The organization of collagen in cryofractured rabbit articular cartilage: a scanning electron microscopic study

Assessing post-traumatic changes in cartilage using T1ρ dispersion parameters

Degeneration of cartilage can be studied non-invasively with quantitative MRI. A promising parameter for detecting early osteoarthritis in articular cartilage is T_1ρ, which can be tuned via the amplitude of the spin-lock pulse. By measuring T_1ρ at several spin-lock amplitudes, the dispersion of T_1ρ is obtained. The aim of this study is to find out if the dispersion contains diagnostically relevant information complementary to a T_1ρ measurement at a single spin-lock amplitude. To this end, five differently acquired dispersion parameters are utilized; A, B, τ_c, T_1ρ/T₂, and R₂ - R_1ρ. An open dataset of an equine model of post-traumatic cartilage was utilized to assess the T_1ρ dispersion parameters for the evaluation of cartilage degeneration. Firstly, the parameters were compared for their sensitivity in detecting degenerative changes. Secondly, the relationship of the dispersion parameters to histological and biomechanical reference parameters was studied. Parameters A, T_1ρ/T₂, and R₂ - R_1ρ were found to be sensitive to lesion-induced changes in the cartilage within sample. Strong correlations of several dispersion parameters with optical density, as well as with collagen fibril angle were found. Most of the dispersion parameters correlated strongly with individual T_1ρ values. The results suggest that dispersion parameters can in some cases provide a more accurate description of the biochemical composition of cartilage as compared to conventional MRI parameters. However, in most cases the information given by the dispersion parameters is more of a refinement than complementary to conventional quantitative MRI.

Biofabrication of the osteochondral unit and its applications: Current and future directions for 3D bioprinting

Multiple prevalent diseases, such as osteoarthritis (OA), for which there is no cure or full understanding, affect the osteochondral unit; a complex interface tissue whose architecture, mechanical nature and physiological characteristics are still yet to be successfully reproduced in vitro. Although there have been multiple tissue engineering-based approaches to recapitulate the three dimensional (3D) structural complexity of the osteochondral unit, there are various aspects that still need to be improved. This review presents the different pre-requisites necessary to develop a human osteochondral unit construct and focuses on 3D bioprinting as a promising manufacturing technique. Examples of 3D bioprinted osteochondral tissues are reviewed, focusing on the most used bioinks, chosen cell types and growth factors. Further information regarding the applications of these 3D bioprinted tissues in the fields of disease modelling, drug testing and implantation is presented. Finally, special attention is given to the limitations that currently hold back these 3D bioprinted tissues from being used as models to investigate diseases such as OA. Information regarding improvements needed in bioink development, bioreactor use, vascularisation and inclusion of additional tissues to further complete an OA disease model, are presented. Overall, this review gives an overview of the evolution in 3D bioprinting of the osteochondral unit and its applications, as well as further illustrating limitations and improvements that could be performed explicitly for disease modelling.

An in silico Framework of Cartilage Degeneration That Integrates Fibril Reorientation and Degradation Along With Altered Hydration and Fixed Charge Density Loss

Injurious mechanical loading of articular cartilage and associated lesions compromise the mechanical and structural integrity of joints and contribute to the onset and progression of cartilage degeneration leading to osteoarthritis (OA). Despite extensive in vitro and in vivo research, it remains unclear how the changes in cartilage composition and structure that occur during cartilage degeneration after injury, interact. Recently, in silico techniques provide a unique integrated platform to investigate the causal mechanisms by which the local mechanical environment of injured cartilage drives cartilage degeneration. Here, we introduce a novel integrated Cartilage Adaptive REorientation Degeneration (CARED) algorithm to predict the interaction between degenerative variations in main cartilage constituents, namely collagen fibril disorganization and degradation, proteoglycan (PG) loss, and change in water content. The algorithm iteratively interacts with a finite element (FE) model of a cartilage explant, with and without variable depth to full-thickness defects. In these FE models, intact and injured explants were subjected to normal (2 MPa unconfined compression in 0.1 s) and injurious mechanical loading (4 MPa unconfined compression in 0.1 s). Depending on the mechanical response of the FE model, the collagen fibril orientation and density, PG and water content were iteratively updated. In the CARED model, fixed charge density (FCD) loss and increased water content were related to decrease in PG content. Our model predictions were consistent with earlier experimental studies. In the intact explant model, minimal degenerative changes were observed under normal loading, while the injurious loading caused a reorientation of collagen fibrils toward the direction perpendicular to the surface, intense collagen degradation at the surface, and intense PG loss in the superficial and middle zones. In the injured explant models, normal loading induced intense collagen degradation, collagen reorientation, and PG depletion both on the surface and around the lesion. Our results confirm that the cartilage lesion depth is a crucial parameter affecting tissue degeneration, even under physiological loading conditions. The results suggest that potential fibril reorientation might prevent or slow down fibril degradation under conditions in which the tissue mechanical homeostasis is perturbed like the presence of defects or injurious loading.

Human articular cartilage is orthotropic where microstructure, micromechanics, and chemistry vary with depth and split-line orientation

OBJECTIVE

Quantitative, micrometer length scale assessment of human articular cartilage is essential to enable progress toward new functional tissue engineering approaches, including utilization of emerging 3D bioprinting technologies, and for improved computational modeling of the osteochondral unit. Thus the objective of this study was to characterize the structural organization, material properties, and chemical composition of human skeletally mature articular cartilage with respect to depth and defined morphological features: normal to the articulating surface, parallel to the split-line, and transverse to the split-line.

METHOD

Three samples from the lateral femoral condyles of 4 healthy adult donors (55-61 years old) were evaluated via histology, second harmonic generation, microindentation, and Raman spectroscopy. All metrics were evaluated as a function of depth and direction relative to the split-line.

RESULTS

All donors presented with intact and healthy tissue. Collagen fiber orientation varied significantly between testing directions and with increasing depth from the articular surface. Both compressive and tensile modulus increased significantly with depth and differed across the middle and deep zones and depended on orthogonal direction relative to the split-line. Similarly, matrix components varied with both depth and direction, where chondroitin sulfate steadily increased with depth while collagen prevalence was highest in the surface layer.

CONCLUSIONS

Microscale measurements of human articular cartilage demonstrate that properties are both depth-dependent and orthotropic and depend on the underlying tissue structure and composition. These findings improve upon existing knowledge establishing more accurate measurements, with greater degree of depth and spatial specificity, as inputs for tissue engineering and computational modeling.

Review of the biomechanics and patterns of limb fractures

The pattern of a limb fracture can be determined by the material property of the bone and the characteristics of the deforming force. In this review we outline the composition and material properties of cortical and cancellous bone, and articular cartilage. We defi ne the biomechanics of fractures and describe the various fracture patterns that are seen clinically.

A micro-architecturally biomimetic collagen template for mesenchymal condensation based cartilage regeneration

The unique arcade-like orientation of collagen fibers enables cartilage to bear mechanical loads. In this study continuous-length aligned collagen threads were woven to emulate the interdigitated arcade structure of the cartilage. The weaving pattern provided a macropore network within which micromass cell pellets were seeded to take advantage of mesenchymal condensation driven chondrogenesis. Compression tests showed that the baseline scaffold had a modulus of 0.83±0.39MPa at a porosity of 80%. The modulus of pellet seeded scaffolds increased by 60% to 1.33±0.37MPa after 28days of culture, converging to the modulus of the native cartilage. The scaffolds displayed duress under displacement controlled low-cycle fatigue at 15% strain amplitude such that load reduction stabilized at 8% after 4500 cycles of loading. The woven structure demonstrated a substantial elastic recoil where 40% mechanical strain was close to completely recovered following unloading. A robust chondrogenesis was observed as evidenced by positive staining for GAGs and type II collagen and aggrecan. Dimethyl methylene blue and sircol assays showed GAGs and collagen productions to increase from 3.36±1.24 and 31.46±3.22 at day 3 to 56.61±12.12 and 136.70±12.29μg/μg of DNA at day 28 of culture. This woven collagen scaffold holds a significant potential for cartilage regeneration with shorter in vitro culture periods due to functionally sufficient mechanical robustness at the baseline. In conclusion, the mimicry of cartilage's arcade architecture resulted in substantial improvement of mechanical function while enabling one of the first pellet delivery platforms enabled by a macroporous network.

