151
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Music E, Futrega K, Doran MR. Sheep as a model for evaluating mesenchymal stem/stromal cell (MSC)-based chondral defect repair. Osteoarthritis Cartilage 2018; 26:730-740. [PMID: 29580978 DOI: 10.1016/j.joca.2018.03.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 02/05/2018] [Accepted: 03/19/2018] [Indexed: 02/02/2023]
Abstract
Osteoarthritis results from the degradation of articular cartilage and is one of the leading global causes of pain and immobility. Cartilage has a limited capacity for self-repair. While repair can be enhanced through surgical intervention, current methods often generate inferior fibrocartilage and repair is transient. The development of tissue engineering strategies to improve repair outcomes is an active area of research. While small animal models such as rodents and rabbits are often used in early pre-clinical work, larger animals that better recapitulate the anatomy and loading of the human joint are required for late-stage preclinical evaluation. Because of their physiological similarities to humans, and low cost relative to other large animals, sheep are routinely used in orthopedic research, including cartilage repair studies. In recent years, there has been considerable research investment into the development of cartilage repair strategies that utilize mesenchymal stem/stromal cells (MSC). In contrast to autologous chondrocytes derived from biopsies of articular cartilage, MSC offer some benefits including greater expansion capacity and elimination of the risk of morbidity at the cartilage biopsy site. The disadvantages of MSC are related to the challenges of inducing and maintaining a stable chondrocyte-like cell population capable of generating hyaline cartilage. Ovine MSC (oMSC) biology and their utility in sheep cartilage repair models have not been reviewed. Herein, we review the biological properties of MSC derived from sheep tissues, and the use of these cells to study articular cartilage repair in this large animal model.
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Affiliation(s)
- E Music
- Queensland University of Technology, Institute of Health and Biomedical Innovation, Brisbane, QLD, Australia; Translational Research Institute, Brisbane, QLD, Australia.
| | - K Futrega
- Queensland University of Technology, Institute of Health and Biomedical Innovation, Brisbane, QLD, Australia; Translational Research Institute, Brisbane, QLD, Australia.
| | - M R Doran
- Queensland University of Technology, Institute of Health and Biomedical Innovation, Brisbane, QLD, Australia; Translational Research Institute, Brisbane, QLD, Australia; Mater Research Institute - University of Queensland, Brisbane, QLD, Australia; Australian National Centre for the Public Awareness of Science, Australian National University, Canberra, ACT, Australia.
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152
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Beveridge JE, Machan JT, Walsh EG, Kiapour AM, Karamchedu NP, Chin KE, Proffen BL, Sieker JT, Murray MM, Fleming BC. Magnetic resonance measurements of tissue quantity and quality using T 2 * relaxometry predict temporal changes in the biomechanical properties of the healing ACL. J Orthop Res 2018; 36:1701-1709. [PMID: 29227559 PMCID: PMC5995620 DOI: 10.1002/jor.23830] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 12/04/2017] [Indexed: 02/04/2023]
Abstract
The purpose of this study was to develop a magnetic resonance T2 * relaxometry-based multiple linear regression model to predict the structural properties of the healing anterior cruciate ligament (ACL) over a 24-week healing period following ACL repair in Yucatan minipigs. Two hypotheses were tested: (i) that a regression model based on ACL sub-volumes containing short and long T2 * relaxation times would outperform a competing model based on sub-volumes of short T2 * relaxation times only; and (ii) that an optimized regression model would be capable of predicting ACL structural properties between 6 and 24 weeks post-repair. ACLs were imaged in 24 minipigs (8/group) at either 6, 12, or 24 weeks after ACL repair. The structural properties of the ACLs were determined from tensile failure tests. Four multiple linear regression models of increasing complexity were fitted to the data. Akaike Information Criterion values and Bland-Altman tests were used to compare model performance and to test the hypotheses. The structural properties predicted from the multiple linear regression model that was based on the change in ACL sub-volumes of both the short and long T2 * relaxation times over the healing period were in closest agreement to the measured values, suggesting that the amounts of both organized and disorganized collagen, and the change in these quantities over time, are required to predict the structural properties of healing ACLs accurately. CLINICAL SIGNIFICANCE our time-specific, T2 *-based regression model may allow us to estimate the structural properties of ACL repairs in vivo longitudinally. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1701-1709, 2018.
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Affiliation(s)
- Jillian E Beveridge
- Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Jason T Machan
- Rhode Island Hospital Biostatistics Core, Providence, Rhode Island
| | - Edward G Walsh
- Division of Biology and Medicine, Department of Neuroscience, Brown University, Providence, Rhode Island
| | | | - Naga Padmini Karamchedu
- Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Kaitlyn E Chin
- Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | | | | | | | - Braden C Fleming
- Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island
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153
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Park BH, Banks SA, Pozzi A. Quantifying meniscal kinematics in dogs. J Orthop Res 2018; 36:1710-1716. [PMID: 29106743 DOI: 10.1002/jor.23800] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 10/21/2017] [Indexed: 02/04/2023]
Abstract
The dog has been used extensively as an experimental model to study meniscal treatments such as meniscectomy, meniscal repair, transplantation, and regeneration. However, there is very little information on meniscal kinematics in the dog. This study used MR imaging to quantify in vitro meniscal kinematics in loaded dog knees in four distinct poses: extension, flexion, internal, and external rotation. A new method was used to track the meniscal poses along the convex and posteriorly tilted tibial plateau. Meniscal displacements were large, displacing 13.5 and 13.7 mm posteriorly on average for the lateral and medial menisci during flexion (p = 0.90). The medial anterior horn and lateral posterior horns were the most mobile structures, showing average translations of 15.9 and 15.1 mm, respectively. Canine menisci are highly mobile and exhibit movements that correlate closely with the relative tibiofemoral positions. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1710-1716, 2018.
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Affiliation(s)
- Brian H Park
- Department of Mechanical & Aerospace Engineering, University of Florida, Room 318 MAE-A, Gainesville, 32611-6250, Florida
| | - Scott A Banks
- Department of Mechanical & Aerospace Engineering, University of Florida, Room 318 MAE-A, Gainesville, 32611-6250, Florida
| | - Antonio Pozzi
- Department of Small Animal Clinical Sciences, University of Florida, Florida.,Department of Small Animal Sciences University of Zurich, Zurich, Switzerland
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154
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Abstract
Failure of analgesic drugs in clinical development is common. Along with the current "reproducibility crisis" in pain research, this has led some to question the use of animal models. Experimental models tend to comprise genetically homogeneous groups of young, male rodents in restricted and unvarying environments, and pain-producing assays that may not closely mimic the natural condition of interest. In addition, typical experimental outcome measures using thresholds or latencies for withdrawal may not adequately reflect clinical pain phenomena pertinent to human patients. It has been suggested that naturally occurring disease in veterinary patients may provide more valid models for the study of painful disease. Many painful conditions in animals resemble those in people. Like humans, veterinary patients are genetically diverse, often live to old age, and enjoy a complex environment, often the same as their owners. There is increasing interest in the development and validation of outcome measures for detecting pain in veterinary patients; these include objective (eg, locomotor activity monitoring, kinetic evaluation, quantitative sensory testing, and bioimaging) and subjective (eg, pain scales and quality of life scales) measures. Veterinary subject diversity, pathophysiological similarities to humans, and diverse outcome measures could yield better generalizability of findings and improved translation potential, potentially benefiting both humans and animals. The Comparative Oncology Trial Consortium in dogs has pawed the way for translational research, surmounting the challenges inherent in veterinary clinical trials. This review describes numerous conditions similarly applicable to pain research, with potential mutual benefits for human and veterinary clinicians, and their respective patients.
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155
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Kharaz YA, Canty-Laird EG, Tew SR, Comerford EJ. Variations in internal structure, composition and protein distribution between intra- and extra-articular knee ligaments and tendons. J Anat 2018; 232:943-955. [PMID: 29498035 PMCID: PMC5978954 DOI: 10.1111/joa.12802] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2018] [Indexed: 12/11/2022] Open
Abstract
Tendons and ligaments play key roles in the musculoskeletal system in both man and animals. Both tissues can undergo traumatic injury, age‐related degeneration and chronic disease, causing discomfort, pain and increased susceptibility to wider degenerative joint disease. To date, tendon and ligament ultrastructural biology is relatively under‐studied in healthy, non‐diseased tissues. This information is essential to understand the pathology of these tissues with regard to function‐related injury and to assist with the future development of tissue‐engineered tendon and ligament structures. This study investigated the morphological, compositional and extracellular matrix protein distribution differences between tendons and ligaments around the non‐diseased canine stifle joint. The morphological, structural characteristics of different regions of the periarticular tendons and ligaments (the intra‐articular anterior cruciate ligament, the extra‐articular medial collateral ligament, the positional long digital extensor tendon and energy‐storing superficial digital flexor tendons) were identified using a novel semi‐objective histological scoring analysis and by determining their biochemical composition. Protein distribution of extracellular matrix collagens, proteoglycans and elastic fibre proteins in anterior cruciate ligament and long digital extensor tendon were also determined using immunostaining techniques. The anterior cruciate ligament was found to have significant morphological differences in comparison with the other three tissues, including less compact collagen architecture, differences in cell nuclei phenotype and increased glycosaminoglycan and elastin content. Intra‐ and interobserver differences of histology scoring resulted in an average score 0.7, indicative of good agreement between observers. Statistically significant differences were also found in the extracellular matrix composition in terms of glycosaminoglycan and elastin content, being more prominent in the anterior cruciate ligament than in the other three tissues. A different distribution of several extracellular matrix proteins was also found between long digital extensor tendon and anterior cruciate ligament, with a significantly increased immunostaining of aggrecan and versican in the anterior cruciate ligament. These findings directly relate to the different functions of tendon and ligament and indicate that the intra‐articular anterior cruciate ligament is subjected to more compressive forces, reflecting an adaptive response to normal or increased loads and resulting in different extracellular matrix composition and arrangement to protect the tissue from damage.
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Affiliation(s)
- Yalda A Kharaz
- Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
| | - Elizabeth G Canty-Laird
- Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK.,The MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA), Liverpool, UK
| | - Simon R Tew
- Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK.,The MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA), Liverpool, UK
| | - Eithne J Comerford
- Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK.,The MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA), Liverpool, UK.,Institute of Veterinary Science, University of Liverpool, Neston, UK
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156
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Wang J, Wu Y, Li H, Liu Y, Bai X, Chau W, Zheng Y, Qin L. Magnesium alloy based interference screw developed for ACL reconstruction attenuates peri-tunnel bone loss in rabbits. Biomaterials 2018; 157:86-97. [DOI: 10.1016/j.biomaterials.2017.12.007] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 12/05/2017] [Accepted: 12/10/2017] [Indexed: 01/03/2023]
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157
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Stem Cells for Cartilage Repair: Preclinical Studies and Insights in Translational Animal Models and Outcome Measures. Stem Cells Int 2018. [PMID: 29535784 PMCID: PMC5832141 DOI: 10.1155/2018/9079538] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Due to the restricted intrinsic capacity of resident chondrocytes to regenerate the lost cartilage postinjury, stem cell-based therapies have been proposed as a novel therapeutic approach for cartilage repair. Moreover, stem cell-based therapies using mesenchymal stem cells (MSCs) or induced pluripotent stem cells (iPSCs) have been used successfully in preclinical and clinical settings. Despite these promising reports, the exact mechanisms underlying stem cell-mediated cartilage repair remain uncertain. Stem cells can contribute to cartilage repair via chondrogenic differentiation, via immunomodulation, or by the production of paracrine factors and extracellular vesicles. But before novel cell-based therapies for cartilage repair can be introduced into the clinic, rigorous testing in preclinical animal models is required. Preclinical models used in regenerative cartilage studies include murine, lapine, caprine, ovine, porcine, canine, and equine models, each associated with its specific advantages and limitations. This review presents a summary of recent in vitro data and from in vivo preclinical studies justifying the use of MSCs and iPSCs in cartilage tissue engineering. Moreover, the advantages and disadvantages of utilizing small and large animals will be discussed, while also describing suitable outcome measures for evaluating cartilage repair.
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158
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Lascelles BDX, Brown DC, Maixner W, Mogil JS. Spontaneous painful disease in companion animals can facilitate the development of chronic pain therapies for humans. Osteoarthritis Cartilage 2018; 26:175-183. [PMID: 29180098 DOI: 10.1016/j.joca.2017.11.011] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 10/17/2017] [Accepted: 11/13/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To outline the role that spontaneous osteoarthritis (OA) in companion animals can play in translational research and therapeutic pharmacological development. OUTLINE Narrative review summarizing the opportunities and limitations of naturally occurring, spontaneous OA as models of human OA pain, with a focus on companion animal pets. The background leading to considering inserting spontaneous disease models in the translational paradigm is provided. The utility of this model is discussed in terms of outcome measures that have been validated as being related to pain, and in terms of the potential for target discovery is outlined. The limitations to using companion animal pets as models of human disease are discussed. CONCLUSIONS Although many steps along the translational drug development pathway have been identified as needing improvement, spontaneous painful OA in companion animals offers translational potential. Such 'models' may better reflect the complex genetic, environmental, temporal and physiological influences present in humans and current data suggests the predictive validity of the models are good. The opportunity for target discovery exists but is, as yet, unproven.
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Affiliation(s)
- B D X Lascelles
- Comparative Pain Research Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA; Comparative Medicine Institute, North Carolina State University, Raleigh, NC, USA; Center for Pain Research and Innovation, UNC School of Dentistry, Chapel Hill, NC, USA; Center for Translational Pain Research, Department of Anesthesiology, Duke University, Durham, NC, USA.
| | - D C Brown
- Translational Comparative Medicine Research, Elanco Animal Health, Greenfield, IN, USA
| | - W Maixner
- Center for Translational Pain Research, Department of Anesthesiology, Duke University, Durham, NC, USA
| | - J S Mogil
- Department of Psychology, Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada; Department of Anesthesia, Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada
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159
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Costa ELD, Teixeira LEM, Pádua BJ, Araújo IDD, Vasconcellos LDS, Dias LSB. Biomechanical study of the effect of platelet rich plasma on the treatment of medial collateral ligament lesion in rabbits. Acta Cir Bras 2018; 32:827-835. [PMID: 29160369 DOI: 10.1590/s0102-865020170100000004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 09/21/2017] [Indexed: 12/30/2022] Open
Abstract
PURPOSE To evaluate the use of platelet-rich plasma in the early stages of healing of traumatic injury of the medial collateral ligament in the knee of rabbits. METHODS Thirty rabbits were subjected to surgical lesion of the medial collateral ligament. Of these, 16 were treated with platelet-rich plasma and 14 with saline (control). After 3 and 6 weeks of treatment, 50% of the animals from each group were sacrificed, and biomechanical tests were performed on the injured ligament to compare the tensile strength between the two groups. RESULTS Platelet-rich plasma significantly increased the tensile strength of the ligament in the groups treated after3 and 6 weeks. In the group treated with platelet-rich plasma vs. saline, the tensile strength values were 3192.5 ± 189.7 g/f vs. 2851.1 ± 193.1 g/f at3 weeks (p = 0.005) and 5915.6 ± 832.0 g/f vs. 4187.6 ± 512.9 g/f at 6 weeks (p = 0.0001). CONCLUSION The use of platelet-rich plasma at the injury site accelerated ligament healing in an animal model, demonstrated by an increase in the tensile strength of the medial collateral ligament.
