and also coincided with the beginning of a steep rise in mineral content. By implication, some loss of matrix may also occur at this point. Development of the highly vascular papillary layer preceded ameloblast shortening and may be associated with changes in the organic matrix prior to its disappearance from the tissue. Further development of this layer was associated with ameloblast shortening. This may also therefore be associated with mineral uptake during maturation.

Chemical changes during formation and maturation of human deciduous enamel

The appearance and chemical composition of a number of developing human deciduous incisors indicated that the enamel passes through the following four developmental stages: 1. Partially mineralized matrix is secreted and some extracellular breakdown occurs. 2. Selective replacement of matrix proteins by tissue fluid begins. 3. Almost all of the matrix protein is replaced by tissue fluid and an influx of calcium phosphate occurs. 4. The enamel becomes almost fully mineralized, mature and hard. These stages of development are similar to those described in rat and bovine tissue. the number of stages simultaneously present in a single tooth differed from rat and bovine enamel, however, as did the rate of change in amino acid composition from developing to mature tissue.