STATEMENT OF SIGNIFICANCE

Mesenchymal condensation is critical for driving chondrogenesis, making high density cell seeding a standard in cartilage tissue engineering. Efforts to date have utilized scaffold free delivery of MSCs in pellet form. This study developed a macroporous scaffold that is fabricated by weaving highly aligned collagen threads. The scaffold can deliver high density cell condensates while providing mechanical stiffness comparable to that of cartilage. The scaffold also mimicked the arcade-like orientation of collagen fibers in cartilage. A highly robust chondrogenesis was observed in this mesenchymal cell pellet delivery system. Baseline mechanical robustness of this scaffold system will enable delivery of cell pellets as early as three days.

Shape of chondrocytes within articular cartilage affects the solid but not the fluid microenvironment under unconfined compression

Metabolic activity of the chondrocytes in articular cartilage is strongly related to their zone-specific shape and the composition and mechanical properties of their surrounding extracellular matrix (ECM). However the mechanisms by which cell shape influences the response of the ECM microenvironment to mechanical loading is yet to be elucidated. This relationship was studied using a biphasic multiscale finite element model of different shaped chondrocytes in the superficial and deep zones of the ECM during unconfined stress relaxation. For chondrocytes in the superficial zone, increasing the cell's initial aspect ratio (length/height) increased the deformation and solid stresses of the chondrocyte and pericellular matrix (PCM) during the loading phase; for chondrocytes in the deep zone the effect of the cell shape on the solid microenvironment was time and variable dependent. However, for superficial and deep zone chondrocytes the cell shape did not affect the fluid pressure and fluid shear stress. These results suggest that mechanotransduction of chondrocytes in articular cartilage may be regulated through the solid phase rather than the fluid phase, and that high stresses and deformations in the solid microenvironment in the superficial zone may be essential for the zone-specific biosynthetic activity of the chondrocyte. The biphasic multiscale computational analysis suggests that maintaining the cell shape is critical for regulating the microenvironment and metabolic activity of the chondrocyte in tissue engineering constructs.

STATEMENT OF SIGNIFICANCE

We investigated the effect of chondrocyte shape on the cellular microenvironment using a biphasic multiscale finite element analysis. Our study showed that cell shapes affects the solid but not the fluid microenvironment of the chondrocyte, and that maintaining the cell shape is critical for regulating the microenvironment and metabolic activity of the chondrocyte in native cartilage and tissue engineering constructs. As far as we know, this is the first study on the mechanotransduction mechanisms by which cell shape influences the response of the microenvironment to mechanical loading. This study is important for understanding cell mechanobiology, not only for regulation of cell phenotype in tissue engineered constructs but, as important, for understanding changes in normal chondrocyte function after post-traumatic injury and in the initiation and progression of osteoarthritis.

A biphasic finite element study on the role of the articular cartilage superficial zone in confined compression

The aim of this study was to investigate the role of the superficial zone on the mechanical behavior of articular cartilage. Confined compression of articular cartilage was modeled using a biphasic finite element analysis to calculate the one-dimensional deformation of the extracellular matrix (ECM) and movement of the interstitial fluid through the ECM and articular surface. The articular cartilage was modeled as an inhomogeneous, nonlinear hyperelastic biphasic material with depth and strain-dependent material properties. Two loading conditions were simulated, one where the superficial zone was loaded with a porous platen (normal test) and the other where the deep zone was loaded with the porous platen (upside down test). Compressing the intact articular cartilage with 0.2 MPa stress reduced the surface permeability by 88%. Removing the superficial zone increased the rate of change for all mechanical parameters and decreased the fluid support ratio of the tissue, resulting in increased tissue deformation. Apparent permeability linearly increased after superficial removal in the normal test, yet it did not change in the upside down test. Orientation of the specimen affected the time-dependent biomechanical behavior of the articular cartilage, but not equilibrium behavior. The two tests with different specimen orientations resulted in very different apparent permeabilities, suggesting that in an experimental study which quantifies material properties of an inhomogeneous material, the specimen orientation should be stated along with the permeability result. The current study provides new insights into the role of the superficial zone on mechanical behavior of the articular cartilage.

Comparative study by computed radiography, histology, and scanning electron microscopy of the articular cartilage of normal goats and in chronic infection with caprine arthritis-encephalitis virus

In the northeast of Brazil, caprine arthritis-encephalitis (CAE) is one of the key reasons for herd productivity decreasing that result in considerable economic losses. A comparative study was carried out using computed radiography (CR), histological analysis (HA), and scanning electronic microscopy (SEM) of the joints of CAE infected and normal goats. Humerus head surface of positive animals presented reduced joint space, increased bone density, and signs of degenerative joint disease (DJD). The carpal joint presented no morphological alterations in CR in any of the animals studied. Tarsus joint was the most affected, characterized by severe DJD, absence of joint space, increased periarticular soft tissue density, edema, and bone sclerosis. Histological analysis showed chronic tissue lesions, complete loss of the surface zone, absence of proteoglycans in the transition and radial zones and destruction of the cartilage surface in the CAE positive animals. Analysis by SEM showed ulcerated lesions with irregular and folded patterns on the joint surface that distinguished the limits between areas of normal and affected cartilage. The morphological study of the joints of normal and CAE positive goats deepened understanding of the alteration in the tissue bioarchitecture of the most affected joints. The SEM finding sustained previous histological reports, similar to those found for rheumatoid arthritis, suggesting that the goat infected with CAE can be considered as a potential model for research in this area.

Prevention of cartilage dehydration in imaging studies with a customized humidity chamber

Quantitative three-dimensional imaging methods such as micro-computed tomography (μCT) allow for the rapid and comprehensive evaluation of cartilage and bone in animal models, which can be used for drug development and related research in arthritis. However, when imaging fresh cartilage tissue in air, a common problem is tissue dehydration which causes movement artifact in the resulting images. These artifacts distort scans and can render them unusable, leading to a considerable loss of time and effort with sample preparation and measurement. The sample itself is also irretrievably damaged by the dehydration, often unable to return to its full tissue thickness upon rehydration. Additionally, imaging with ionic contrast agents such as Hexabrix(TM) must be performed in air, otherwise the agent will be washed out if immersed in a liquid. The first goal of this study was to design a customized humidity chamber to maintain cartilage hydration without the need for immersion. Following this, the use of the humidity chamber during a synchrotron radiation-μCT scan was validated and its performance evaluated. Results showed that the loss of fluid film volume is associated with scanning at low humidity (87%), and can be avoided using the humidity chamber. Coupling this technology with advances in synchrotron imaging (e.g., phase contrast imaging) or contrast agents is promising.

The layered structure of the articular surface

OBJECTIVE

Articular cartilage is roughly separated into three areas: the tangential, middle, and deep zones. The structure and molecular components of an additional important zone, the most superficial zone (MSZ), which directly faces the joint cavity, have yet to be conclusively elucidated. The purpose of the present study was to use multiple methods to study the MSZ in order to determine its structure.

MATERIALS AND METHODS

Knees from 16 pigs (age, 6 months) were used. Full-thickness cartilage specimens were harvested from the femoral groove. The MSZ was observed using light microscopy, transmission electron microscopy (TEM), and scanning electron microscopy (SEM) in combination with histochemical and immunohistochemical methods.

RESULTS

The combined findings from the three different observational methods indicate that the MSZ is subdivided into three layers. Among these three layers, collagen subtypes I, II, and III are present in the innermost (third) layer of the MSZ. Beneath the third layer, type II collagen is the predominant type, with small amounts of type III collagen. This layer beneath the third layer is considered to be the tangential layer.