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Affiliation(s)
- Eduardo Louzada da Costa
- MSc, Department of Orthopedics, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte-MG, Brazil. Conception and design of the study; acquisition, analysis and interpretation of data; manuscript writing; critical revision
| | - Luiz Eduardo Moreira Teixeira
- PhD, Assistant Professor, Department of Locomotive Apparatus, UFMG, Belo Horizonte-MG, Brazil. Conception and design of the study; acquisition, analysis and interpretation of data; manuscript writing; critical revision
| | - Bruno Jannotti Pádua
- MD, Department of Orthopedics, UFMG, Belo Horizonte-MG, Brazil. Acquisition, analysis and interpretation of data
| | - Ivana Duval de Araújo
- PhD, Assistant Professor, Department of Surgery, UFMG, Belo Horizonte-MG, Brazil. Conception and design of the study; acquisition, analysis and interpretation of data; manuscript writing; critical revision
| | - Leonardo de Souza Vasconcellos
- PhD, Assistant Professor, Pharmacy Department, UFMG, Belo Horizonte-MG, Brazil. Acquisition, analysis and interpretation of data; manuscript writing; critical revision
| | - Luide Scalioni Borges Dias
- Graduate student, School of Medicine, UFMG, Belo Horizonte-MG, Brazil. Acquisition, analysis and interpretation of data
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160
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Huwe LW, Brown WE, Hu JC, Athanasiou KA. Characterization of costal cartilage and its suitability as a cell source for articular cartilage tissue engineering. J Tissue Eng Regen Med 2018; 12:1163-1176. [PMID: 29286211 DOI: 10.1002/term.2630] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 11/23/2017] [Accepted: 12/11/2017] [Indexed: 12/16/2022]
Abstract
Costal cartilage is a promising donor source of chondrocytes to alleviate cell scarcity in articular cartilage tissue engineering. Limited knowledge exists, however, on costal cartilage characteristics. This study describes the characterization of costal cartilage and articular cartilage properties and compares neocartilage engineered with costal chondrocytes to native articular cartilage, all within a sheep model. Specifically, we (a) quantitatively characterized the properties of costal cartilage in comparison to patellofemoral articular cartilage, and (b) evaluated the quality of neocartilage derived from costal chondrocytes for potential use in articular cartilage regeneration. Ovine costal and articular cartilages from various topographical locations were characterized mechanically, biochemically, and histologically. Costal cartilage was stiffer in compression but softer and weaker in tension than articular cartilage. These differences were attributed to high amounts of glycosaminoglycans and mineralization and a low amount of collagen in costal cartilage. Compared to articular cartilage, costal cartilage was more densely populated with chondrocytes, rendering it an excellent chondrocyte source. In terms of tissue engineering, using the self-assembling process, costal chondrocytes formed articular cartilage-like neocartilage. Quantitatively compared via a functionality index, neocartilage achieved 55% of the medial condyle cartilage mechanical and biochemical properties. This characterization study highlighted the differences between costal and articular cartilages in native forms and demonstrated that costal cartilage is a valuable source of chondrocytes suitable for articular cartilage regeneration strategies.
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Affiliation(s)
| | - Wendy E Brown
- Department of Biomedical Engineering, University of California Irvine, Irvine, CA, USA
| | - Jerry C Hu
- Department of Biomedical Engineering, University of California Irvine, Irvine, CA, USA
| | - Kyriacos A Athanasiou
- Department of Biomedical Engineering, University of California Irvine, Irvine, CA, USA
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161
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Zhang L, Guan T, Qi J, Zhang S, Zhou X, Liu Y, Fu S. A model of anterior cruciate ligament injury in cynomolgus monkeys developed via arthroscopic surgery. Exp Ther Med 2018; 15:2239-2246. [PMID: 29456631 PMCID: PMC5795381 DOI: 10.3892/etm.2018.5722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 01/05/2018] [Indexed: 12/16/2022] Open
Abstract
The anterior cruciate ligament (ACL) is an important structure that maintains the stability of knee joints. Animal models of ACL injury are helpful to explore its underlying mechanisms, and strategies for prevention, treatment and rehabilitation. Therefore, the aim of the present study was to develop an efficient model of ACL injury in cynomolgus monkeys via arthroscopic techniques. In the present study, 18 cynomolgus monkeys were randomly divided into a model group (n=6), a sham operation group (n=6) and a blank control group (n=6). One-quarter of the ACL was removed under arthroscopy in the model group. In the sham operation group, only arthroscopic exploration was performed as a control. In the blank control group, monkeys were housed under the same conditions for the same length of time. Magnetic resonance imaging examination was performed pre- and post-operatively, as well as measurements of the circumference of the thigh and calf, and of the maximum flexion degree of the knee. Anterior drawer test, Lachman test and pivot-shift tests were also performed. The results revealed that the injured side of the knees in the model group became unstable, as determined from evaluation of the physical tests. In conclusion, based on these findings, the modeling method of ACL injury was effective, and may contribute to the associated research concerning ACL injury.
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Affiliation(s)
- Lei Zhang
- Department of Orthopedics, The Affiliated T.C.M Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Taiyuan Guan
- Department of Orthopedics, The Affiliated T.C.M Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Ji Qi
- Department of Orthopedics, School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - Shaoqun Zhang
- Department of Orthopedics, School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - Xin Zhou
- Department of Orthopedics, The Affiliated T.C.M Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Yang Liu
- Department of Orthopedics, The Affiliated T.C.M Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Shijie Fu
- Department of Orthopedics, The Affiliated T.C.M Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
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162
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Oláh T, Reinhard J, Gao L, Goebel LKH, Madry H. Reliable landmarks for precise topographical analyses of pathological structural changes of the ovine tibial plateau in 2-D and 3-D subspaces. Sci Rep 2018; 8:75. [PMID: 29311696 PMCID: PMC5758565 DOI: 10.1038/s41598-017-18426-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 12/06/2017] [Indexed: 11/09/2022] Open
Abstract
Selecting identical topographical locations to analyse pathological structural changes of the osteochondral unit in translational models remains difficult. The specific aim of the study was to provide objectively defined reference points on the ovine tibial plateau based on 2-D sections of micro-CT images useful for reproducible sample harvesting and as standardized landmarks for landmark-based 3-D image registration. We propose 5 reference points, 11 reference lines and 12 subregions that are detectable macroscopically and on 2-D micro-CT sections. Their value was confirmed applying landmark-based rigid and affine 3-D registration methods. Intra- and interobserver comparison showed high reliabilities, and constant positions (standard errors < 1%). Spatial patterns of the thicknesses of the articular cartilage and subchondral bone plate were revealed by measurements in 96 individual points of the tibial plateau. As a case study, pathological phenomena 6 months following OA induction in vivo such as osteophytes and areas of OA development were mapped to the individual subregions. These new reference points and subregions are directly identifiable on tibial plateau specimens or macroscopic images, enabling a precise topographical location of pathological structural changes of the osteochondral unit in both 2-D and 3-D subspaces in a region-appropriate fashion relevant for translational investigations.
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Affiliation(s)
- Tamás Oláh
- Center of Experimental Orthopaedics, Saarland University, Homburg, Germany
| | - Jan Reinhard
- Center of Experimental Orthopaedics, Saarland University, Homburg, Germany
| | - Liang Gao
- Center of Experimental Orthopaedics, Saarland University, Homburg, Germany
| | - Lars K H Goebel
- Center of Experimental Orthopaedics, Saarland University, Homburg, Germany.,Department of Orthopaedic Surgery, Saarland University Medical Center, Homburg, Germany
| | - Henning Madry
- Center of Experimental Orthopaedics, Saarland University, Homburg, Germany. .,Department of Orthopaedic Surgery, Saarland University Medical Center, Homburg, Germany.
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163
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Huwe LW, Brown WE, Hu JC, Athanasiou KA. Characterization of costal cartilage and its suitability as a cell source for articular cartilage tissue engineering. J Tissue Eng Regen Med 2017. [PMID: 29286211 DOI: 10.1002/term.2630.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Costal cartilage is a promising donor source of chondrocytes to alleviate cell scarcity in articular cartilage tissue engineering. Limited knowledge exists, however, on costal cartilage characteristics. This study describes the characterization of costal cartilage and articular cartilage properties and compares neocartilage engineered with costal chondrocytes to native articular cartilage, all within a sheep model. Specifically, we (a) quantitatively characterized the properties of costal cartilage in comparison to patellofemoral articular cartilage, and (b) evaluated the quality of neocartilage derived from costal chondrocytes for potential use in articular cartilage regeneration. Ovine costal and articular cartilages from various topographical locations were characterized mechanically, biochemically, and histologically. Costal cartilage was stiffer in compression but softer and weaker in tension than articular cartilage. These differences were attributed to high amounts of glycosaminoglycans and mineralization and a low amount of collagen in costal cartilage. Compared to articular cartilage, costal cartilage was more densely populated with chondrocytes, rendering it an excellent chondrocyte source. In terms of tissue engineering, using the self-assembling process, costal chondrocytes formed articular cartilage-like neocartilage. Quantitatively compared via a functionality index, neocartilage achieved 55% of the medial condyle cartilage mechanical and biochemical properties. This characterization study highlighted the differences between costal and articular cartilages in native forms and demonstrated that costal cartilage is a valuable source of chondrocytes suitable for articular cartilage regeneration strategies.
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Affiliation(s)
| | - Wendy E Brown
- Department of Biomedical Engineering, University of California Irvine, Irvine, CA, USA
| | - Jerry C Hu
- Department of Biomedical Engineering, University of California Irvine, Irvine, CA, USA
| | - Kyriacos A Athanasiou
- Department of Biomedical Engineering, University of California Irvine, Irvine, CA, USA
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164
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Diotalevi L, Petit Y, Brailovski V, Nichols S, Marchionatti E, Wagnac É. Quasi-static tensile properties of the Cranial Cruciate Ligament (CrCL) in adult cattle: towards the design of a prosthetic CrCL. J Mech Behav Biomed Mater 2017; 79:239-245. [PMID: 29331937 DOI: 10.1016/j.jmbbm.2017.12.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 12/10/2017] [Accepted: 12/22/2017] [Indexed: 11/18/2022]
Abstract
Mechanical properties of the Cranial Cruciate Ligament (CrCL) in adult cattle are not well documented and protocols used in the literature focus on testing a full femur-CrCL-tibia complex rather than an isolated CrCL. The aim of this study was to assess a wider range of tensile properties of the CrCL along its anatomic axis with experimental measurements of the global elongation, displacement and strain fields, in order to provide guidelines for the design of CrCL prosthetic surrogates. Fourteen bovine CrCL were harvested from seven mature cows (5.1 ± 1.3 years) weighing 631 ± 90kg. The mean CrCL length was 41.4 ± 1.5mm and its mean cross-section was 103.9 ± 23.8mm2. Pre-conditioning was achieved with 30 cycles of loading from 30 to 200N at a strain rate of 0.02s-1. Specimens were then loaded to failure at the same strain rate. The following results were obtained: the mean ultimate tensile load (UTL) 4372 ± 1485N and the median [quartiles] maximal global elongation 19.3 [17.8; 21.4] %. At first physical signs of tearing, the mean load was 3315 ± 1336N and mean elongation 13.5 ± 4.9%. The mean absorbed energy at failure was 5.23 ± 2.08 MJ.mm-3 and the mean stiffness at various levels of elongation was: 220 ± 195N.%-1 (5%), 285 ± 162N.%-1 (10%), 239 ± 200N.%-1 (15%), 146 ± 59N.%-1 (20%), 153 ± 136N.%-1 (25%). None of these properties were related to the bovine weight, age and side of the body (p > 0.05). An ideal prosthetic surrogate should then follow these sets of properties and the experimental data suggest that the in-vivo maximal elongation is below 13.5%.
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Affiliation(s)
- Lucien Diotalevi
- Department of Mechanical Engineering, École de Technologie Supérieure, 1100 rue Notre-Dame Ouest, Montréal, Québec, Canada H3C 1K3; Research Center, Hôpital du Sacré-Cœur de Montréal, 5400 boulevard Gouin, Montréal, Québec, Canada H4J 1C5.
| | - Yvan Petit
- Department of Mechanical Engineering, École de Technologie Supérieure, 1100 rue Notre-Dame Ouest, Montréal, Québec, Canada H3C 1K3; Research Center, Hôpital du Sacré-Cœur de Montréal, 5400 boulevard Gouin, Montréal, Québec, Canada H4J 1C5.
| | - Vladimir Brailovski
- Department of Mechanical Engineering, École de Technologie Supérieure, 1100 rue Notre-Dame Ouest, Montréal, Québec, Canada H3C 1K3; Research Center, Hôpital du Sacré-Cœur de Montréal, 5400 boulevard Gouin, Montréal, Québec, Canada H4J 1C5.
| | - Sylvain Nichols
- Université de Montréal, Faculty of Veterinary Medicine, 3200 rue Sciotte, Saint-Hyacinthe, Québec, Canada J2S 2M2.
| | - Emma Marchionatti
- Université de Montréal, Faculty of Veterinary Medicine, 3200 rue Sciotte, Saint-Hyacinthe, Québec, Canada J2S 2M2.
| | - Éric Wagnac
- Department of Mechanical Engineering, École de Technologie Supérieure, 1100 rue Notre-Dame Ouest, Montréal, Québec, Canada H3C 1K3; Research Center, Hôpital du Sacré-Cœur de Montréal, 5400 boulevard Gouin, Montréal, Québec, Canada H4J 1C5.
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165
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Emami A, Tepper J, Short B, Yaksh TL, Bendele AM, Ramani T, Cisternas AF, Chang JH, Mellon RD. Toxicology Evaluation of Drugs Administered via Uncommon Routes: Intranasal, Intraocular, Intrathecal/Intraspinal, and Intra-Articular. Int J Toxicol 2017; 37:4-27. [PMID: 29264927 DOI: 10.1177/1091581817741840] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
As the need for nasal, ocular, spinal, and articular therapeutic compounds increases, toxicology assessments of drugs administered via these routes play an important role in human safety. This symposium outlined the local and systemic evaluation to support safety during the development of these drugs in nonclinical models with some case studies. Discussions included selection of appropriate species for the intended route; conducting nonclinical studies that closely mimic the intended use with adequate duration; functional assessment, if deemed necessary; evaluation of local tissues with special histological staining procedure; and evaluations of safety margins based on local and systemic toxicity.