CONCLUSIONS

Our observations indicate that the MSZ is subdivided into three layers. Further analysis of the molecular components in each layer may improve our understanding of the structure of the articular surface.

Quantitative MRI techniques of cartilage composition

Due to aging populations and increasing rates of obesity in the developed world, the prevalence of osteoarthritis (OA) is continually increasing. Decreasing the societal and patient burden of this disease motivates research in prevention, early detection of OA, and novel treatment strategies against OA. One key facet of this effort is the need to track the degradation of tissues within joints, especially cartilage. Currently, conventional imaging techniques provide accurate means to detect morphological deterioration of cartilage in the later stages of OA, but these methods are not sensitive to the subtle biochemical changes during early disease stages. Novel quantitative techniques with magnetic resonance imaging (MRI) provide direct and indirect assessments of cartilage composition, and thus allow for earlier detection and tracking of OA. This review describes the most prominent quantitative MRI techniques to date-dGEMRIC, T2 mapping, T1rho mapping, and sodium imaging. Other, less-validated methods for quantifying cartilage composition are also described-Ultrashort echo time (UTE), gagCEST, and diffusion-weighted imaging (DWI). For each technique, this article discusses the proposed biochemical correlates, as well its advantages and limitations for clinical and research use. The article concludes with a detailed discussion of how the field of quantitative MRI has progressed to provide information regarding two specific patient populations through clinical research-patients with anterior cruciate ligament rupture and patients with impingement in the hip. While quantitative imaging techniques continue to rapidly evolve, specific challenges for each technique as well as challenges to clinical applications remain.

The trochlear cleft: the “black line” of the trochlear trough

OBJECTIVE

The “cartilage black line sign” is a recently described T2 dark cartilage lesion that we have identified appearing as a cleft in the trochlear trough. The purpose of our study was to define the MR imaging characteristics of a trochlear cleft, determine its incidence, and correlate the MR findings with arthroscopy.

MATERIALS AND METHODS

A total of 1,300 consecutive MR examinations of the knee were retrospectively reviewed by consensus of two fellowship-trained musculoskeletal radiologists. The MR imaging characteristics and location of a trochlear cleft were determined. Imaging results were compared to arthroscopy when available. Patient age and gender were compared to 25 randomly selected control patients without trochlear clefts.

RESULTS

A total of 25 (1.9%) individuals (11 females and 14 males; age range 19–45 years; mean age 28 years) were diagnosed with a trochlear cleft. The control group consisted of 11 females and 14 males; age range 19–83 years; mean age 46 years. Mean cleft length was 7 mm (range 6–12 mm); cleft location was consistently in the lower trochlear trough. No full-thickness cartilage defects were identified in the eight individuals in whom arthroscopic correlation was available. A grade 2 cartilage lesion was identified in a single individual; another progressed from grade 0 to a full-thickness trochlear lesion over an 8-month interval. Eight individuals were athletes. No significant difference in gender was noted between the two groups, however, the study group was significantly younger p<0.0001.

CONCLUSIONS

A trochlear cleft is a rare finding in young active individuals. It most likely indicates an incomplete cartilage fissure which may rarely progress to a full-thickness defect.

ASSESSMENT OF THREE-DIMENSIONAL ARCHITECTURE OF COLLAGEN FIBERS IN THE SUPERFICIAL ZONE OF BOVINE ARTICULAR CARTILAGE

The aim of this study is to investigate the structure and the collagen matrix of the superficial zone of articular cartilage using a 3D imaging technique. The split line thought to represent the orientation of the collagen fibres in the superficial zone was found using Hultkrantz's method. A semitransparent membrane was physically peeled off from the most superficial surface of bovine articular cartilage. Using fibre optic laser scanning confocal microscopy, the collagen matrix in normal cartilage, the membrane and the cartilage with the membrane peeled off were studied. The superficial zone was found to contain a more sophisticated 3D collagenous matrix than previously reported. The collagen matrix in the membrane consists of interwoven long collagen bundles, and the collagen fibres immediately subjacent to it align spatially in a predominantly oblique direction to the articular surface. The split line does not represent the orientation of the collagen in the membrane. This study presents a 3D visualization technique for a minimal-invasive examination of the 3D architecture of the collagen fibres in the superficial zone of articular cartilage, and offers a new insight into the 3D structure of the collagen matrix in the superficial zone of native cartilage.

MRI appearance of normal articular cartilage

At each joint, the extracellular matrix of cartilage is arranged in a complex and characteristic organization that is specific for that joint. This structure exerts a strong influence on the appearance of magnetic resonance (MR) images through orientation-related alterations in T2 decay. As a result, the MR appearance of cartilage at each joint is predictable and specific for that joint. The diagnostic utility of MR imaging for evaluating cartilage is enhanced when the acquisition and review of the images is informed by an understanding of this relationship between normal structure and the MR appearance of cartilage.

MR imaging of articular cartilage physiology

The newer magnetic resonance (MR) imaging methods can give insights into the initiation, progression, and eventual treatment of osteoarthritis. Sodium imaging is specific for changes in proteoglycan (PG) content without the need for an exogenous contrast agent. T1ρ imaging is sensitive to early PG depletion. Delayed gadolinium-enhanced MR imaging has high resolution and sensitivity. T2 mapping is straightforward and is sensitive to changes in collagen and water content. Ultrashort echo time MR imaging examines the osteochondral junction. Magnetization transfer provides improved contrast between cartilage and fluid. Diffusion-weighted imaging may be a valuable tool in postoperative imaging.

Changes in articular cartilage mechanics with meniscectomy: A novel image-based modeling approach and comparison to patterns of OA

Meniscectomy is a significant risk factor for osteoarthritis, involving altered cell synthesis, central fibrillation, and peripheral osteophyte formation. Though changes in articular cartilage contact pressure are known, changes in tissue-level mechanical parameters within articular cartilage are not well understood. Recent imaging research has revealed the effects of meniscectomy on the time-dependent deformation of physiologically loaded articular cartilage. To determine tissue-level cartilage mechanics that underlie observed deformation, a novel finite element modeling approach using imaging data and a contacting indenter boundary condition was developed. The indenter method reproduces observed articular surface deformation and avoids assumptions about tangential stretching. Comparison of results from an indenter model with a traditional femur-tibia model verified the method, giving errors in displacement, solid and fluid stress, and strain below 1% (RMS) and 7% (max.) of the absolute maximum of the parameters of interest. Indenter finite element models using real joint image data showed increased fluid pressure, fluid exudation, loss of fluid load support, and increased tensile strains centrally on the tibial condyle after meniscectomy-patterns corresponding to clinical observations of cartilage matrix damage and fibrillation. Peripherally there was decreased consolidation, which corresponds to reduced contact and fluid pressure in this analysis. Clinically, these areas have exhibited advance of the subchondral growth front, biological destruction of the cartilage matrix, cartilage thinning, and eventual replacement of the cartilage via endochondral ossification. Characterizing the changes in cartilage mechanics with meniscectomy and correspondence with observed tissue-level effects may help elucidate the etiology of joint-level degradation seen in osteoarthritis.

Further studies on the anisotropic distribution of collagen in articular cartilage by μMRI

To further study the anisotropic distribution of the collagen matrix in articular cartilage, microscopic magnetic resonance imaging experiments were carried out on articular cartilages from the central load-bearing area of three canine humeral heads at 13 μm resolution across the depth of tissue. Quantitative T2 images were acquired when the tissue blocks were rotated, relative to B0, along two orthogonal directions, both perpendicular to the normal axis of the articular surface. The T2 relaxation rate (R2) was modeled, by three fibril structural configurations (solid cone, funnel, and fan), to represent the anisotropy of the collagen fibrils in cartilage from the articular surface to the cartilage/bone interface. A set of complex and depth-dependent characteristics of collagen distribution was found in articular cartilage. In particular, there were two anisotropic components in the superficial zone and an asymmetrical component in the radial zone of cartilage. A complex model of the three-dimensional fibril architecture in articular cartilage is proposed, which has a leaf-like or layer-like structure in the radial zone, arises in a radial manner from the subchondral bone, spreads and arches passing the isotropic transitional zone, and exhibits two distinct anisotropic components (vertical and transverse) in the surface portion of the tissue.

Anisotropic dynamic changes in the pore network structure, fluid diffusion and fluid flow in articular cartilage under compression

A compression cell designed to fit inside an NMR spectrometer was used to investigate the in situ mechanical strain response, structural changes to the internal pore structure, and the diffusion and flow of interstitial water in full-thickness cartilage samples as it was deforming dynamically under a constant compressive load (pressure). We distinguish between the hydrostatic pressure acting on the interstitial fluid and the pore pressure acting on the cartilage fibril network. Our results show that properties related to the pore matrix microstructure such as diffusion and hydraulic conductivity are strongly influenced by the hydrostatic pressure in the interstitial fluid of the dynamically deforming cartilage which differ significantly from the properties measured under static i.e. equilibrium loading conditions (when the hydrostatic pressure has relaxed back to zero). The magnitude of the hydrostatic fluid pressure also appears to affect the way cartilage's pore matrix changes during deformation with implications for the diffusion and flow-driven fluid transport through the deforming pore matrix. We also show strong evidence for a highly anisotropic pore structure and deformational dynamics that allows cartilage to deform without significantly altering the axial porosity of the matrix even at very large strains. The insensitivity of the axial porosity to compressive strain may be playing a critical function in directing the flow of pressurized interstitial fluid in the compressed cartilage to the surface, to support the load, and provide a protective interfacial fluid film that 'weeps' out from the deforming tissue and thereby enhances the (elasto)hydrodynamic efficacy of sliding joints. Our results appear to show a close synergy between the structure of cartilage and both the hydrodynamic and boundary lubrication mechanisms.

The collagen fibril structure in the superficial zone of articular cartilage by microMRI

OBJECTIVE

To investigate the fibril architecture of the collagen matrix in the superficial zone (SZ) of articular cartilage non-destructively by microscopic magnetic resonance imaging (microMRI) T(2) anisotropy.

METHOD

Six specimens of canine humeral cartilage were rotated in such a way that the normal axis of the articular surface of the cartilage specimen remained stationary and perpendicular to the static magnetic field, over a range of 180 degrees and at a step of 15 degrees. At each rotation angle, a quantitative T(2) image was constructed at 13 microm pixel resolution.

RESULTS

A set of complex and depth-dependent patterns was found in the microMRI T(2) anisotropy along the depth of the tissue. In the SZ, the T(2) anisotropy is clearly periodic, which demonstrates that the distribution of the collagen fibrils in the SZ is not random. In the transitional zone, the periodicity of the T(2) anisotropy approximately doubles with respect to that in the SZ. In the initial part of the radial zone (RZ), the T(2) anisotropy is also periodic but inverse to that in the SZ. In the deep part of the RZ, the T(2) anisotropy becomes increasingly weaker and eventually disappears.

CONCLUSION

There exists a certain degree of collagen anisotropy in all zones of articular cartilage. The anisotropic imaging data can be interpreted with the aid of a collagen architecture model.

Molecular NMR T2 values can predict cartilage stress-relaxation parameters

Articular cartilage lines synovial joints and functions as a low-friction deformable tissue to enable smooth and stable joint articulation. The objective of this study was to determine the relationships between cartilage stress-relaxation properties and the collagen and GAG NMR transverse relaxation times (T(2)) toward understanding mechanisms of cartilage viscoelasticity. Stress-relaxation tests were performed on both cultured and enzymatically digested bovine cartilage, followed by measurements of both the collagen and GAG T(2) using the Call-Purcell-Meiboom-Gill pulse sequence. The peak and equilibrium stresses were correlated with the GAG T(2), and the stress-relaxation time constant was correlated with the collagen T(2). Multiple linear regression models were successful in using the specific T(2) values to predict the stress-relaxation properties. As a model of osteoarthritis, enzymatic digestion with collagenase and testicular hyaluronidase had weak effects on T(2) values. These data present a complex picture of cartilage mechanical behavior, with cartilage stiffness associated with the GAG T(2) values and the stress-relaxation time constant associated with the collagen T(2).

Changes in pore morphology and fluid transport in compressed articular cartilage and the implications for joint lubrication

Cartilage sections were cut from the middle zone of pig knee articular cartilage and attached to substrates in two different kinds of newly designed 'pressure cells', one for fluorescence the other for NMR measurements. The fluorescence cell was filled with buffer solution containing fluorescently marked 70 kDa dextran which was allowed to diffuse into the cartilage pores. A second glass surface was then pressed down onto the thin cartilage sample under different loads (pressures), and the resulting compression (strain) and change in pore volume were measured as a function of time, simultaneously with measurements of the lateral diffusion and flow pattern of the dextran molecules using Fluorescence Recovery After Photobleaching (FRAP). Complementary experiments were made on the normal diffusion coefficients of pure electrolyte solutions (no dextran) in thicker cartilage sections with pulse-gradient NMR using a new pressure cell suitable for such measurements. Taken together our results show that the highly anisotropic structure of cartilage has a strong effect on the way fluid diffuses laterally and normally at different stages of compression. Our results also show how geometric constraints on a cartilage network and trapped high MW polymer such as HA during normal compressions are likely to affect both the normal and the lateral mobilities of polyelectrolytes and water.

Simulation of high tensile Poisson's ratios of articular cartilage with a finite element fibril-reinforced hyperelastic model

Analyses with a finite element fibril-reinforced hyperelastic model were undertaken in this study to simulate high tensile Poisson's ratios that have been consistently documented in experimental studies of articular cartilage. The solid phase was represented by an isotropic matrix reinforced with four sets of fibrils, two of them aligned in orthogonal directions and two oblique fibrils in a symmetric configuration respect to the orthogonal axes. Two distinct hyperelastic functions were used to represent the matrix and the fibrils. Results of the analyses showed that only by considering non-orthogonal fibrils was it possible to represent Poisson's ratios higher than one. Constrains in the grips and finite deformations played a minor role in the calculated Poisson's ratio. This study also showed that the model with oblique fibrils at 45 degrees was able to represent significant differences in Poisson's ratios near 1 documented in experimental studies. However, even considering constrains in the grips, this model was not capable to simulate Poisson's ratios near 2 that have been reported in other studies. The study also confirmed that only with a high relation between the stiffness of the fibers and that of the matrix was it possible to obtain high Poisson's ratios for the tissue. Results suggest that analytical models with a finite number of fibrils are appropriate to represent main mechanical effects of articular cartilage.

Multinuclear NMR and microscopic MRI studies of the articular cartilage nanostructure

Studies of the structure of articular cartilage by a number of NMR spectroscopic and imaging techniques are reviewed. Advantage is taken of the fact that the NMR investigations can be done non-invasively on the intact tissue and do not require sectioning, slicing and decalcification as in the case of electron microscopy. The different contributions to 1H T2 relaxation are described and it is pointed out that ignoring the biexponential behavior of the transverse relaxation can lead to serious errors in the proton density measurements and the T2 characterization of the articular cartilage. A way to slow the transverse relaxation and to minimize its angular dependence by the use of dipolar echo is described. 2H double quantum filtered spectroscopic MRI is a powerful technique to follow the orientation and density of the collagen fibers in articular cartilage. Using this technique, it was found that attachment of the cartilage to the bone has a stabilizing effect on the collagen matrix and that the hydroxyapatite in the calcified zone resides near the collagen fibers but does not contribute to their order. In response to mechanical pressure, it was shown that the collagen fibers flatten near the surface and become crimped near the bone. A number of NMR techniques have been described for the measurement of 23Na residual quadrupolar interaction. It was found that this can serve as a very sensitive measure of the depletion of proteoglycans. Finally, a combination of the above techniques was used to study a maturation of articular cartilage in pigs. The increased order and density of the collagen fibers from newborn to adult pigs revealed itself as a shortening of T2 and significant increase of the residual quadrupolar interaction of both 2H and 23Na nuclei.