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Affiliation(s)
- Armaghan Emami
- 1 US Food and Drug Administration, Silver Spring, MD, USA
| | - Jeff Tepper
- 2 Tepper Nonclinical Consulting, San Carlos, CA, USA
| | - Brian Short
- 3 Brian Short Consulting, LLC, Trabuco Canyon, CA, USA
| | - Tony L Yaksh
- 4 Department of Anesthesiology, University of California, San Diego, La Jolla, CA, USA
| | | | | | | | - Jay H Chang
- 1 US Food and Drug Administration, Silver Spring, MD, USA
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166
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Cone SG, Simpson SG, Piedrahita JA, Fordham LA, Spang JT, Fisher MB. Orientation changes in the cruciate ligaments of the knee during skeletal growth: A porcine model. J Orthop Res 2017; 35:2725-2732. [PMID: 28471537 PMCID: PMC5671372 DOI: 10.1002/jor.23594] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 04/24/2017] [Indexed: 02/04/2023]
Abstract
Musculoskeletal injuries in pediatric patients are on the rise, including significant increases in anterior cruciate ligament (ACL) injuries. Previous studies have found major anatomical changes during skeletal growth in the soft tissues of the knee. Specifically, the ACL and the posterior cruciate ligament (PCL) change in their relative orientation to the tibial plateau throughout growth. In order to develop age-specific treatments for ACL injuries, the purpose of this study was to characterize orientation changes in the cruciate ligaments of the Yorkshire pig, a common pre-clinical model, during skeletal growth in order to verify the applicability of this model for pediatric musculoskeletal studies. Hind limbs were isolated from female Yorkshire pigs ranging in age from newborn to late adolescence and were then imaged using high field strength magnetic resonance imaging. Orientation changes were quantified from the magnetic resonance images using image segmentation software. Statistically significant increases were found in the coronal and sagittal angles of the ACL relative to the tibial plateau during pre-adolescent growth. Additional changes were observed in the PCL angle, Blumensaat angle, intercondylar roof angle, and the aspect ratio of the intercondylar notch. Only the sagittal angle of the ACL relative to the tibial plateau experienced statistically significant changes through late adolescence. The age-dependent properties of the ACL and PCL in the female pig mirrored results found in female human patients, suggesting that the porcine model may provide a pre-clinical platform to study the cruciate ligaments during skeletal growth. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2725-2732, 2017.
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Affiliation(s)
- Stephanie G. Cone
- Department of Biomedical Engineering, North Carolina State University, Raleigh, NC 27695, USA and the University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA,Comparative Medicine Institute, North Carolina State University, Raleigh, NC 27695, USA
| | - Sean G. Simpson
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, NC 27695, USA
| | - Jorge A. Piedrahita
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC 27695, USA,Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, NC 27695, USA
| | - Lynn A. Fordham
- Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, NC 27599, USA
| | - Jeffrey T. Spang
- Department of Orthopaedics, University of North Carolina School of Medicine, Chapel Hill, NC 27599, USA
| | - Matthew B. Fisher
- Department of Biomedical Engineering, North Carolina State University, Raleigh, NC 27695, USA and the University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA,Comparative Medicine Institute, North Carolina State University, Raleigh, NC 27695, USA,Department of Orthopaedics, University of North Carolina School of Medicine, Chapel Hill, NC 27599, USA,Corresponding author: Matthew B. Fisher, Ph.D., Assistant Professor, Department of Biomedical Engineering, North Carolina State University & University of North Carolina at Chapel Hill, 4208C Engineering Building III, Raleigh, NC 27695, Phone: 919-515-5242,
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167
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Rodriguez ML, Li L. Compression-rate-dependent nonlinear mechanics of normal and impaired porcine knee joints. BMC Musculoskelet Disord 2017; 18:447. [PMID: 29137624 PMCID: PMC5686835 DOI: 10.1186/s12891-017-1805-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 11/06/2017] [Indexed: 11/10/2022] Open
Abstract
Background The knee joint performs mechanical functions with various loading and unloading processes. Past studies have focused on the kinematics and elastic response of the joint with less understanding of the rate-dependent load response associated with viscoelastic and poromechanical behaviors. Methods Forty-five fresh porcine knee joints were used in the present study to determine the loading-rate-dependent force-compression relationship, creep and relaxation of normal, dehydrated and meniscectomized joints. Results The mechanical tests of all normal intact joints showed similar strong compression-rate-dependent behavior: for a given compression-magnitude up to 1.2 mm, the reaction force varied 6 times over compression rates. While the static response was essentially linear, the nonlinear behavior was boosted with the increased compression rate to approach the asymptote or limit at approximately 2 mm/s. On the other hand, the joint stiffness varied approximately 3 times over different joints, when accounting for the maturity and breed of the animals. Both a loss of joint hydration and a total meniscectomy greatly compromised the load support in the joint, resulting in a reduction of load support as much as 60% from the corresponding intact joint. However, the former only weakened the transient load support, but the latter also greatly weakened the equilibrium load support. A total meniscectomy did not diminish the compression-rate-dependence of the joint though. Conclusions These findings are consistent with the fluid-pressurization loading mechanism, which may have a significant implication in the joint mechanical function and cartilage mechanobiology.
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Affiliation(s)
- Marcel Leonardo Rodriguez
- Department of Mechanical and Manufacturing Engineering, University of Calgary, 2500 University Drive, N.W, Calgary, AB, T2N 1N4, Canada
| | - LePing Li
- Department of Mechanical and Manufacturing Engineering, University of Calgary, 2500 University Drive, N.W, Calgary, AB, T2N 1N4, Canada.
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168
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Dhollander A, Malone A, Price J, Getgood A. Determination of knee cartilage volume and surface area in beagle dogs: a pilot study. J Exp Orthop 2017; 4:35. [PMID: 29105014 PMCID: PMC5673056 DOI: 10.1186/s40634-017-0109-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 09/28/2017] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The objective of this study was to determine the cartilage volume and surface area of male and female Beagle dog knees using 3D (3 dimensional) reconstructed MRI images. METHODS Six Beagle Dogs (Canis familiaris) (3 males and 3 females) of 10-18 months old and weighing between 7.2 and 17.1 kg underwent a MRI evaluation of both knees. The data acquired allowed a 3D reconstruction of the knee and measurement of the cartilage volume and surface area. RESULTS Mean knee cartilage volume (averaged over the right and left knees) of animals between 7.2 and 17.1 kg ranged from 319.7 to 647.3 mm3; while the mean knee cartilage surface area ranged from 427.14 to 757.2 mm2. There was evidence of both knee volume and surface area increasing linearly with animal bodyweight. CONCLUSIONS The cartilage volume and surface area of the Beagle dog appears to correlate significantly with body weight. This study provides a reference base for future studies investigating cartilage related pathology such as osteoarthritis.
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Affiliation(s)
- Aad Dhollander
- The Fowler Kennedy Sport Medicine Clinic, 3M Centre, The University of Western Ontario, London, ON N6A 3K7 Canada
- AZ Klina, Department of Orthopedic Surgery and Traumatology, Augustijnslei 100, 2930 Brasschaat, Belgium
| | - Amanda Malone
- Eupraxia Pharmaceuticals, Victoria, BC V8R 5J2 Canada
| | - James Price
- Eupraxia Pharmaceuticals, Victoria, BC V8R 5J2 Canada
| | - Alan Getgood
- The Fowler Kennedy Sport Medicine Clinic, 3M Centre, The University of Western Ontario, London, ON N6A 3K7 Canada
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169
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Qu D, Subramony SD, Boskey AL, Pleshko N, Doty SB, Lu HH. Compositional mapping of the mature anterior cruciate ligament-to-bone insertion. J Orthop Res 2017; 35:2513-2523. [PMID: 28176356 PMCID: PMC5548644 DOI: 10.1002/jor.23539] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 01/27/2017] [Indexed: 02/04/2023]
Abstract
The anterior cruciate ligament (ACL)-to-bone interface constitutes a complex, multi-tissue structure comprised of contiguous ligament, non-mineralized fibrocartilage, mineralized fibrocartilage, and bone regions. This composite structure enables load transfer between structurally and functionally dissimilar tissues and is critical for ligament homeostasis and joint stability. Presently, there is a lack of quantitative understanding of the matrix composition and organization across this junction, especially after the onset of skeletal maturity. The objective of this study is to characterize the adult bovine ACL-to-bone interface using Fourier transform infrared spectroscopic imaging (FTIRI), testing the hypothesis that regional changes in collagen, proteoglycan, and mineral distribution, as well as matrix organization, persist at the mature insertion. It was observed that while collagen content increases continuously across the adult interface, collagen alignment decreases between ligament and bone. Proteoglycans were primarily localized to the fibrocartilage region and an exponential increase in mineral content was observed between the non-mineralized and mineralized regions. These observations reveal significant changes in collagen distribution and alignment with maturity, and these trends underscore the role of physiologic loading in postnatal matrix remodeling. Findings from this study provide new insights into interface organization and serve as benchmark design criteria for interface regeneration and integrative soft tissue repair. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2513-2523, 2017.
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Affiliation(s)
- Dovina Qu
- Biomaterials and Interface Tissue Engineering Laboratory, Department of Biomedical Engineering, Columbia University, New York, NY 10027
| | - Siddarth D. Subramony
- Biomaterials and Interface Tissue Engineering Laboratory, Department of Biomedical Engineering, Columbia University, New York, NY 10027
| | - Adele L. Boskey
- Musculoskeletal Integrity Program, Hospital for Special Surgery, New York, NY 10021
| | - Nancy Pleshko
- Tissue Imaging and Spectroscopy Laboratory, Department of Bioengineering, Temple University, Philadelphia, PA 19122
| | - Stephen B. Doty
- Analytical Microscopy Laboratory, Hospital for Special Surgery, New York, NY 10021
| | - Helen H. Lu
- Biomaterials and Interface Tissue Engineering Laboratory, Department of Biomedical Engineering, Columbia University, New York, NY 10027,To whom all correspondence should be addressed: Helen H. Lu, Ph.D., Department of Biomedical Engineering, Columbia University1210 Amsterdam Avenue, 351 Engineering Terrace, MC 8904, New York, NY 10027, 212-854-4071 (office), 212-854-8725 (fax),
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170
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Cone SG, Warren PB, Fisher MB. Rise of the Pigs: Utilization of the Porcine Model to Study Musculoskeletal Biomechanics and Tissue Engineering During Skeletal Growth. Tissue Eng Part C Methods 2017; 23:763-780. [PMID: 28726574 PMCID: PMC5689129 DOI: 10.1089/ten.tec.2017.0227] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Accepted: 07/14/2017] [Indexed: 12/17/2022] Open
Abstract
Large animal models play an essential role in the study of tissue engineering and regenerative medicine (TERM), as well as biomechanics. The porcine model has been increasingly used to study the musculoskeletal system, including specific joints, such as the knee and temporomandibular joints, and tissues, such as bone, cartilage, and ligaments. In particular, pigs have been utilized to evaluate the role of skeletal growth on the biomechanics and engineered replacements of these joints and tissues. In this review, we explore the publication history of the use of pig models in biomechanics and TERM discuss interspecies comparative studies, highlight studies on the effect of skeletal growth and other biological considerations in the porcine model, and present challenges and emerging opportunities for using this model to study functional TERM.
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Affiliation(s)
- Stephanie G. Cone
- Department of Biomedical Engineering, North Carolina State University, Raleigh, North Carolina and University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina
| | - Paul B. Warren
- Department of Biomedical Engineering, North Carolina State University, Raleigh, North Carolina and University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina
| | - Matthew B. Fisher
- Department of Biomedical Engineering, North Carolina State University, Raleigh, North Carolina and University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina
- Department of Orthopaedics, University of North Carolina School of Medicine, Chapel Hill, North Carolina
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171
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Hexter AT, Pendegrass C, Haddad F, Blunn G. Demineralized Bone Matrix to Augment Tendon-Bone Healing: A Systematic Review. Orthop J Sports Med 2017; 5:2325967117734517. [PMID: 29124078 PMCID: PMC5661670 DOI: 10.1177/2325967117734517] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Background: Following injury to the rotator cuff and anterior cruciate ligament, a direct enthesis is not regenerated, and healing occurs with biomechanically inferior fibrous tissue. Demineralized bone matrix (DBM) is a collagen scaffold that contains growth factors and is a promising biological material for tendon and ligament repair because it can regenerate a direct fibrocartilaginous insertion via endochondral ossification. Purpose: To provide a comprehensive review of the literature investigating the use of DBM to augment tendon-bone healing in tendon repair and anterior cruciate ligament reconstruction (ACLR). Study Design: Systematic review. Methods: Electronic databases (MEDLINE and EMBASE) were searched for preclinical and clinical studies that evaluated the use of DBM in tendon repair and ACLR. Search terms included the following: (“demineralized bone matrix” OR “demineralized cortical bone”) AND (“tissue scaffold” OR “tissue engineering” OR “ligament” OR “tendon” OR “anterior cruciate ligament” OR “rotator cuff”). Peer-reviewed articles written in English were included, and no date restriction was applied (searches performed February 10, 2017). Methodological quality was assessed with peer-reviewed scoring criteria. Results: The search strategy identified 339 articles. After removal of duplicates and screening according to inclusion criteria, 8 studies were included for full review (tendon repair, n = 4; ACLR, n = 4). No human clinical studies were identified. All 8 studies were preclinical animal studies with good methodological quality. Five studies compared DBM augmentation with non-DBM controls, of which 4 (80%) reported positive findings in terms of histological and biomechanical outcomes. Conclusion: Preclinical evidence indicates that DBM can improve tendon-bone healing, although clinical studies are lacking. A range of animal models of tendon repair and ACLR showed that DBM can re-create a direct fibrocartilaginous enthesis, although the animal models are not without limitations. Before clinical trials are justified, research is required that determines the best source of DBM (allogenic vs xenogenic) and the best form of DBM (demineralized cortical bone vs DBM paste) to be used in them.