Use of polarization-sensitive optical coherence tomography to determine the directional polarization sensitivity of articular cartilage and meniscus

The directional polarization sensitivity of articular cartilage and meniscus is investigated by use of polarization-sensitive optical coherence tomography (PS-OCT) by varying the angle of incident illumination. Experimental results show that when the incident light is perpendicular to the tissue surface, normal articular cartilage demonstrates little polarization sensitivity, while meniscus demonstrates strong polarization sensitivity. Differences in optical phase retardation produced by articular cartilage and meniscus are observed when the incident angle of the scanning light beam is adjusted between 0 and 90 deg relative to the tissue surface. Directional polarization sensitivity of articular cartilage and meniscus as obtained by PS-OCT imaging using variations in the angle of incident illumination can be used to assess the orientation and organization of the collagen matrix of these tissues. The polarization sensitivity as evidenced by the Stokes vector and optical phase retardation images can be explained by the orientation of the angle of illumination relative to the unique structural organization of the collagen fibrils and fibers of articular cartilage and meniscus.

Determination of characteristics of degenerative joint disease using optical coherence tomography and polarization sensitive optical coherence tomography

BACKGROUND AND OBJECTIVES

Previous studies have demonstrated that optical coherence tomography (OCT) could be used to delineate alterations in the microstructure of cartilage, and have suggested that changes in the polarization state of light as detected by OCT could provide information on the birefringence properties of articular cartilage as influenced by disease. In this study we have used both OCT and polarization sensitive optical coherence tomography (PS-OCT) technologies to evaluate normal and abnormal bovine articular cartilage according to established structural, organizational, and birefringent characteristics of degenerative joint disease (DJD) in order to determine if this technology can be used to differentiate various stages of DJD as a minimally invasive imaging tool.

MATERIALS AND METHODS

Fresh bovine femoral-tibial joints were obtained from an abattoir, and 45 cartilage specimens were harvested from 8 tibial plateaus. Whole ex vivo specimens of normal and degenerative articular cartilage were imaged by both OCT and PS-OCT, then fixed and processed for histological evaluation. OCT/PS-OCT images and corresponding histology sections of each specimen were scored according to a modified Mankin structural grading scale and compared.

RESULTS

OCT and PS-OCT imaging allowed structural evaluation of intact articular cartilage along a 6 mm surface length to a depth of 2 mm with a transverse resolution of 12 microm and an axial resolution of 10 microm. The OCT and PS-OCT images demonstrated characteristic alterations in the structure of articular cartilage with a high correlation to histological evaluation (kappa = 0.776). The OCT images were able to demonstrate early to advanced structural changes of articular cartilage while the optical phase retardation images obtained by PS-OCT imaging were able to discriminate areas where disorganization of the cartilage matrix was present, however, these characteristics are much different than those reported where OCT images alone were used to characterize tissue birefringence. No evidence of differences in OCT or PS-OCT images were detected between specimens of similar structural characteristics where proteoglycan was judged present or absent by safranin-O Fast Green staining.

CONCLUSIONS

The combined use of OCT and PS-OCT technologies to obtain images from a single system is able to demonstrate and discriminate between characteristics of very early stages of surface irregularities not previously reported for OCT imaging, to deep clefts and collagen matrix disorganization for tissue at depths of up to 2 mm with good correlation to histology. PS-OCT and accumulated optical phase retardation images of articular cartilage as constructed from alterations in Stokes vector parameters appear to give a valuable but different assessment of alterations in tissue birefringence and organization than have been reported for OCT images obtained with the use of polarized or non-polarized light sources. This is the first time that alterations in the polarization state of light reflected from within the tissue have been demonstrated to be consistent with changes observed in the orientation and organization of the collagen matrix in advanced stages of DJD. The degree of phase transformation of light reflected from within the tissue as determined by PS-OCT imaging does not appear to be altered by the presence or absence of proteoglycan.

Multinuclear NMR and MRI studies of the maturation of pig articular cartilage

The maturation of pig articular cartilage was followed by (2)H in-phase double quantum filtered (IP-DQF) spectroscopic MRI, (1)H T(2) MRI, and (23)Na DQF and triple quantum filtered MRS. The results all lead to the conclusion that the order and density of the collagen fibers in articular cartilage increase from birth to maturity. At birth, both (2)H IP-DQF signal and (1)H T(2) were homogeneous throughout the cartilage and their values independent of the orientation of the plug relative to the magnetic field. At maturation, the (2)H IP-DQF spectrum near the bone is composed of two pairs of quadrupolar split satellites and the (1)H T(2) relaxation is biexponential, indicating the presence of two groups of collagen fibers. The (2)H satellites are orientation dependent, indicating that the two groups of fibers are well ordered at maturation. The fast component of (1)H T(2) is also orientation dependent and thus we have concluded that this component results from residual dipolar interaction, while the slow T(2) component in mature cartilage, as well as the T(2) relaxation in immature cartilage, is governed by other mechanisms.

Opposing cartilages in the patellofemoral joint adapt differently to long-term cruciate deficiency: chondrocyte deformation and reorientation with compression

OBJECTIVE

The purposes of this study were to quantify patellofemoral histology in the feline knee 67 months post-anterior cruciate ligament transection (ACL-T) and to apply an in situ static load of physiological magnitude to the articular cartilage and evaluate the resulting cartilage and chondrocyte deformation.

DESIGN

Six cats were sacrificed 67+/-6 months post-unilateral ACL-T. Static compression was applied to the cartilage surfaces of the patellofemoral joint using a cylindrical metal indentor. After fixation, full thickness osteochondral blocks were harvested and sections cut from not-indented and indented areas. Chondrocyte shape, orientation and volumetric fraction as well as cartilage thickness were evaluated.

RESULTS

Experimental and contralateral patellae were histologically different compared to normal with thickened cartilage, rounded superficial chondrocytes, and uneven proteoglycan staining throughout. In contrast, no differences were apparent in 10 of the 12 femoral groove samples. The structural reorganisation of the experimental patellae cartilage that occurred with load was also different compared to normal. Specifically, the indentation shape was deeper and had steeper sides and the realignment of deep zone cells at angles of 45 degrees and 135 degrees observed in normal cartilage was no longer apparent in the experimental tissue.

CONCLUSIONS

Two directly articulating cartilage surfaces of the feline patellofemoral joint have completely contrasting responses to long-term ACL-T. We speculate that this could be a result of the different nature of the loads experienced by the two surfaces (intermittent vs constant) and/or the differences in the histology and material properties of the two tissues in their normal state, and/or an inherent difference in the biological response capabilities of the articular cartilages.

A fibril-reinforced poroviscoelastic swelling model for articular cartilage

From a mechanical point of view, the most relevant components of articular cartilage are the tight and highly organized collagen network together with the charged proteoglycans. Due to the fixed charges of the proteoglycans, the cation concentration inside the tissue is higher than in the surrounding synovial fluid. This excess of ion particles leads to an osmotic pressure difference, which causes swelling of the tissue. The fibrillar collagen network resists straining and swelling pressures. This combination makes cartilage a unique, highly hydrated and pressurized tissue, enforced with a strained collagen network. Many theories to explain articular cartilage behavior under loading, expressed in computational models that either include the swelling behavior or the properties of the anisotropic collagen structure, can be found in the literature. The most common tests used to determine the mechanical quality of articular cartilage are those of confined compression, unconfined compression, indentation and swelling. All theories currently available in the literature can explain the cartilage response occurring in some of the above tests, but none of them can explain these for all of the tests. We hypothesized that a model including simultaneous mathematical descriptions of (1) the swelling properties due to the fixed-change densities of the proteoglycans and (2) the anisotropic viscoelastic collagen structure, can explain all these test simultaneously. To study this hypothesis we extended our fibril-reinforced poroviscoelastic finite element model with our biphasic swelling model. We have shown that the newly developed fibril-reinforced poroviscoelastic swelling (FPVES) model for articular cartilage can simultaneously account for the reaction force during swelling, confined compression, indentation and unconfined compression as well as the lateral deformation during unconfined compression. Using this theory it is possible to analyze the link between the collagen network and the swelling properties of articular cartilage.

The effect of detachment of the articular cartilage from its calcified zone on the cartilage microstructure, assessed by 2H-spectroscopic double quantum filtered MRI

Most studies on articular cartilage properties have been conducted after detachment of the cartilage from the bone. In the present work we investigated the effect of detachment on collagen fiber architecture. We used one-dimensional (2)H double quantum filtered MRI on cartilage bone plugs equilibrated in deuterated saline. The quadrupolar splittings observed in the different zones were related to the degree of order and the density of the collagen fibers. The method is non-destructive, allowing for measurements on the same plug without the need for fixation, dehydration, sectioning and decalcification. Detachment of the radial from the calcified zone resulted in swelling of the cartilage plug in physiological saline and a concomitant decrease in the quadrupolar splitting. The effect of mechanical pressure on the (2)H quadrupolar splittings for the detached cartilage and for the calcified zone-bone plugs were compared with those of the same zones in the intact cartilage-bone plug. The splitting in the radial zone of the detached cartilage collapsed at much smaller loads compared to the intact cartilage-bone plug. The effect of the load on the size of the cartilage was also greater for the detached plug. These results indicate that anchoring of the cartilage to the bone through the calcified zone plays an important role in retaining the order of the collagen fibers. The water (2)H quadrupolar splitting in intact and proteoglycan-depleted cartilage was the same, indicating that the proteoglycans do not contribute to the ordering of the collagen fibers.

Stresses in the local collagen network of articular cartilage: a poroviscoelastic fibril-reinforced finite element study

Osteoarthritis (OA) is a multifactorial disease, resulting in diarthrodial joint wear and eventually destruction. Swelling of cartilage, which is proportional to the amount of collagen damage, is an initial event of cartilage degeneration, so damage to the collagen fibril network is likely to be one of the earliest signs of OA cartilage degeneration. We propose that the local stresses and strains in the collagen fibrils, which cause the damage, cannot be determined dependably without taking the local arcade-like collagen-fibril structure into account. We investigate this using a poroviscoelastic fibril-reinforced FEA model. The constitutive fibril properties were determined by fitting numerical data to experimental results of unconfined compression and indentation tests on samples of bovine patellar articular cartilage. It was demonstrated that with this model the stresses and strains in the collagen fibrils can be calculated. It was also exhibited that fibrils with different orientations at the same location can be loaded differently, depending on the local architecture of the collagen network. To the best of our knowledge, the present model is the first that can account for these features. We conclude that the local stresses and strains in the articular cartilage are highly influenced by the local morphology of the collagen-fibril network.

X-ray detection of structural orientation in human articular cartilage

OBJECTIVE

To determine the feasibility of detecting the structural orientation in cartilage with Diffraction Enhanced X-Ray Imaging.

DESIGN

Human tali and femoral head specimens were Diffraction Enhanced X-Ray Imaged (DEI) at the SYRMEP beamline at Elettra at various energy levels to detect the architectural arrangement of collagen within cartilage. DEI utilizes a monochromatic and highly collimated beam, with an analyzer crystal that selectively weights out photons according to the angle they have been deviated with respect to the original direction. This provides images of very high contrast, and with the rejection of X-ray scatter.

RESULTS

DEI allowed the visualization of articular cartilage and a structural orientation, resembling arcades, within.

CONCLUSION

Our diffraction enhanced images represent the first radiographic detection of the structural orientation in cartilage. Our data are in line with previous studies on the structural organization of joint cartilage. They confirm the model of a vaulting system of collagen fiber bundles interrupted by proteoglycan aggregates.

Mapping the fiber orientation in articular cartilage at rest and under pressure studied by 2H double quantum filtered MRI

The one-dimensional (2)H double quantum filtered (DQF) spectroscopic imaging technique was used to study the orientation of collagen fibers in articular cartilage. The method detects only water molecules in anisotropic environments, which in cartilage is caused by their interaction with the collagen fibers. A large quadrupolar splitting was observed in the calcified zone and a smaller splitting in the radial zone. In the transitional zone the splitting was not resolved and a small splitting was again detected in the superficial zone. From measurements performed at two orientations of the plug relative to the magnetic field it was deduced that in the calcified and radial zones the fibers are oriented perpendicular to the bone, bending at the transitional zone and flattening at the superficial zone. The effect of load applied to the cartilage-bone plug was monitored by the same technique. At low loads there is a small decrease in the quadrupolar splitting in the calcified zone, a marked decrease in the radial zone, and an increase of the splitting accompanied by a thickening of the superficial zone. Under high loads, while the thickening and the splitting of the superficial zone further increase, the splitting in the radial and calcified zones completely collapse. Pressure-induced changes in the thickness of the surface zone indicate flattening of the collagen fibers near the surface. The marked collapse of the splitting near the bone at high pressures may result from crimping of the collagen fibers.

The effects of immobilization on the characteristics of articular cartilage: current concepts and future directions

OBJECTIVE

The purpose of this paper is to review current data and concepts concerning the effect of immobilization on articular cartilage in animal models. We also evaluate the methods to measure articular cartilage changes in humans.

METHODS

Studies looking at the effects of immobilization on morphological, biochemical, and biomechanical characteristics of articular cartilage are reviewed.

RESULTS

Articular cartilage changes in immobilized animals include altered proteoglycan synthesis, as well as thinning and softening of the tissue. The overall thickness of articular cartilage in the knee decreases up to 9% after 11 weeks of immobilization and the deformation rate under test load increases up to 42%. Quantitative data about changes in human articular cartilage following immobilization are not available. This is mainly due to the lack of an accurate, reproducible, and non-invasive method to characterize articular cartilage.

DISCUSSION

An understanding of the alterations in articular cartilage following short and long term immobilization in humans is essential for the optimization of rehabilitation programs. Refined imaging techniques combined with state-of-the-art visualization tools could allow the systematical monitoring of articular cartilage morphology changes in immobilized humans.

Functional anatomy of articular cartilage under compressive loading Quantitative aspects of global, local and zonal reactions of the collagenous network with respect to the surface integrity

OBJECTIVE

To assess the influence of local compressive loading on the arrangement of the collagenous fibers in intact articular cartilage. To quantitate the zonal deformation of intact cartilage under load. To analyse the influence of removal of the tangential zone on the load-induced changes.

MATERIALS AND METHODS

380 cylinder shaped cartilage-on-bone samples (d=7 mm) were harvested from 20 bovine femoral heads. In 120 of them the tangential zone was removed. All samples were loaded for 20 min by 0.42 MPa or 0.98 MPa. After proteoglycan extraction, fixation in 4% formalin, dehydration by increasing concentrations of acetone, critical point drying, freeze-fracturing and gold-coating the samples were analysed by scanning-electron-microscopy.

RESULTS

Fiber bulging away from the center of load occurred in an area larger than the directly loaded one and its extent increased parallel to loading (P< 0.01). Crimp was seen only under the indenter and spread with increasing load from the intermediate zone into the tangential zone and radial zone. The absolute height of tangential zone and intermediate zone together remained constant under all loading situations at the costs of the radial zone. All changes due to loading were fully reversible. Removal of the tangential zone reduced the area of bulging (P< 0.01) but markedly increased the amount of crimp. Overall radial strain was not altered, but overall superficial tangential strain was increased by up to 20% (P< 0.01) and high peaks in the local distribution of superficial tensile strain developed.