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Affiliation(s)
- Adam T Hexter
- Institute of Orthopaedic and Musculoskeletal Sciences, University College London, Royal National Orthopaedic Hospital, Middlesex, UK
| | - Catherine Pendegrass
- Institute of Orthopaedic and Musculoskeletal Sciences, University College London, Royal National Orthopaedic Hospital, Middlesex, UK
| | | | - Gordon Blunn
- Institute of Orthopaedic and Musculoskeletal Sciences, University College London, Royal National Orthopaedic Hospital, Middlesex, UK
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172
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Brzezinski A, Ghodbane SA, Patel JM, Perry BA, Gatt CJ, Dunn MG. * The Ovine Model for Meniscus Tissue Engineering: Considerations of Anatomy, Function, Implantation, and Evaluation. Tissue Eng Part C Methods 2017; 23:829-841. [PMID: 28805136 DOI: 10.1089/ten.tec.2017.0192] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Meniscus injuries represent one of the most-common intra-articular knee injuries. The current treatment options include meniscectomy and allograft transplantation, both with poor long-term outcomes. Therefore, there is a need for regenerative techniques to restore meniscal function. To preclinically test scaffolds for meniscus replacement, large animal models need to be established and standardized. This review establishes the anatomical and compositional similarities between human and sheep menisci and provides guidance for implantation and evaluation of such devices. The ovine meniscus represents a scaled-down version of the human meniscus, with only slight structural differences that can be addressed during device fabrication. Implantation protocols in sheep remain a challenge, as the meniscus cannot be visualized with the arthroscopic-assisted procedures commonly performed in human patients. Thus, we recommend the appropriate implantation protocols for meniscus visualization, ligamentous restoration, and surgical fixation of both total and partial meniscus replacement devices. Last, due to the lack of standardization in evaluation techniques, we recommend a comprehensive battery of tests to evaluate the efficacy of meniscus replacement implants. We recommend other investigators utilize these surgical and testing techniques to establish the ovine model as the gold standard for preclinical evaluation of meniscus replacement devices.
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Affiliation(s)
- Andrzej Brzezinski
- 1 Department of Orthopaedic Surgery, Rutgers Biomedical and Health Sciences-Robert Wood Johnson Medical School , New Brunswick, New Jersey
| | - Salim A Ghodbane
- 1 Department of Orthopaedic Surgery, Rutgers Biomedical and Health Sciences-Robert Wood Johnson Medical School , New Brunswick, New Jersey.,2 Department of Biomedical Engineering, Rutgers, The State University of New Jersey , Piscataway, New Jersey
| | - Jay M Patel
- 1 Department of Orthopaedic Surgery, Rutgers Biomedical and Health Sciences-Robert Wood Johnson Medical School , New Brunswick, New Jersey.,2 Department of Biomedical Engineering, Rutgers, The State University of New Jersey , Piscataway, New Jersey
| | - Barbara A Perry
- 1 Department of Orthopaedic Surgery, Rutgers Biomedical and Health Sciences-Robert Wood Johnson Medical School , New Brunswick, New Jersey
| | - Charles J Gatt
- 1 Department of Orthopaedic Surgery, Rutgers Biomedical and Health Sciences-Robert Wood Johnson Medical School , New Brunswick, New Jersey.,2 Department of Biomedical Engineering, Rutgers, The State University of New Jersey , Piscataway, New Jersey
| | - Michael G Dunn
- 1 Department of Orthopaedic Surgery, Rutgers Biomedical and Health Sciences-Robert Wood Johnson Medical School , New Brunswick, New Jersey.,2 Department of Biomedical Engineering, Rutgers, The State University of New Jersey , Piscataway, New Jersey
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173
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Kiapour AM, Fleming BC, Murray MM. Structural and Anatomic Restoration of the Anterior Cruciate Ligament Is Associated With Less Cartilage Damage 1 Year After Surgery: Healing Ligament Properties Affect Cartilage Damage. Orthop J Sports Med 2017; 5:2325967117723886. [PMID: 28875154 PMCID: PMC5576541 DOI: 10.1177/2325967117723886] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Abnormal joint motion has been linked to joint arthrosis after anterior cruciate ligament (ACL) reconstruction. However, the relationships between the graft properties (ie, structural and anatomic) and extent of posttraumatic osteoarthritis are not well defined. HYPOTHESES (1) The structural (tensile) and anatomic (area and alignment) properties of the reconstructed graft or repaired ACL correlate with the total cartilage lesion area 1 year after ACL surgery, and (2) side-to-side differences in anterior-posterior (AP) knee laxity correlate with the total cartilage lesion area 1 year postoperatively. STUDY DESIGN Controlled laboratory study. METHODS Sixteen minipigs underwent unilateral ACL transection and were randomly treated with ACL reconstruction or bridge-enhanced ACL repair. The tensile properties, cross-sectional area, and multiplanar alignment of the healing ACL or graft, AP knee laxity, and cartilage lesion areas were assessed 1 year after surgery. RESULTS In the reconstructed group, the normalized graft yield and maximum failure loads, cross-sectional area, sagittal and coronal elevation angles, and side-to-side differences in AP knee laxity at 60° of flexion were associated with the total cartilage lesion area 1 year after surgery (R2 > 0.5, P < .04). In the repaired group, normalized ACL yield load, linear stiffness, cross-sectional area, and the sagittal and coronal elevation angles were associated with the total cartilage lesion area (R2 > 0.5, P < .05). Smaller cartilage lesion areas were observed in the surgically treated knees when the structural and anatomic properties of the ligament or graft and AP laxity values were closer to those of the contralateral ACL-intact knee. Reconstructed grafts had a significantly larger normalized cross-sectional area and sagittal elevation angle (more vertical) when compared with repaired ACLs (P < .02). CONCLUSION The tensile properties, cross-sectional area, and multiplanar alignment of the healing ACLs or grafts and AP knee laxity in reconstructed knees were associated with the extent of tibiofemoral cartilage damage after ACL surgery. CLINICAL RELEVANCE These data highlight the need for novel ACL injury treatments that can restore the structural and anatomic properties of the torn ACL to those of the native ACL in an effort to minimize the risk of early-onset posttraumatic osteoarthritis.
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Affiliation(s)
- Ata M Kiapour
- Department of Orthopaedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Braden C Fleming
- Department of Orthopaedics, Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, Rhode Island, USA
| | - Martha M Murray
- Department of Orthopaedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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174
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van de Bunt F, Emanuel KS, Wijffels T, Kooren PN, Kingma I, Smit TH. A novel physiological testing device to study knee biomechanics in vitro. Knee 2017; 24:718-725. [PMID: 28462799 DOI: 10.1016/j.knee.2017.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 03/23/2017] [Accepted: 04/04/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND To properly study knee kinetics, kinematics and the effects of injury and surgical treatment in vitro, the knee should be constrained as little as possible, while imposing physiological loads. A novel dynamic biomechanical knee system (BKS) is presented here. The aim of this study was to test the feasibility and reproducibility of the system and demonstrate its features with an Anterior Cruciate Ligament (ACL) lesion model. METHODS Six goat knees were used in the current study. Flexion and extension simulating gait was imposed by a servo-motor, while normal joint load was applied by two artificial muscles. Intra-class correlation coefficients (ICCs) were assessed for inter-test measures, while paired t-tests were performed for comparison between intact knees and knees with ACL-lesion. RESULTS The ICC's for inter-test measures based on all six goat knees were excellent: varus/valgus: ICC=0.93; rotation: ICC=0.94 (all p<0.01), and translation in frontal (x)-, side (y)- and upward (z)-direction (ICC=0.90, 0.88 & 0.94) (all p<0.01). A significant increase in joint center movement was found in knees after creating an ACL-lesion (p=0.018): translation increased more than two-fold in frontal (p=0.016), side (p=0.004) and upward (p=0.018) direction. CONCLUSIONS Five degrees of motion were reproducibly assessed in the intact joint, suggesting that the goat knee may find its natural pathway when loaded in the BKS. The novel five-degrees-of-freedom knee system allows a detailed study of the effect of a diversity of defects and surgical treatments on knee biomechanics under physiological loading conditions.
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Affiliation(s)
- Fabian van de Bunt
- Department of Orthopaedic Surgery, VU University Medical Center, Amsterdam, The Netherlands.
| | - Kaj S Emanuel
- Faculty of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, The Netherlands.
| | - Thomas Wijffels
- Department of Physics and Medical Technology, VU University Medical Center, Amsterdam, The Netherlands.
| | - Peter N Kooren
- Department of Physics and Medical Technology, VU University Medical Center, Amsterdam, The Netherlands.
| | - Idsart Kingma
- Faculty of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, The Netherlands.
| | - Theodoor H Smit
- Faculty of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, The Netherlands; Department of Medical Biology, Academic Medical Center, University of Amsterdam, Netherlands.
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175
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Ocal MK, Sabanci SS, Cobanoglu M, Enercan M. Anterior Femoral Bow and Possible Effect on the Stifle Joint: A Comparison between Humans and Dogs. Anat Histol Embryol 2017; 46:391-396. [DOI: 10.1111/ahe.12281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M. K. Ocal
- Department of Anatomy; Faculty of Veterinary Medicine; Near East University; Nicosia Cyprus
| | - S. S. Sabanci
- Department of Anatomy; Faculty of Veterinary Medicine; Kirikkale University; Kirikkale Turkey
| | - M. Cobanoglu
- Department of Orthopaedic Surgery; Faculty of Medicine; Adnan Menderes University; Aydin Turkey
| | - M. Enercan
- Istanbul Spine Center at Florence Nightingale Hospital; Istanbul Turkey
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176
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Kondo S, Muneta T, Nakagawa Y, Koga H, Watanabe T, Tsuji K, Sotome S, Okawa A, Kiuchi S, Ono H, Mizuno M, Sekiya I. Transplantation of autologous synovial mesenchymal stem cells promotes meniscus regeneration in aged primates. J Orthop Res 2017; 35:1274-1282. [PMID: 26916126 DOI: 10.1002/jor.23211] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 02/17/2016] [Indexed: 02/04/2023]
Abstract
Transplantation of aggregates of synovial mesenchymal stem cells (MSCs) enhanced meniscus regeneration in rats. Anatomy and biological properties of the meniscus depend on animal species. To apply this technique clinically, it is valuable to investigate the use of animals genetically close to humans. We investigated whether transplantation of aggregates of autologous synovial MSCs promoted meniscal regeneration in aged primates. Chynomolgus primates between 12 and 13 years old were used. After the anterior halves of the medial menisci in both knees were removed, an average of 14 aggregates consisting of 250,000 synovial MSCs were transplanted onto the meniscus defect. No aggregates were transplanted to the opposite knee for the control. Meniscus and articular cartilage were analyzed macroscopically, histologically, and by MRI T1rho mapping at 8 (n = 3) and 16 weeks (n = 4). The medial meniscus was larger and the modified Pauli's histological score for the regenerated meniscus was better in the MSC group than in the control group in each primate at 8 and 16 weeks. Mankin's score for the medial femoral condyle cartilage was better in the MSC group than in the control group in all primates at 16 weeks. T1rho value for both the regenerated meniscus and adjacent articular cartilage in the MSC group was closer to the normal meniscus than in the control group in all primates at 16 weeks. Transplantation of aggregates of autologous synovial MSCs promoted meniscus regeneration and delayed progression of degeneration of articular cartilage in aged primates. This is the first report dealing with meniscus regeneration in primates. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1274-1282, 2017.
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Affiliation(s)
- Shimpei Kondo
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeshi Muneta
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yusuke Nakagawa
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.,Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Toshifumi Watanabe
- Department of Cartilage Regeneration, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Kunikazu Tsuji
- Department of Cartilage Regeneration, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Shinichi Sotome
- Department of Orthopaedic Research and Development, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Atsushi Okawa
- Department of Orthopaedic and Spinal Surgery, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | | | | | - Mitsuru Mizuno
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ichiro Sekiya
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan
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177
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Waller KA, Chin KE, Jay GD, Zhang LX, Teeple E, McAllister S, Badger GJ, Schmidt TA, Fleming BC. Intra-articular Recombinant Human Proteoglycan 4 Mitigates Cartilage Damage After Destabilization of the Medial Meniscus in the Yucatan Minipig. Am J Sports Med 2017; 45:1512-1521. [PMID: 28129516 PMCID: PMC5453820 DOI: 10.1177/0363546516686965] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Lubricin, or proteoglycan 4 (PRG4), is a glycoprotein responsible for joint boundary lubrication. PRG4 has been shown previously to be down-regulated after traumatic joint injury such as a meniscal tear. Preliminary evidence suggests that intra-articular injection of PRG4 after injury will reduce cartilage damage in rat models of surgically induced posttraumatic osteoarthritis. OBJECTIVE To determine the efficacy of intra-articular injection of full-length recombinant human lubricin (rhPRG4) for reducing cartilage damage after medial meniscal destabilization (DMM) in a preclinical large animal model. STUDY DESIGN Controlled laboratory study. METHODS Unilateral DMM was performed in 29 Yucatan minipigs. One week after DMM, animals received 3 weekly intra-articular injections (3 mL per injection): (1) rhPRG4 (1.3 mg/mL; n = 10); (2) rhPRG4+hyaluronan (1.3 mg/mL rhPRG4 and 3 mg/mL hyaluronan [~950 kDA]; n = 10); and (3) phosphate-buffered saline (PBS; n = 9). Hindlimbs were harvested 26 weeks after surgery. Cartilage integrity was evaluated by use of macroscopic (India ink) and microscopic (safranin O-fast green and hematoxylin and eosin) scoring systems. Secondary outcomes evaluated via enzyme-linked immunosorbent assay (ELISA) included PRG4 levels in synovial fluid, carboxy-terminal telepeptide of type II collagen (CTX-II) concentrations in urine and serum, and interleukin 1β (IL-1β) levels in synovial fluid and serum. RESULTS The rhPRG4 group had significantly less macroscopic cartilage damage in the medial tibial plateau compared with the PBS group ( P = .002). No difference was found between the rhPRG4+hyaluronan and PBS groups ( P = .23). However, no differences in microscopic damage scores were observed between the 3 groups ( P = .70). PRG4 production was elevated in the rhPRG4 group synovial fluid compared with the PBS group ( P = .033). The rhPRG4 group presented significantly lower urinary CTX-II levels, but not serum levels, when compared with the PBS ( P = .013) and rhPRG4+hyaluronan ( P = .011) groups. In serum and synovial fluid, both rhPRG4 ( P = .006; P = .017) and rhPRG4+hyaluronan groups ( P = .009; P = .03) presented decreased IL-1β levels. CONCLUSION All groups exhibited significant cartilage degeneration after DMM surgery. However, animals treated with rhPRG4 had the least amount of cartilage damage and less inflammation, providing evidence that intra-articular injections of rhPRG4 may slow the progression of posttraumatic osteoarthritis. CLINICAL RELEVANCE Patients with meniscal trauma are at high risk for posttraumatic osteoarthritis. This study demonstrates that an intra-articular injection regimen of rhPRG4 may attenuate cartilage damage after meniscal injury.