CONCLUSIONS

The collagenous architecture is a dynamic property of the articular cartilage adapting to its respective loading situation. Crimp reflects local compressive strain. Under compressive loading larger portions of cartilage than the directly loaded areas are functionally included in the process of load transmission. During this process the tangential zone and the intermediate zone form a common functional unit providing a high degree of fiber cross-linkage as a possible mechanism to increase zonal compressive stiffness. Removal of the tangential zone seems to impair distribution of a locally applied compressive load sideways and leads to a reduced cartilage volume included in the process of load transmission. An intact tangential zone contributes to prevent peaks of surface tensile strain.

Collagen architecture and failure processes in bovine patellar cartilage

Cartilage fails by fibrillation and wearing away. This study was designed to identify the microscopic failure processes in the collagen network of bovine cartilage using scanning electron microscopy. Cartilage samples from fibrillated cartilage from the bovine patella were removed from the bone, fixed, digested to remove proteoglycans, freeze-fractured, and processed for SEM. The architecture of the collagen network in the normal cartilage was first defined, and then the failure processes were identified by examining sites of fibrillation and at crack tips. The bovine patellar cartilage was organised with a superficial layer composed of 3-5 lamina, attached to a sub-superficial tissue by angled bridging fibrils. Collagen in the sub-superficial tissue was organised in lamina oriented in the radial direction up to the transition zone. Failure of the system occurred by cracks forming in superficial layer and lamina, creating flaps of lamina that rolled up into the larger 'fronds'. Larger cracks not following the laminar planes occurred in the transition, mid, and deep zones. Failure at the crack tips in the sub-superficial tissue appeared to be by peeling of collagen fibrils, as opposed to breaking of collagen fibrils, suggesting a 'glue' bonding the collagen fibrils in a parallel fashion. Cracks propagated by breaking these bonds. This bond could be a site of disease action, since weakening of the bond would accelerate crack propagation.

A fibril reinforced nonhomogeneous poroelastic model for articular cartilage: inhomogeneous response in unconfined compression

The depth dependence of material properties of articular cartilage, known as the zonal differences, is incorporated into a nonlinear fibril-reinforced poroelastic model developed previously in order to explore the significance of material heterogeneity in the mechanical behavior of cartilage. The material variations proposed are based on extensive observations. The collagen fibrils are modeled as a distinct constituent which reinforces the other two constituents representing proteoglycans and water. The Young's modulus and Poisson's ratio of the drained nonfibrillar matrix are so determined that the aggregate compressive modulus for confined geometry fits the experimental data. Three nonlinear factors are considered, i.e. the effect of finite deformation, the dependence of permeability on dilatation and the fibril stiffening with its tensile strain. Solutions are extracted using a finite element procedure to simulate unconfined compression tests. The features of the model are then demonstrated with an emphasis on the results obtainable only with a nonhomogeneous model, showing reasonable agreement with experiments. The model suggests mechanical behaviors significantly different from those revealed by homogeneous models: not only the depth variations of the strains which are expected by qualitative analyses, but also, for instance, the relaxation-time dependence of the axial strain which is normally not expected in a relaxation test. Therefore, such a nonhomogeneous model is necessary for better understanding of the mechanical behavior of cartilage.

In vitro MR imaging of hyaline cartilage: correlation with scanning electron microscopy

OBJECTIVE

Our goal was to determine how the three-dimensional structure of hyaline cartilage affects its MR appearance and to correlate this appearance with detailed structural analysis using scanning electron microscopy and freeze-fracture sectioning techniques.

MATERIALS AND METHODS

In vitro 7-T spin-echo MR images of hyaline cartilage specimens from four patients undergoing above-knee amputations were obtained parallel and perpendicular to the main magnetic field. Specimens were imaged with low- and high-power scanning electron microscopy after freeze fracturing. The corresponding images from both techniques were analyzed with specific attention to the three-dimensional structure of the cartilage, collagen fibril orientation, and respective changes in the MR appearance.

RESULTS

Freeze fracturing of cartilage reveals a curved fracture plane. Expected changes in signal intensity predicted by the magic angle effect correlated with observed changes in signal intensity across the thickness of the sample. Changes in individual collagen fibril orientation did not correspond to MR layering.

CONCLUSION

The three-dimensional organization of collagen in cartilage has a strong influence on the MR appearance of cartilage. This influence is caused by the restriction of water mobility and the resulting magic angle effect caused by curvature of the collagen network, possibly because of the influence on proteoglycan orientation.

Structural periodicity in human articular cartilage: comparison between magnetic resonance imaging and histological findings

OBJECTIVE

To relate the vertical striations visualized in the deeper layers of articular cartilage by Magnetic Resonance Imaging (MRI) to histological features.

METHODS

Two knee joints recovered at post-mortem from males in their seventies with no history or visual evidence of joint disease were examined. MR images were obtained in a 4.7 T 400 mm-bore magnet, after which the knees were fixed, sectioned, and examined histologically.

RESULTS

High resolution MR showed vertical high/low signal striations with a two to three-fold variation in signal intensity and a periodicity of 0.56 (+/-0.16 mm), most prominent in weight bearing areas. Histological sections revealed alternating light and dark staining areas with a periodicity of 1.01+/-0.54 mm in the lower zones of the cartilage, some, but not all of which clearly represented folding. Given that MR will only visualize vertical structures in cartilage aligned at 90 degrees, whereas histology will cut them at varying angles, it is likely that the vertical structures seen by each modality correspond, and that they represent structural heterogeneity in cartilage; perhaps the presence of plates of high collagen and proteoglycan content.

CONCLUSION

The vertical striations seen routinely in the deep zones of hyaline articular cartilage on histological sections are not artefactual; they are likely to represent structural heterogeneity due to the presence of areas of high collagen and high proteoglycan content that exist in weight-bearing areas. This structural heterogeneity may be of great importance to the integrity and function of the cartilage.

The surface contour of articular cartilage in an intact, loaded joint

The friction coefficients measured in diarthrodial joints are small. Theories of joint lubrication attribute this efficiency to entrapment or movement of synovial fluid, yet anatomical models of the surface are based on studies of isolated fragments of cartilage, not functional joints. To investigate the functional interrelationship of joint surfaces and synovial fluid, the ultrastructure of loaded joints was examined. Twenty-four New Zealand white rabbit knee joints were loaded either statically or moved ex vivo using simulated muscle forces and then plunge-frozen under load. After fixation in the frozen/loaded state by freeze-substitution fixation, the medial joint compartments were embedded in epoxy resin while still articulated. Bone was trimmed away from the articular surfaces, permitting the cartilage to be sectioned for light and electron microscopy. These joint surfaces were then compared with controls which were not loaded, not moved or had been disarticulated prior to embedding. Articular surfaces of loaded joints were smooth at magnifications from x 35 to x 7500, whereas the tibial surfaces of nonloaded joints were irregular. Small pools of joint fluid were observed at the meniscal edge and beneath the anterior horn of the meniscus. At magnifications of x 40000, the joint surfaces were separated by a uniform 100 nm space containing fluid. An amorphous, electron dense articular surface lamina was present but, when loaded, was thicker and flatter than previously reported. No surface pits or bumps were visible in embedded, loaded joints. This is the first ultrastructural study of intact loaded joints. The findings suggest that fluid film lubrication is present in diarthrodial joints, but the fluid sequestration postulated in several models is not apparent.