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Affiliation(s)
- Kimberly A. Waller
- Department of Orthopaedics, Warren Alpert Medical School of Brown University/Rhode Island Hospital, Providence, RI
| | - Kaitlyn E. Chin
- Department of Orthopaedics, Warren Alpert Medical School of Brown University/Rhode Island Hospital, Providence, RI
| | - Gregory D. Jay
- Department of Emergency Medicine, Warren Alpert Medical School of Brown University/Rhode Island Hospital, Providence, RI,School of Engineering, Brown University, Providence, RI
| | - Ling X. Zhang
- Department of Emergency Medicine, Warren Alpert Medical School of Brown University/Rhode Island Hospital, Providence, RI
| | - Erin Teeple
- Department of Occupational and Environmental Medicine, Harvard School of Public Health, Boston, MA,Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA
| | - Scott McAllister
- Department of Orthopaedics, Warren Alpert Medical School of Brown University/Rhode Island Hospital, Providence, RI
| | - Gary J. Badger
- Department of Medical Biostatistics, University of Vermont, Burlington, VT
| | - Tannin A. Schmidt
- Faculty of Kinesiology & Schulich School of Engineering, University of Calgary, Calgary, Alberta, Canada
| | - Braden C. Fleming
- Department of Orthopaedics, Warren Alpert Medical School of Brown University/Rhode Island Hospital, Providence, RI,School of Engineering, Brown University, Providence, RI
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178
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Zhao L, Lee PV, Ackland DC, Broom ND, Thambyah A. Microstructure Variations in the Soft-Hard Tissue Junction of the Human Anterior Cruciate Ligament. Anat Rec (Hoboken) 2017; 300:1547-1559. [DOI: 10.1002/ar.23608] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 03/21/2017] [Accepted: 04/06/2017] [Indexed: 01/18/2023]
Affiliation(s)
- Lei Zhao
- Experimental Tissue Mechanics Laboratory; Department of Chemical and Materials Engineering, University of Auckland; Auckland New Zealand
| | - Peter V.S. Lee
- Department of Biomedical Engineering; University of Melbourne; Victoria Australia
| | - David C. Ackland
- Department of Biomedical Engineering; University of Melbourne; Victoria Australia
| | - Neil D. Broom
- Experimental Tissue Mechanics Laboratory; Department of Chemical and Materials Engineering, University of Auckland; Auckland New Zealand
| | - Ashvin Thambyah
- Experimental Tissue Mechanics Laboratory; Department of Chemical and Materials Engineering, University of Auckland; Auckland New Zealand
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179
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Heckelsmiller DJ, James Rudert M, Baer TE, Pedersen DR, Fredericks DC, Goetz JE. Changes in Joint Contact Mechanics in a Large Quadrupedal Animal Model After Partial Meniscectomy and a Focal Cartilage Injury. J Biomech Eng 2017; 139:2610240. [PMID: 28267190 DOI: 10.1115/1.4036148] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Indexed: 11/08/2022]
Abstract
Acute mechanical damage and the resulting joint contact abnormalities are central to the initiation and progression of post-traumatic osteoarthritis (PTOA). Study of PTOA is typically performed in vivo with replicate animals using artificially induced injury features. The goal of this work was to measure changes in a joint contact stress in the knee of a large quadruped after creation of a clinically realistic overload injury and a focal cartilage defect. Whole-joint overload was achieved by excising a 5-mm wedge of the anterior medial meniscus. Focal cartilage defects were created using a custom pneumatic impact gun specifically developed and mechanically characterized for this work. To evaluate the effect of these injuries on joint contact mechanics, Tekscan (Tekscan, Inc., South Boston, MA) measurements were obtained pre-operatively, postmeniscectomy, and postimpact (1.2-J) in a nonrandomized group of axially loaded cadaveric sheep knees. Postmeniscectomy, peak contact stress in the medial compartment is increased by 71% (p = 0.03) and contact area is decreased by 35% (p = 0.001); the center of pressure (CoP) shifted toward the cruciate ligaments in both the medial (p = 0.004) and lateral (p = 0.03) compartments. The creation of a cartilage defect did not significantly change any aspect of contact mechanics measured in the meniscectomized knee. This work characterizes the mechanical environment present in a quadrupedal animal knee joint after two methods to reproducibly induce joint injury features that lead to PTOA.
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Affiliation(s)
- David J Heckelsmiller
- Department of Orthopedics and Rehabilitation, The University of Iowa, Iowa City, IA 52242-1100;Department of Biomedical Engineering, The University of Iowa, Iowa City, IA 52242-1100
| | - M James Rudert
- Department of Orthopedics and Rehabilitation, The University of Iowa, Iowa City, IA 52242-1100
| | - Thomas E Baer
- Department of Orthopedics and Rehabilitation, The University of Iowa, Iowa City, IA 52242-1100
| | - Douglas R Pedersen
- Department of Orthopedics and Rehabilitation, The University of Iowa, Iowa City, IA 52242-1100;Department of Biomedical Engineering, The University of Iowa, Iowa City, IA 52242-1100
| | - Douglas C Fredericks
- Department of Orthopedics and Rehabilitation, The University of Iowa, Iowa City, IA 52242-1100
| | - Jessica E Goetz
- Orthopedic Biomechanics Lab, Department of Orthopedics and Rehabilitation, The University of Iowa, 2181 Westlawn Building, Iowa City, IA 52242-1100;Department of Biomedical Engineering, The University of Iowa, Iowa City, IA 52242-1100 e-mail:
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180
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Chen S, Fu P, Wu H, Pei M. Meniscus, articular cartilage and nucleus pulposus: a comparative review of cartilage-like tissues in anatomy, development and function. Cell Tissue Res 2017; 370:53-70. [PMID: 28413859 DOI: 10.1007/s00441-017-2613-0] [Citation(s) in RCA: 111] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 03/17/2017] [Indexed: 01/07/2023]
Abstract
The degradation of cartilage in the human body is impacted by aging, disease, genetic predisposition and continued insults resulting from daily activity. The burden of cartilage defects (osteoarthritis, rheumatoid arthritis, intervertebral disc damage, knee replacement surgeries, etc.) is daunting in light of substantial economic and social stresses. This review strives to broaden the scope of regenerative medicine and tissue engineering approaches used for cartilage repair by comparing and contrasting the anatomical and functional nature of the meniscus, articular cartilage (AC) and nucleus pulposus (NP). Many review papers have provided detailed evaluations of these cartilages and cartilage-like tissues individually but none have comprehensively examined the parallels and inconsistencies in signaling, genetic expression and extracellular matrix composition between tissues. For the first time, this review outlines the importance of understanding these three tissues as unique entities, providing a comparative analysis of anatomy, ultrastructure, biochemistry and function for each tissue. This novel approach highlights the similarities and differences between tissues, progressing research toward an understanding of what defines each tissue as distinctive. The goal of this paper is to provide researchers with the fundamental knowledge to correctly engineer the meniscus, AC and NP without inadvertently developing the wrong tissue function or biochemistry.
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Affiliation(s)
- Song Chen
- Stem Cell and Tissue Engineering Laboratory, Department of Orthopaedics and Division of Exercise Physiology, West Virginia University, One Medical Center Drive, PO Box 9196, Morgantown, WV, 26506-9196, USA
- Department of Orthopaedics, Changzheng Hospital, Second Military Medical University, Shanghai, 200003, People's Republic of China
| | - Peiliang Fu
- Department of Orthopaedics, Changzheng Hospital, Second Military Medical University, Shanghai, 200003, People's Republic of China
| | - Haishan Wu
- Department of Orthopaedics, Changzheng Hospital, Second Military Medical University, Shanghai, 200003, People's Republic of China
| | - Ming Pei
- Stem Cell and Tissue Engineering Laboratory, Department of Orthopaedics and Division of Exercise Physiology, West Virginia University, One Medical Center Drive, PO Box 9196, Morgantown, WV, 26506-9196, USA.
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181
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Ingham SJM, de Carvalho RT, Martins CAQ, Lertwanich P, Abdalla RJ, Smolinski P, Lovejoy CO, Fu FH. Anterolateral ligament anatomy: a comparative anatomical study. Knee Surg Sports Traumatol Arthrosc 2017; 25:1048-1054. [PMID: 26713325 DOI: 10.1007/s00167-015-3956-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 12/15/2015] [Indexed: 01/24/2023]
Abstract
PURPOSE Some anatomical studies have indicated that the anterolateral ligament (ALL) of the knee is distinct ligamentous structure in humans. The purpose of this study is to compare the lateral anatomy of the knee among human and various animal specimens. METHODS Fifty-eight fresh-frozen knee specimens, from 24 different animal species, were used for this anatomical study. The same researchers dissected all the specimens in this study, and dissections were performed in a careful and standardized manner. RESULTS An ALL was not found in any of the 58 knees dissected. Another interesting finding in this study is that some primate species (the prosimians: the red and black and white lemurs) have two LCLs. CONCLUSION The clinical relevance of this study is the lack of isolation of the ALL as a unique structure in animal species. Therefore, precaution is recommended before assessing the need for surgery to reconstruct the ALL as a singular ligament.
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Affiliation(s)
- Sheila Jean McNeill Ingham
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 3471 Fifth Avenue, suite #1011, Pittsburgh, PA, 15213-3221, USA.,Department of Orthopaedic Surgery, Federal University of São Paulo, São Paulo, SP, Brazil
| | | | - Cesar A Q Martins
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 3471 Fifth Avenue, suite #1011, Pittsburgh, PA, 15213-3221, USA
| | - Pisit Lertwanich
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 3471 Fifth Avenue, suite #1011, Pittsburgh, PA, 15213-3221, USA.,Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Rene Jorge Abdalla
- Department of Orthopaedic Surgery, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Patrick Smolinski
- Department of Mechanical Engineering and Material Science, University of Pittsburgh, Pittsburgh, PA, USA
| | - C Owen Lovejoy
- Department of Anthropology, School of Biomedical Sciences, Kent State University, Kent, OH, USA
| | - Freddie H Fu
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 3471 Fifth Avenue, suite #1011, Pittsburgh, PA, 15213-3221, USA. .,Department of Mechanical Engineering and Material Science, University of Pittsburgh, Pittsburgh, PA, USA.
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182
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Caprine Endometrial Mesenchymal Stromal Stem Cell: Multilineage Potential, Characterization, and Growth Kinetics in Breeding and Anestrous Stages. Vet Med Int 2017; 2017:5052801. [PMID: 28357151 PMCID: PMC5357535 DOI: 10.1155/2017/5052801] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 12/10/2015] [Accepted: 01/10/2016] [Indexed: 11/17/2022] Open
Abstract
The endometrial layer of the uterus contains a population of cells with similar characteristics of mesenchymal stem cells (MSCs). In the present study, caprine endometrial mesenchymal stromal stem cells (En-MSCs) characters and differentiation potential to chondrogenic, osteogenic, and adipogenic cell lines as well as their growth kinetics in breeding and anestrous stages were evaluated. En-MSCs were enzymatically isolated from endometrial layer of the uterus of adult goats and were cultured and subcultured until passage 4. The growth kinetics and population doubling time (PDT) of caprine En-MSCs in breeding and anestrous stages were determined. En-MSCs in passage 4 were used for the karyotyping and differentiation into chondrocytes, osteocytes, and adipocytes. The PDT in anestrus phase was 40.6 h and in cyclic goats was 53 h. En-MSCs were fibroblast-like in all passages. The number of chromosomes was normal (2n = 60) with no chromosomal instability. Chondrogenic, osteogenic, and adipogenic differentiation of En-MSCs was confirmed by staining with Alcian blue, Alizarin red, and Oil Red O, respectively. Caprine En-MSCs demonstrated to be an alternative source of MSCs for cell therapy purposes in regenerative medicine.
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183
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van der Kraan PM. Factors that influence outcome in experimental osteoarthritis. Osteoarthritis Cartilage 2017; 25:369-375. [PMID: 27616682 DOI: 10.1016/j.joca.2016.09.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 08/23/2016] [Accepted: 09/01/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Osteoarthritis (OA) is the most common joint disease but an effective pharmacological therapy has not been developed yet. To identify targets for treatment and ways to interfere with OA development and progression both spontaneous and induced OA models are still needed. In this narrative review it is discussed what variables can be identified that lead to variation in OA animal model studies. DESIGN Literature was screened (Pubmed) with the following terms; OA animal models in combination with species, age, strain, gender/sex, housing, diet, fighting, circadian rhythm, transgenic. Relevant articles were selected and additional papers were searched for and read for specific subtopics. RESULTS Studies with OA models are subject to a multitude of variables, stimuli and conditions that can influence the outcome of an animal experiment. Outcome will depend on amongst others; the model used, species and strain, age, gender, diet, housing conditions, circadian rhythm, timing of intervention, stress levels and activity. Variations in these variables can account for discrepancies between OA model experiments, intervention studies and conclusions. CONCLUSION To improve OA animal model research, investigators should be aware of all the stimuli and conditions that can interfere with disease development and disease intervention and take these into account in their study design and execution.
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Affiliation(s)
- P M van der Kraan
- Experimental Rheumatology, Radboudumc, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
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184
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Shimomura K, Rothrauff BB, Tuan RS. Region-Specific Effect of the Decellularized Meniscus Extracellular Matrix on Mesenchymal Stem Cell-Based Meniscus Tissue Engineering. Am J Sports Med 2017; 45:604-611. [PMID: 27895039 DOI: 10.1177/0363546516674184] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The meniscus is the most commonly injured knee structure, and surgical repair is often ineffective. Tissue engineering-based repair or regeneration may provide a needed solution. Decellularized, tissue-derived extracellular matrices (ECMs) have received attention for their potential use as tissue-engineered scaffolds. In considering meniscus-derived ECMs (mECMs) for meniscus tissue engineering, it is noteworthy that the inner and outer regions of the meniscus have different structural and biochemical features, potentially directing the differentiation of cells toward region-specific phenotypes. PURPOSE To investigate the applicability of mECMs for meniscus tissue engineering by specifically comparing region-dependent effects of mECMs on 3-dimensional constructs seeded with human bone marrow mesenchymal stem cells (hBMSCs). STUDY DESIGN Controlled laboratory study. METHODS Bovine menisci were divided into inner and outer halves and were minced, treated with Triton X-100 and DNase, and extracted with urea. Then, hBMSCs (1 × 106 cells/mL) were encapsulated in a photo-cross-linked 10% polyethylene glycol diacrylate scaffold containing mECMs (60 μg/mL) derived from either the inner or outer meniscus, with an ECM-free scaffold as a control. The cell-seeded constructs were cultured with chondrogenic medium containing recombinant human transforming growth factor β3 (TGF-β3) and were analyzed for expression of meniscus-associated genes as well as for the collagen (hydroxyproline) and glycosaminoglycan content as a function of time. RESULTS Decellularization was verified by the absence of 4',6-diamidino-2-phenylindole (DAPI)-stained cell nuclei and a reduction in the DNA content. Quantitative real-time polymerase chain reaction showed that collagen type I expression was significantly higher in the outer mECM group than in the other groups, while collagen type II and aggrecan expression was highest in the inner mECM group. The collagen (hydroxyproline) content was highest in the outer mECM group, while the glycosaminoglycan content was higher in both the inner and outer mECM groups compared with the control group. CONCLUSION These results showed that the inner mECM enhances the fibrocartilaginous differentiation of hBMSCs, while the outer mECM promotes a more fibroblastic phenotype. Our findings support the feasibility of fabricating bioactive scaffolds using region-specific mECM preparations for meniscus tissue engineering. CLINICAL RELEVANCE This is the first report to demonstrate the feasibility of applying region-specific mECMs for the engineering of meniscus implants capable of reproducing the biphasic, anatomic, and biochemical characteristics of the meniscus, features that should contribute to the feasibility of their clinical application.
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Affiliation(s)
- Kazunori Shimomura
- Medicine for Sports and Performing Arts, Department of Health and Sport Sciences, Osaka University Graduate School of Medicine, Osaka, Japan.,Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Benjamin B Rothrauff
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Rocky S Tuan
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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185
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Chen H, Zuo Q, Wang Y, Song J, Yang H, Zhang Y, Li B. Inducing goat pluripotent stem cells with four transcription factor mRNAs that activate endogenous promoters. BMC Biotechnol 2017; 17:11. [PMID: 28193206 PMCID: PMC5307868 DOI: 10.1186/s12896-017-0336-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 02/10/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Traditional approaches for generating goat pluripotent stem cells (iPSCs) suffer from complexity and low preparation efficiency. Therefore, we tried to derive goat iPSCs with a new method by transfecting exogenous Oct4, Sox2, Klf4 and c-Myc mRNAs into goat embryonic fibroblasts (GEFs), and explore the mechanisms regarding the transcription regulation of the reprogramming factors in goat iPSCs induction. RESULTS mRNAs of the four reprogramming factors were transfected into GEFs, and were localized in nucleus with approximately 90% transfection efficiency. After five consecutive transfections, GEFs tended to aggregate by day 10. Clones appeared on day 15-18, and typical embryonic stem cell -like clones formed on day 20. One thousand AKP staining positive clones were achieved in 104 GEFs, with approximately 1.0% induction efficiency. Immunofluorescence staining and qRT-PCR detection of the ESCs markers confirmed the properties of the goat iPSCs. The achieved goat iPSCs could be cultured to 22nd passage, which showed normal karyotype. The goat iPSCs were able to differentiate into embryoid bodies with three germ layers. qRT-PCR and western blot showed activated endogenous pluripotent factors expression in the later phase of mRNA-induced goat iPSCs induction. Epigenetic analysis of the endogenous pluripotent gene Nanog revealed its demethylation status in derived goat iPSCs. Core promoter regions of the four reprogramming factors were determined. Transcription factor binding sites, including Elf-1, AP-2, SP1, C/EBP and MZF1, were identified to be functional in the core promoter regions of these reprogramming genes. Demethylation and deacetylation of the promoters enhanced their transcription activities. CONCLUSIONS We successfully generated goat iPSCs by transfection of Oct4, Sox2, Klf4 and c-Myc mRNAs into GEFs, which initiated the endogenous reprogramming network and altered the methylation status of pluripotent genes. Core promoter regions and functional transcription binding sites of the four reprogramming genes were identified. Epigenetic regulation was revealed to participate in mRNA induced iPSCs formation. Our study provides a safe and efficient approach for goat. iPSCs generation.
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Affiliation(s)
- Hao Chen
- Department of Orthopaedics, The Frist Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou, Jiangsu, 215006, People's Republic of China
| | - Qisheng Zuo
- Key Laboratory of Animal Breeding Reproduction and Molecular Design for Jiangsu Province, College of Animal Science and Technology, Yangzhou University, 88 South University Ave., Yangzhou, Jiangsu, 225009, People's Republic of China
| | - Yingjie Wang
- Key Laboratory of Animal Breeding Reproduction and Molecular Design for Jiangsu Province, College of Animal Science and Technology, Yangzhou University, 88 South University Ave., Yangzhou, Jiangsu, 225009, People's Republic of China
| | - Jiuzhou Song
- Animal & Avian Sciences, University of Maryland, Baltimore, MD, 20741, USA
| | - Huilin Yang
- Department of Orthopaedics, The Frist Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou, Jiangsu, 215006, People's Republic of China.
| | - Yani Zhang
- Key Laboratory of Animal Breeding Reproduction and Molecular Design for Jiangsu Province, College of Animal Science and Technology, Yangzhou University, 88 South University Ave., Yangzhou, Jiangsu, 225009, People's Republic of China
| | - Bichun Li
- Key Laboratory of Animal Breeding Reproduction and Molecular Design for Jiangsu Province, College of Animal Science and Technology, Yangzhou University, 88 South University Ave., Yangzhou, Jiangsu, 225009, People's Republic of China.
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186
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Effect of radial meniscal tear on in situ forces of meniscus and tibiofemoral relationship. Knee Surg Sports Traumatol Arthrosc 2017; 25:355-361. [PMID: 28012003 DOI: 10.1007/s00167-016-4395-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 12/01/2016] [Indexed: 01/14/2023]
Abstract
PURPOSE To clarify the effect of the radial tear of the lateral meniscus on the in situ meniscus force and the tibiofemoral relationship under axial loads and valgus torques. METHODS Ten intact porcine knees were settled to a 6-degree of freedom robotic system, while the force and 3-dimensional path of the knees were recorded via Universal Force Sensor (UFS) during 3 cycles of 250-N axial load and 5-Nm valgus torque at 15°, 30°, 45°, and 60° of knee flexion. The same examination was performed on the following 3 meniscal states sequentially; 33, 66, and 100% width of radial tears at the middle segment of the lateral meniscus, while recording the force and path of the knees via UFS. Finally, all paths were reproduced after total lateral meniscectomy and the in situ force of the lateral meniscus were calculated with the principle of superposition. RESULTS The radial tear of 100% width significantly decreased the in situ force of the lateral meniscus and caused tibial medial shift and valgus rotation at 30°-60° of knee flexion in both testing protocols. Under a 250-N axial load at 60° of knee flexion, the in situ force decreased to 36 ± 29 N with 100% width of radial tear, which was 122 ± 38 N in the intact state. Additionally, the tibia shifted medially by 2.1 ± 0.9 mm and valgusrotated by 2.5 ± 1.9° with the complete radial tear. However, the radial tear of 33 or 66% width had little effect on either the in situ force or the tibial position. CONCLUSION A radial tear of 100% width involving the rim significantly decreased the in situ force of the lateral meniscus and caused medial shift and valgus rotation of the tibia, whereas a radial tear of up to 66% width produced only little change. The clinical relevance is that loss of meniscal functions due to complete radial tear can lead to abnormal stress concentration in a focal area of cartilage and can increase the risk of osteoarthritis in the future.
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Qu D, Chuang PJ, Prateepchinda S, Balasubramanian PS, Yao X, Doty SB, Hendon CP, Lu HH. Micro- and Ultrastructural Characterization of Age-Related Changes at the Anterior Cruciate Ligament-to-Bone Insertion. ACS Biomater Sci Eng 2016; 3:2806-2814. [PMID: 33418704 DOI: 10.1021/acsbiomaterials.6b00602] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
There remains a lack of understanding of the structural changes that occur across the complex, multitissue anterior cruciate ligament (ACL)-to-bone insertion as a function of aging. The objective of this study is to provide a multiscale comparison of matrix properties across the skeletally immature and mature ACL-to-bone insertion. Using complementary imaging methods, micro- and ultrastructural analysis of the insertion revealed that collagen fiber orientation at the interface changes with age, though the degree of collagen organization is maintained over time. These changes are accompanied by a decrease in collagen fibril density and are likely driven by physiological loading. Mineral crystal structure and crystallinity are conserved over time, despite regional differences in crystallinity between the interface and bone. This suggests that mineral chemistry is established early in development and underscores its important functional role. Collectively, these findings provide new insights into interface development and set critical design benchmarks for integrative soft tissue repair.
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Affiliation(s)
- Dovina Qu
- Biomaterials and Interface Tissue Engineering Laboratory, Department of Biomedical Engineering, Columbia University, 1210 Amsterdam Avenue, 351 Engineering Terrace, MC 8904, New York, New York 10027, United States
| | - Philip J Chuang
- Biomaterials and Interface Tissue Engineering Laboratory, Department of Biomedical Engineering, Columbia University, 1210 Amsterdam Avenue, 351 Engineering Terrace, MC 8904, New York, New York 10027, United States
| | - Sagaw Prateepchinda
- Biomaterials and Interface Tissue Engineering Laboratory, Department of Biomedical Engineering, Columbia University, 1210 Amsterdam Avenue, 351 Engineering Terrace, MC 8904, New York, New York 10027, United States
| | - Priya S Balasubramanian
- Structure-Function Imaging Laboratory, Department of Electrical Engineering, Columbia University, 500 W. 120th Street, 1300 S. W. Mudd Building, MC 4712, New York, New York 10027, United States
| | - Xinwen Yao
- Structure-Function Imaging Laboratory, Department of Electrical Engineering, Columbia University, 500 W. 120th Street, 1300 S. W. Mudd Building, MC 4712, New York, New York 10027, United States
| | - Stephen B Doty
- Analytical Microscopy Laboratory, Hospital for Special Surgery, 535 East 70th Street, New York, New York 10021, United States
| | - Christine P Hendon
- Structure-Function Imaging Laboratory, Department of Electrical Engineering, Columbia University, 500 W. 120th Street, 1300 S. W. Mudd Building, MC 4712, New York, New York 10027, United States
| | - Helen H Lu
- Biomaterials and Interface Tissue Engineering Laboratory, Department of Biomedical Engineering, Columbia University, 1210 Amsterdam Avenue, 351 Engineering Terrace, MC 8904, New York, New York 10027, United States
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188
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Cucchiarini M, de Girolamo L, Filardo G, Oliveira JM, Orth P, Pape D, Reboul P. Basic science of osteoarthritis. J Exp Orthop 2016; 3:22. [PMID: 27624438 PMCID: PMC5021646 DOI: 10.1186/s40634-016-0060-6] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 09/09/2016] [Indexed: 12/20/2022] Open
Abstract
Osteoarthritis (OA) is a prevalent, disabling disorder of the joints that affects a large population worldwide and for which there is no definitive cure. This review provides critical insights into the basic knowledge on OA that may lead to innovative end efficient new therapeutic regimens. While degradation of the articular cartilage is the hallmark of OA, with altered interactions between chondrocytes and compounds of the extracellular matrix, the subchondral bone has been also described as a key component of the disease, involving specific pathomechanisms controlling its initiation and progression. The identification of such events (and thus of possible targets for therapy) has been made possible by the availability of a number of animal models that aim at reproducing the human pathology, in particular large models of high tibial osteotomy (HTO). From a therapeutic point of view, mesenchymal stem cells (MSCs) represent a promising option for the treatment of OA and may be used concomitantly with functional substitutes integrating scaffolds and drugs/growth factors in tissue engineering setups. Altogether, these advances in the fundamental and experimental knowledge on OA may allow for the generation of improved, adapted therapeutic regimens to treat human OA.
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Affiliation(s)
- Magali Cucchiarini
- Center of Experimental Orthopaedics, Saarland University Medical Center and Saarland University, Kirrbergerstr. Bldg 37, D-66421, Homburg, Germany.
| | - Laura de Girolamo
- Orthopaedic Biotechnology Laboratory, Galeazzi Orthopaedic Institute, Milan, Italy
| | - Giuseppe Filardo
- Orthopaedic and Traumatologic I Clinic, Biomechanics Laboratory, Rizzoli Orthopaedic Institute, University of Bologna, Bologna, Italy
| | - J Miguel Oliveira
- 3B's Research Group - Biomaterials, Biodegradables and Biomimetics, Univ. Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Avepark - Parque de Ciência e Tecnologia, Zona Industrial da Gandra, Barco GMR, Barco, Guimarães, Portugal
- ICVS/3B's - PT Government Associated Laboratory, Barco, Guimarães, Portugal
| | - Patrick Orth
- Center of Experimental Orthopaedics, Saarland University Medical Center and Saarland University, Kirrbergerstr. Bldg 37, D-66421, Homburg, Germany
- Department of Orthopaedic Surgery, Saarland University Medical Center and Saarland University, Homburg, Saar, Germany
| | - Dietrich Pape
- Department of Orthopaedic Surgery, Centre Hospitalier de Luxembourg, Luxembourg ville, Luxembourg
- Sports Medicine Research Laboratory, Public Research Centre for Health, Luxembourg, Centre Médical de la Fondation Norbert Metz, Luxembourg ville, Luxembourg
| | - Pascal Reboul
- UMR 7365 CNRS-Université de Lorraine, IMoPA, Biopôle de l'Université de Lorraine, Campus Biologie-Santé, Vandoeuvre-lès-Nancy, France
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Relationship between increased in vivo meniscal loads and abnormal tibiofemoral surface alignment in ACL deficient sheep is varied. J Biomech 2016; 49:3824-3832. [DOI: 10.1016/j.jbiomech.2016.10.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 10/01/2016] [Accepted: 10/11/2016] [Indexed: 01/14/2023]
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190
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Takroni T, Laouar L, Adesida A, Elliott JAW, Jomha NM. Anatomical study: comparing the human, sheep and pig knee meniscus. J Exp Orthop 2016; 3:35. [PMID: 27928740 PMCID: PMC5143332 DOI: 10.1186/s40634-016-0071-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 11/30/2016] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Animal models are commonly used in investigating new treatment options for knee joint injuries including injuries to the meniscus. The reliability and applicability of these models to replicate findings in humans depends on determining the most suitable animal proxy. Therefore, this study was designed to compare the wet weight, volume and dimensions of the human meniscus with two commonly used animal models: sheep and pig. METHODS Human menisci (n = 6 pairs) were obtained from the knee joints of cadaveric male donors. Sheep menisci (n = 6 pairs) and pig menisci (n = 22 pairs) were obtained from the stifle joints of adult sheep and pigs. Meniscal wet weight, volume and dimensions of the body were measured and compared among the species. Anatomical dimensions included circumference, width, peripheral height, articular height and superior articular length. RESULTS The circumference of human menisci (lateral: 84.0 mm, medial: 88.7 mm) was significantly longer than that of sheep (lateral: 50.0 mm, medial: 55.5 mm) and pig (lateral: 66.8 mm, medial: 64.9 mm). The majority of the remaining dimensions of the medial and all of the remaining dimensions of the lateral menisci in sheep showed no statistical difference in comparison to the human menisci. The meniscal weight in pig was significantly larger (lateral: 6.4 g, medial: 5.0 g) than the human (lateral: 4.9 g, medial: 4.4 g) and sheep (lateral: 2.5 g, medial: 2.2 g). Porcine meniscal volume (lateral: 6.5 ml, medial: 5.1 ml) was also larger than the human (lateral: 5.0 ml, medial: 4.5 ml) and sheep (lateral: 2.3 ml, medial: 2.2 ml) menisci. The dimensions measured in the pig meniscus were generally larger than human menisci with statistically significant differences in most categories. CONCLUSION Sheep meniscal dimensions more closely matched human meniscal dimensions than the pig meniscal dimensions. This information may help guide the choice of an animal proxy in meniscal research.
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Affiliation(s)
- Talal Takroni
- Department of Surgery, Laboratory of Orthopaedic Research, University of Alberta, Edmonton, Canada.
- Rabigh Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
| | - Leila Laouar
- Department of Surgery, Laboratory of Orthopaedic Research, University of Alberta, Edmonton, Canada
| | - Adetola Adesida
- Department of Surgery, Laboratory of Stem Cell Biology and Orthopaedic Tissue Engineering, University of Alberta, Edmonton, Canada
| | - Janet A W Elliott
- Department of Chemical and Materials Engineering, University of Alberta, Edmonton, Canada
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Canada
| | - Nadr M Jomha
- Department of Surgery, Laboratory of Orthopaedic Research, University of Alberta, Edmonton, Canada
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Hindle P, Baily J, Khan N, Biant LC, Simpson AHR, Péault B. Perivascular Mesenchymal Stem Cells in Sheep: Characterization and Autologous Transplantation in a Model of Articular Cartilage Repair. Stem Cells Dev 2016; 25:1659-1669. [PMID: 27554322 DOI: 10.1089/scd.2016.0165] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Previous research has indicated that purified perivascular stem cells (PSCs) have increased chondrogenic potential compared to conventional mesenchymal stem cells (MSCs) derived in culture. This study aimed to develop an autologous large animal model for PSC transplantation and to specifically determine if implanted cells are retained in articular cartilage defects. Immunohistochemistry and fluorescence-activated cell sorting were used to ascertain the reactivity of anti-human and anti-ovine antibodies, which were combined and used to identify and isolate pericytes (CD34-CD45-CD146+) and adventitial cells (CD34+CD45-CD146-). The purified cells demonstrated osteogenic, adipogenic, and chondrogenic potential in culture. Autologous ovine PSCs (oPSCs) were isolated, cultured, and efficiently transfected using a green fluorescence protein (GFP) encoding lentivirus. The cells were implanted into articular cartilage defects on the medial femoral condyle using hydrogel and collagen membranes. Four weeks following implantation, the condyle was explanted and confocal laser scanning microscopy demonstrated the presence of oPSCs in the defect repaired with the hydrogel. These data suggest the testability in a large animal of native MSC autologous grafting, thus avoiding possible biases associated with xenotransplantation. Such a setting will be used in priority for indications in orthopedics, at first to model articular cartilage repair.
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Affiliation(s)
- Paul Hindle
- 1 MRC Centre for Regenerative Medicine, The University of Edinburgh , Edinburgh, United Kingdom
- 2 Department of Trauma and Orthopaedic Surgery, The Royal Infirmary of Edinburgh , Edinburgh, United Kingdom
| | - James Baily
- 1 MRC Centre for Regenerative Medicine, The University of Edinburgh , Edinburgh, United Kingdom
| | - Nusrat Khan
- 1 MRC Centre for Regenerative Medicine, The University of Edinburgh , Edinburgh, United Kingdom
| | - Leela C Biant
- 2 Department of Trauma and Orthopaedic Surgery, The Royal Infirmary of Edinburgh , Edinburgh, United Kingdom
| | - A Hamish R Simpson
- 2 Department of Trauma and Orthopaedic Surgery, The Royal Infirmary of Edinburgh , Edinburgh, United Kingdom
| | - Bruno Péault
- 1 MRC Centre for Regenerative Medicine, The University of Edinburgh , Edinburgh, United Kingdom
- 3 The University of California , Los Angeles, Los Angeles, California
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Zaino NL, Hedgeland MJ, Ciani MJ, Clark AM, Kuxhaus L, Michalek AJ. White-Tailed Deer as an Ex Vivo Knee Model: Joint Morphometry and ACL Rupture Strength. Ann Biomed Eng 2016; 45:1093-1100. [PMID: 27718092 DOI: 10.1007/s10439-016-1746-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 10/04/2016] [Indexed: 11/30/2022]
Abstract
Animal joints are valuable proxies for those of humans in biomechanical studies, however commonly used quadruped knees differ greatly from human knees in scale and morphometry. To test the suitability of the cervine stifle joint (deer knee) as a laboratory model, gross morphometry, ACL cross section, and ACL rupture strength were measured and compared to values previously reported for the knees of humans and commonly studied animals. Twelve knee joints from wild white-tailed deer were tested. Several morphometry parameters, including bicondylar width (53.5 ± 3.0 mm) and notch width (14.7 ± 2.5 mm), showed a high degree of similarity to those of the human knee, while both medial (16.7 ± 2.1°) and lateral (17.6 ± 4.7°) tibial slopes were steeper than in humans but less steep than other quadrupeds. The median ACL rupture force (2054 N, 95% CI 2017-2256 N), mean stiffness (260 ± 166 N/mm), mean length (33 ± 7 mm), and mean cross sectional area (44.8 ± 18.3 mm2) were also comparable to previously reported values for human knees. In our limited sample size, no significant sexual dimorphism in strength or morphometry was observed (p ≥ 0.05 for all parameters), though female specimens generally had steeper tibial slopes (lateral: p = 0.52, medial: p = 0.07). Our results suggest that the deer knee may be a suitable model for ex vivo studies of ACL rupture and repair.
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Affiliation(s)
- Nicole L Zaino
- Department of Mechanical & Aeronautical Engineering, Clarkson University, 8 Clarkson Ave., Box 5725, Potsdam, NY, 13699, USA
| | - Mark J Hedgeland
- Department of Mechanical & Aeronautical Engineering, Clarkson University, 8 Clarkson Ave., Box 5725, Potsdam, NY, 13699, USA
| | - Mario J Ciani
- Department of Occupational Therapy, Clarkson University, Potsdam, USA
| | | | - Laurel Kuxhaus
- Department of Mechanical & Aeronautical Engineering, Clarkson University, 8 Clarkson Ave., Box 5725, Potsdam, NY, 13699, USA
| | - Arthur J Michalek
- Department of Mechanical & Aeronautical Engineering, Clarkson University, 8 Clarkson Ave., Box 5725, Potsdam, NY, 13699, USA.
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193
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Rothrauff BB, Numpaisal PO, Lauro BB, Alexander PG, Debski RE, Musahl V, Tuan RS. Augmented repair of radial meniscus tear with biomimetic electrospun scaffold: an in vitro mechanical analysis. J Exp Orthop 2016; 3:23. [PMID: 27624439 PMCID: PMC5021645 DOI: 10.1186/s40634-016-0058-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 09/02/2016] [Indexed: 01/26/2023] Open
Abstract
Background Large radial tears that disrupt the circumferential fibers of the meniscus are associated with reduced meniscal function and increased risk of joint degeneration. Electrospun fibrous scaffolds can mimic the topography and mechanics of fibrocartilaginous tissues and simultaneously serve as carriers of cells and growth factors, yet their incorporation into clinically relevant suture repair techniques for radial meniscus tears is unexplored. The purposes of this study were to (1) evaluate the effect of fiber orientation on the tensile properties and suture-retention strength of multilayered electrospun scaffolds and (2) determine the mechanical effects of scaffold inclusion within a surgical repair of a simulated radial meniscal tear. The experimental hypothesis was that augmentation with a multilayered scaffold would not compromise the strength of the repair. Methods Three multilayered electrospun scaffolds with different fiber orientations were fabricated–aligned, random, and biomimetic. The biomimetic scaffold was comprised of four layers in the following order (deep to superficial)–aligned longitudinal, aligned transverse, aligned longitudinal, and random–respectively corresponding to circumferential, radial, circumferential, and superficial collagen fibers of the native meniscus. Material properties (i.e., ultimate stress, modulus, etc.) of the scaffolds were determined in the parallel and perpendicular directions, as was suture retention strength. Complete radial tears of lateral bovine meniscus explants were repaired with a double horizontal mattress suture technique, with or without inclusion of the biomimetic scaffold sheath. Both repair groups, as well as native controls, were cyclically loaded between 5 and 20 N for 500 cycles and then loaded to failure. Clamp-to-clamp distance (i.e., residual elongation) was measured following various cycles. Ultimate load, ultimate elongation, and stiffness, were also determined. Group differences were evaluated by one-way ANOVA or Student’s t-test where appropriate. Results Aligned scaffolds possessed the most anisotropic mechanical properties, whereas random scaffolds showed uniform properties in the parallel and perpendicular directions. In comparison, the biomimetic scaffold possessed moduli in the parallel (68.7 ± 14.7 MPa) and perpendicular (39.4 ± 11.6 MPa) directions that respectively approximate the reported circumferential and radial tensile properties of native menisci. The ultimate suture retention load of the biomimetic scaffold in the parallel direction (7.2 ± 1.6 N) was significantly higher than all other conditions (p < 0.001). Biomimetic scaffold augmentation did not compromise mechanical properties when compared against suture repair in terms of residual elongation after 500 cycles (scaffold: 5.05 ± 0.89 mm vs. repair: 4.78 ± 1.24 mm), ultimate failure load (137.1 ± 31.0 N vs. 124.4 ± 21.4 N), ultimate elongation (12.09 ± 5.89 mm vs. 10.14 ± 4.61 mm), and stiffness (20.8 ± 3.6 vs. 18.4 ± 4.7 N/mm). Conclusions While multilayered scaffold sheets were successfully fabricated to mimic the ultrastructure and anisotropic tensile properties of native menisci, improvements in suture retention strength or adoption of superior surgical techniques will be needed to further enhance the mechanical strength of repairs of radial meniscal tears.
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Affiliation(s)
- Benjamin B Rothrauff
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 450 Technology Drive, Room 221, Pittsburgh, PA, 15219, USA.,McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, 15219, USA
| | - Piya-On Numpaisal
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 450 Technology Drive, Room 221, Pittsburgh, PA, 15219, USA.,College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Brian B Lauro
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 450 Technology Drive, Room 221, Pittsburgh, PA, 15219, USA.,Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Peter G Alexander
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 450 Technology Drive, Room 221, Pittsburgh, PA, 15219, USA
| | - Richard E Debski
- Orthopaedic Robotics Laboratory, Department of Orthopaedic Surgery, University of Pittsburgh, 300 Technology Drive, Pittsburgh, PA, USA.,Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA.,McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, 15219, USA
| | - Volker Musahl
- Orthopaedic Robotics Laboratory, Department of Orthopaedic Surgery, University of Pittsburgh, 300 Technology Drive, Pittsburgh, PA, USA.,Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Rocky S Tuan
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 450 Technology Drive, Room 221, Pittsburgh, PA, 15219, USA. .,Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA. .,McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, 15219, USA.
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Hart JL, May KD, Kieves NR, Mich PM, Goh CSS, Palmer RH, Duerr FM. Comparison of owner satisfaction between stifle joint orthoses and tibial plateau leveling osteotomy for the management of cranial cruciate ligament disease in dogs. J Am Vet Med Assoc 2016; 249:391-8. [DOI: 10.2460/javma.249.4.391] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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195
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Levillain A, Magoariec H, Boulocher C, Decambron A, Viateau V, Hoc T. Viscoelastic properties of rabbit osteoarthritic menisci: A correlation with matrix alterations. J Mech Behav Biomed Mater 2016; 65:1-10. [PMID: 27543842 DOI: 10.1016/j.jmbbm.2016.08.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 07/23/2016] [Accepted: 08/05/2016] [Indexed: 01/11/2023]
Abstract
The aim of this study was to evaluate the effect of early osteoarthritis (OA) on the viscoelastic properties of rabbit menisci and to correlate the mechanical alterations with the microstructural changes. Anterior Cruciate Ligament Transection (ACLT) was performed in six male New-Zealand White rabbits on the right knee joint. Six healthy rabbits served as controls. Menisci were removed six weeks after ACLT and were graded macroscopically. Indentation-relaxation tests were performed in the anterior and posterior regions of the medial menisci. The collagen fibre organization and glycosaminoglycan (GAG) content were assessed by biphotonic confocal microscopy and histology, respectively. OA menisci displayed severe macroscopic lesions compared with healthy menisci (p=0.009). Moreover, the instantaneous and equilibrium moduli, which were 2.9±1.0MPa and 0.60±0.18MPa in the anterior region of healthy menisci, respectively, decreased significantly (p=0.03 and p=0.004, respectively) in OA menisci by 55% and 57%, respectively, indicating a global decrease in meniscal stiffness in this region. The equilibrium modulus alone decreased significantly (p=0.04) in the posterior region, going from 0.60±0.18MPa to 0.26±012MPa. This induced a loss of tissue elasticity. These mechanical changes were associated in the posterior region with a structural disruption of the superficial layers, from which the tie fibres emanate, and with a decrease in the GAG content in the anterior region. Consequently, the circumferential collagen fibres of the deep zone were dissociated and the collagen bundles were less compact. Our results demonstrate the strong meniscal modifications induced by ACLT at an early stage of OA and highlight the relationship between structural and chemical matrix alterations and mechanical properties.
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Affiliation(s)
- A Levillain
- LTDS, UMR CNRS 5513, Université de Lyon, Ecole centrale de Lyon, 36av Guy de Collongue, 69134 Ecully Cedex, France
| | - H Magoariec
- LTDS, UMR CNRS 5513, Université de Lyon, Ecole centrale de Lyon, 36av Guy de Collongue, 69134 Ecully Cedex, France
| | - C Boulocher
- Research unit ICE, UPSP 2011.03.101, Université de Lyon, veterinary campus of VetAgro Sup, 69 280 Marcy l'Etoile, France
| | - A Decambron
- B2OA, UMR 7052, ENVA, 7Avenue du Général de Gaulle, 94700 Maisons-Alfort, France
| | - V Viateau
- B2OA, UMR 7052, ENVA, 7Avenue du Général de Gaulle, 94700 Maisons-Alfort, France
| | - T Hoc
- LTDS, UMR CNRS 5513, Université de Lyon, Ecole centrale de Lyon, 36av Guy de Collongue, 69134 Ecully Cedex, France.
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Teuschl A, Heimel P, Nürnberger S, van Griensven M, Redl H, Nau T. A Novel Silk Fiber-Based Scaffold for Regeneration of the Anterior Cruciate Ligament: Histological Results From a Study in Sheep. Am J Sports Med 2016; 44:1547-57. [PMID: 26957219 DOI: 10.1177/0363546516631954] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Because of ongoing problems with anterior cruciate ligament (ACL) reconstruction, new approaches in the treatment of ACL injuries, particularly strategies based on tissue engineering, have gained increasing research interest. To allow for ACL regeneration, a structured scaffold that provides a mechanical basis, has cells from different sources, and comprises mechanical as well as biological factors is needed. Biological materials, biodegradable polymers, and composite materials are being used and tested as scaffolds. The optimal scaffold for ACL regeneration should be biocompatible and biodegradable to allow tissue ingrowth but also needs to have the right mechanical properties to provide immediate mechanical stability. HYPOTHESES The study hypotheses were that (1) a novel degradable silk fiber-based scaffold with mechanical properties similar to the native ACL will be able to initiate ligament regeneration after ACL resection and reconstruction under in vivo conditions and (2) additional cell seeding of the scaffold with autologous stromal vascular fraction-containing adipose-derived stem cells will increase regenerative activity. STUDY DESIGN Controlled laboratory study. METHODS A total of 33 mountain sheep underwent ACL resection and randomization to 2 experimental groups: (1) ACL reconstruction with a scaffold alone and (2) ACL reconstruction with a cell-seeded scaffold. Histological evaluation of the intra-articular portion of the reconstructed/regenerated ligament was performed after 6 and 12 months. RESULTS After 6 months, connective tissue surrounded the silk scaffold with ingrowth in some areas. The cell-seeded scaffolds had a significant lower silk content compared with the unseeded scaffolds and demonstrated a higher content of newly formed tissue. After 12 months, the density of the silk fibers decreased significantly, and the ingrowth of newly formed tissue increased in both groups. No differences between the 2 groups regarding silk fiber degradation and regenerated tissue were detected at 12 months. CONCLUSION The novel silk fiber-based scaffold was able to stimulate ACL regeneration under in vivo conditions. Additional cell seeding led to increased tissue regeneration and decreased silk fiber content at 6 months, whereas these differences were not present at 12 months. CLINICAL RELEVANCE ACL regeneration using a silk fiber-based scaffold with and without additional cell seeding may provide a new treatment option after joint injuries.
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Affiliation(s)
- Andreas Teuschl
- Department of Biochemical Engineering, University of Applied Sciences Technikum Wien, Vienna, Austria Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Vienna, Austria Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Patrick Heimel
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Vienna, Austria Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Medical University of Vienna, Vienna, Austria
| | - Silvia Nürnberger
- Austrian Cluster for Tissue Regeneration, Vienna, Austria Department of Traumatology, Medical University of Vienna, Vienna, Austria
| | - Martijn van Griensven
- Department of Experimental Trauma Surgery, Technical University of Munich, Munich, Germany
| | - Heinz Redl
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Vienna, Austria Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Thomas Nau
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Vienna, Austria Austrian Cluster for Tissue Regeneration, Vienna, Austria
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Levingstone TJ, Ramesh A, Brady RT, Brama PA, Kearney C, Gleeson JP, O'Brien FJ. Cell-free multi-layered collagen-based scaffolds demonstrate layer specific regeneration of functional osteochondral tissue in caprine joints. Biomaterials 2016; 87:69-81. [DOI: 10.1016/j.biomaterials.2016.02.006] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 01/31/2016] [Accepted: 02/04/2016] [Indexed: 12/24/2022]
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Martin RK, Gillis D, Leiter J, Shantz JS, MacDonald P. A Porcine Knee Model Is Valid for Use in the Evaluation of Arthroscopic Skills: A Pilot Study. Clin Orthop Relat Res 2016; 474:965-70. [PMID: 26260394 PMCID: PMC4773334 DOI: 10.1007/s11999-015-4498-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Previously validated knee arthroscopy evaluation tools have used human cadaveric knees. This is unsustainable because of the cost and scarcity of these specimens. Porcine (pig) knees are anatomically similar, affordable, and easily obtainable; however, whether porcine knees represent a suitable alternative to human specimens has not been evaluated. QUESTIONS/PURPOSES The purpose of this study was to determine whether porcine knees are similar to human cadaveric knees for the assessment of knee arthroscopy skills by evaluating (1) the validity of the porcine model (whether trainees of the same level of ability scored similarly when using the two models) and (2) the reliability of the porcine model (whether surgeons with experience achieved higher scores than surgeons with less experience in the porcine model). METHODS Eleven orthopaedic surgery residents (five junior residents and six senior residents), one orthopaedic sports medicine fellow, and three attending orthopaedic surgeons were enrolled. Participants were provided instructions for a proper arthroscopic examination of the knee and asked to identify, and then probe, the listed anatomic structures on both the human and porcine knee specimens. Each participant was asked to demonstrate the following skills: joint manipulation, instrument control and triangulation, fluid management, maintenance of field of view, economy of movement, and efficiency. The Objective Assessment of Arthroscopic Skills (OAAS) and checklist for diagnostic arthroscopy of the knee were used for skills assessment by one observer. Internal consistency, a measure of how well the assessment tool measures the skills being studied, was determined by Cronbach's α and group differences investigated by paired t-test and Wilcoxon signed-rank tests where appropriate. Based on a sample size calculation, a total of 37 subjects would be required for the full-scale research study to achieve a power of 0.80, with α set at 0.05, to detect a difference in OAAS score of 4.73 (25%). This value is outside of the 95% confidence intervals for the human knee. RESULTS We found the porcine model to have a high level of face validity. There was no difference with the numbers available in total OAAS scores (mean ± SD; 95% confidence interval [CI]) within subjects between the human (18.93 ± 7.54; 14.76-23.11) and porcine (17.87 ± 6.36; 14.34-21.39) knees (p = 0.433). There was also no difference (p = 0.234) with the numbers available in overall OAAS score among participants working on either human (2.60 ± 1.35; 1.85-3.35) or porcine (2.33 ± 0.90; 1.84-2.83) specimens. Internal consistency of the simulation for both the human and porcine knees was high and did not differ between groups (Cronbach's α was 0.919 in the human knee and 0.954 in the porcine knee), suggesting the OAAS outcome score specifically assesses arthroscopic skill of participants in both the human and porcine models. More experienced arthroscopists scored higher than did less experienced trainees; there was high correlation (Pearson's correlation coefficient r, 95% CI) between years of experience and total OAAS scores in human (0.78; 0.46-0.92) and porcine (0.80; 0.49-0.93) diagnostic arthroscopy models. CONCLUSIONS The porcine cadaveric knee model was a valid surrogate for the human knee in arthroscopic skills assessment. CLINICAL RELEVANCE Trainees can be objectively evaluated using an affordable model that allows summative and formative feedback in the laboratory at a fraction of the cost of previously validated methods.
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Affiliation(s)
- R Kyle Martin
- Orthopaedic Surgery, University of Manitoba, 75 Poseidon Bay, Winnipeg, MB, R3M 0H3, Canada.
| | - Danny Gillis
- Orthopaedic Surgery, Emory University, Atlanta, GA, USA
| | - Jeff Leiter
- Orthopaedic Surgery, University of Manitoba, 75 Poseidon Bay, Winnipeg, MB, R3M 0H3, Canada
| | | | - Peter MacDonald
- Orthopaedic Surgery, University of Manitoba, 75 Poseidon Bay, Winnipeg, MB, R3M 0H3, Canada
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Civitarese D, Donahue TLH, LaPrade CM, Saroki AJ, Moulton SG, Schon JM, LaPrade RF. Qualitative and quantitative measurement of the anterior and posterior meniscal root attachments of the New Zealand white rabbit. J Exp Orthop 2016; 3:10. [PMID: 26928558 PMCID: PMC4771646 DOI: 10.1186/s40634-016-0046-4] [Citation(s) in RCA: 2] [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: 01/18/2016] [Accepted: 02/24/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to quantify the meniscal root anatomy of the New Zealand white rabbit to better understand this animal model for future in vitro and in vivo joint degeneration studies. METHODS Ten non-paired fresh frozen New Zealand white rabbit knee stifle joints were carefully disarticulated for this study. Measurements were made for all bony landmarks and ligamentous structure attachment sites on the tibial plateau. The following soft tissue structures were consistently identified in the rabbit stifle joint: the anterior root attachment of the lateral meniscus, the anterior root attachment of the medial meniscus, the anterior cruciate ligament, the posterior root attachment of the medial meniscus, the ligament of Wrisberg, the posterior cruciate ligament, and the posterior meniscotibial ligament. The following bony landmarks were consistently identified: the extensor digitorum longus groove, the medial tibial eminence, the center of the tibial tuberosity, and the lateral tibial eminence. RESULTS The center of the anterior cruciate ligament and the medial tibial eminence apex were found to be 3.4 ± 0.3 mm (2.9-3.6) and 6.1 ± 0.6 mm (5.1-7.0) respectively from the center of the medical anterior root attachment. The center of the anterior cruciate ligament and the lateral tibial eminence apex were found to be 2.1 ± 0.5 mm (1.2-2.7) and 7.0 ± 0.6 mm (6.4-8.2) respectively from the center of the lateral anterior root attachment. The center of the posterior cruciate ligament and the medial tibial eminence apex were found to be 2.0 ± 0.7 mm (0.5-2.6) and 1.8 ± 0.4 mm (1.2-2.4) respectively from the center of the medial posterior root attachment. CONCLUSIONS This study augments our understanding of the comparative anatomy of the rabbit stifle joint. This information will be useful for future biomechanical, surgical, and in vitro studies utilizing the rabbit stifle as a model for human knee joint degenerative diseases.
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Affiliation(s)
- David Civitarese
- Department of Biomedical Engineering, Steadman Philippon Research Institute, 181 West Meadow Drive Suite 1000, Vail, CO, 81657, USA.
| | - Tammy L Haut Donahue
- Department of Mechanical Engineering, Colorado State University, Building A106 Engineering, Fort Collins, CO, 80523, USA.
| | - Christopher M LaPrade
- Department of Biomedical Engineering, Steadman Philippon Research Institute, 181 West Meadow Drive Suite 1000, Vail, CO, 81657, USA.
| | - Adriana J Saroki
- Department of Biomedical Engineering, Steadman Philippon Research Institute, 181 West Meadow Drive Suite 1000, Vail, CO, 81657, USA.
| | - Samuel G Moulton
- Department of Biomedical Engineering, Steadman Philippon Research Institute, 181 West Meadow Drive Suite 1000, Vail, CO, 81657, USA.
| | - Jason M Schon
- Department of Biomedical Engineering, Steadman Philippon Research Institute, 181 West Meadow Drive Suite 1000, Vail, CO, 81657, USA.
| | - Robert F LaPrade
- Department of Biomedical Engineering, Steadman Philippon Research Institute, 181 West Meadow Drive Suite 1000, Vail, CO, 81657, USA. .,The Steadman Clinic, 181 West Meadow Drive Suite 400, Vail, CO, 81657, USA.
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Kuyinu EL, Narayanan G, Nair LS, Laurencin CT. Animal models of osteoarthritis: classification, update, and measurement of outcomes. J Orthop Surg Res 2016; 11:19. [PMID: 26837951 PMCID: PMC4738796 DOI: 10.1186/s13018-016-0346-5] [Citation(s) in RCA: 345] [Impact Index Per Article: 43.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 01/11/2016] [Indexed: 12/13/2022] Open
Abstract
Osteoarthritis (OA) is one of the most commonly occurring forms of arthritis in the world today. It is a debilitating chronic illness causing pain and immense discomfort to the affected individual. Significant research is currently ongoing to understand its pathophysiology and develop successful treatment regimens based on this knowledge. Animal models have played a key role in achieving this goal. Animal models currently used to study osteoarthritis can be classified based on the etiology under investigation, primary osteoarthritis, and post-traumatic osteoarthritis, to better clarify the relationship between these models and the pathogenesis of the disease. Non-invasive animal models have shown significant promise in understanding early osteoarthritic changes. Imaging modalities play a pivotal role in understanding the pathogenesis of OA and the correlation with pain. These imaging studies would also allow in vivo surveillance of the disease as a function of time in the animal model. This review summarizes the current understanding of the disease pathogenesis, invasive and non-invasive animal models, imaging modalities, and pain assessment techniques in the animals.
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Affiliation(s)
- Emmanuel L Kuyinu
- Institute for Regenerative Engineering, University of Connecticut Health, Farmington, CT, USA. .,Raymond and Beverly Sackler Center for Biomedical, Biological, Physical and Engineering Sciences, University of Connecticut Health, Farmington, CT, USA. .,Department of Orthopaedic Surgery, University of Connecticut Health, Farmington, CT, USA.
| | - Ganesh Narayanan
- Institute for Regenerative Engineering, University of Connecticut Health, Farmington, CT, USA. .,Raymond and Beverly Sackler Center for Biomedical, Biological, Physical and Engineering Sciences, University of Connecticut Health, Farmington, CT, USA. .,Department of Orthopaedic Surgery, University of Connecticut Health, Farmington, CT, USA.
| | - Lakshmi S Nair
- Institute for Regenerative Engineering, University of Connecticut Health, Farmington, CT, USA. .,Raymond and Beverly Sackler Center for Biomedical, Biological, Physical and Engineering Sciences, University of Connecticut Health, Farmington, CT, USA. .,Department of Orthopaedic Surgery, University of Connecticut Health, Farmington, CT, USA. .,Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA. .,Department of Materials Science and Engineering, University of Connecticut, Storrs, CT, USA. .,Institute of Materials Science, University of Connecticut, Storrs, CT, USA.
| | - Cato T Laurencin
- Institute for Regenerative Engineering, University of Connecticut Health, Farmington, CT, USA. .,Raymond and Beverly Sackler Center for Biomedical, Biological, Physical and Engineering Sciences, University of Connecticut Health, Farmington, CT, USA. .,Department of Orthopaedic Surgery, University of Connecticut Health, Farmington, CT, USA. .,Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA. .,Department of Materials Science and Engineering, University of Connecticut, Storrs, CT, USA. .,Institute of Materials Science, University of Connecticut, Storrs, CT, USA. .,Department of Craniofacial Sciences, School of Dental Medicine, University of Connecticut Health, Farmington, CT, USA. .,Department of Chemical and Biomolecular Engineering, University of Connecticut, Storrs, CT, USA.
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