Collagen fibre arrangement in the tibial plateau articular cartilage of man and other mammalian species

Experimental animal models are frequently used to study articular cartilage, but the relevance to man remains problematic. In this study animal models were compared by examination of the collagen fibre arrangement in the medial tibial plateau of human, cow, pig, dog, sheep, rabbit and rat specimens. 24 cartilage samples from each species were prepared and maximum cartilage thickness in the central tibial plateau measured. Samples were fixed, dehydrated, freeze-fractured and imaged by scanning electron microscopy (SEM). At low magnification, 2 different arrangements of collagen fibres were observed: leaf-like (human, pig, dog) and columnar (cow, sheep, rabbit, rat). The porcine collagen structure was the most similar to that of man. This arrangement was consistent from the radial to the upper zones. Under higher magnification at the surface of the leaves, the collagen was more randomly oriented, whereas the columns consisted of parallel collagen fibrils. The maximum thickness of cartilage did not correlate with the type of collagen arrangement but was correlated with the body weight of the species (r = 0.785). When using animal models for investigating human articular cartilage function or pathology, the differences in arrangement of collagen fibres in tibial plateau cartilage between laboratory animals should be considered especially if morphological evaluation is planned.

Deformation of articular cartilage collagen structure under static and cyclic loading

Relatively little is known about the morphology of articular cartilage under conditions of normal use, yet a more profound knowledge is both critical to the understanding of cartilage function and helpful for the validation of tissue-engineered cartilage. In this study, the deformation of the articular cartilage of the tibial plateau under compressive static and cyclic loading is characterized. Whole knee joints of rabbits were loaded ex vivo while the knee was held statically or allowed to move against resistance. Load magnitudes of quadriceps were maintained at either three (high) or one (low) times body weight for 30 minutes. For cyclic loading, the tibia was flexed between 70 and 150 degrees relative to the femur at 1 Hz with either a cyclic or constant force. The recovery of cartilage after unloading was examined for each loading condition. At the end of the loading, specimens were cryofixed while under load, freeze-substituted, and prepared for scanning electron microscopy. Morphological examination demonstrated significantly higher deformation of the collagen structure throughout all cartilage zones under static loading conditions compared with cyclic loading conditions in which deformation was limited to the superficial regions. The minimum thickness of the cartilage that remained after loading was dependent on the magnitude of load and was significantly smaller with static loads (54% of the thickness of the unloaded controls) than after cyclic loading or constant-force cyclic loading (78 or 66% of the thickness of the unloaded controls, p < 0.05). Acute bending of the collagen fibers was observed under both loading conditions: in the superficial half of the articular cartilage after static loading and in the superficial quarter after cyclic loading. Complete recovery of all deformation occurred within 30 minutes but was significantly faster after cyclic loading. These data suggest that the structure of the collagen of articular cartilage exhibits a zone-specific deformation that is dependent on the magnitude and type of load.

Composition and dynamics of articular cartilage: structure, function, and maintaining healthy state

Disorders of articular cartilage represent some of the most common and debilitating diseases encountered in orthopaedic practice. Understanding the normal functioning of articular cartilage is a prerequisite to understanding its pathologic processes. The mechanical properties of articular cartilage arise from the complex structure and interactions of its biochemical constituents: mostly water, electrolytes, and a solid matrix composed primarily of collagen and proteoglycan. The viscoelastic properties of cartilage, due primarily to fluid flow through the solid matrix, can explain much of the deformational responses observed under many loading conditions. Degenerative processes can often be explained by a breakdown of the normal load-bearing capacity of cartilage which arises from the mechanics of this fluid flow. Several factors which may lead to such a breakdown include direct trauma to the cartilage, obesity, immobilization, and excessive repetitive loading of the cartilage. Sports activity, without traumatic injury, does not appear to be a risk factor for the development of osteoarthritis in the normal joint; however, such activity may be harmful to an abnormal joint.

Incompressibility of the solid matrix of articular cartilage under high hydrostatic pressures

The objective of this study was to test the hypothesis that the organic solid matrix of articular cartilage is incompressible under physiological levels of pressure. Due to its anisotropic swelling behavior, an anisotropic version of the biphasic theory was used to predict the deformation and internal stress fields. This theory predicts that, under hydrostatic loading of cartilage via a pressurized external fluid, a state of uniform hydrostatic fluid pressure exists within the tissue regardless of the anisotropic nature of the solid matrix. The theory also predicts that if the solid matrix is intrinsically incompressible, the tissue will not deform under hydrostatic loading conditions. This prediction, i.e., no deformation, was experimentally tested by subjecting specimens of normal bovine articular cartilage to hydrostatic pressures. A new high pressure hydrostatic loading chamber was designed and built for this purpose. It was found that normal bovine articular cartilage, when subject to hydrostatic pressures up to 12 M Pa, does not deform measurably. This experimental finding supports one of the fundamental assumptions of the biphasic theory for cartilage, i.e., the organic solid matrix of the tissue is intrinsically incompressible when loaded within the normal physiologic range of pressures. Hydrostatic loading has often heen used in cartilage explant cultures for tissue metabolism studies. The findings of this study provides an accurate method to calculate the states of stress acting on the fluid and solid phases of the tissue in these hydrostatically loaded explant culture experiments, and suggest that tissue deformation will be minimal under pure hydrostatic pressurization.

Quantitation and localization of cartilage degeneration following the induction of osteoarthritis in the rabbit knee

OBJECTIVE

To develop and apply a new video imaging technique to quantify and localize Indian ink staining of cartilage of the rabbit femorotibial joint after the induction of osteoarthritis by unilateral transection of the anterior cruciate ligament (ACLT).

METHODS

Nine weeks after surgery, femora and tibiae from 11 ACLT and contralateral control knees were harvested and positioned to obtain calibrated gray-scale images of the ink-painted articular cartilage surfaces that are opposed with the knee in 90 degrees flexion. Images were processed so that areas of normal cartilage gave a relatively high reflectance score, whereas ink-stained fibrillated cartilage and exposed bone gave low scores.

RESULTS

Comparison of the medial and lateral femoral condyles and tibial plateaus (MFC, LFC, MTP, LTP) of control and ACLT knees showed that the area of the MTP not covered by the meniscus had a significantly lower reflectance score (P < 0.001) than other areas. ACLT led to an 11% decrease (P < 0.001) in the overall reflectance score. The reflectance score decreased as a traditional morphological grading of degeneration increased. ACLT-induced degeneration had a predilection for the posteromedial aspects of the joint, and to a lesser extent, the anterolateral aspects. In the tibial plateaus, ACLT caused significant degeneration in the covered, but not the uncovered, areas. Image scores of opposing cartilage surfaces (i.e., MFC vs MTP and LFC vs LTP) were significantly (R = 0.56-0.70, P < 0.001) correlated in ACLT and control knees.

DISCUSSION

Identification and characterization of cartilage areas prone to degeneration may be particularly useful for further analysis of biochemical and biomechanical mechanisms in osteoarthritis, as well as the efficacy of therapeutic interventions.

Postnatal development of the collagen matrix in rabbit tibial plateau articular cartilage

Changes in the 3-dimensional arrangement of the articular cartilage matrix during growth of the rabbit tibial plateau were studied. Knees from newborn, and 1, 2 and 6 wk-old rabbits were compared with those of adults by light and electron microscopy. The specimens were fixed, embedded en bloc in epoxy resin and sectioned vertically/coronally through the point where the articular cartilage was thickest in the adult medial tibial plateau. At birth, the proximal tibial epiphysis was cartilaginous, but nascent articular cartilage was recognisable as a densely cellular layer covering the tibial condyle. Within 30 microns of the articular surface, the chondrocytes were flattened and collagen fibres ran among these cells in a direction parallel to the surface. Deeper in the articular cartilage, rounded cells were evenly distributed within a random collagen fibril network. At the centre of the plateau, the tangential layer changed little during growth, whereas the subjacent cellular layer grew in thickness and steadily achieved a more vertical character in the organisation of its constituent collagen and cellular elements. At 1 wk, cells were separated into clusters by acellular regions filled with collagen fibrils. At 2 wk, cells within the forming radial zone were aligned in columns bracketed by vertical collagen fibres. Continuity of these vertical fibres with those in the tangential surface layer was evident at this age. The chondrocytes were surrounded by fibrous capsules typical of chondrons. By 6 wk, the bases of the radial collagen fibres in the very centre of the condyle had calcified, as had the adjacent hypertrophic hyaline cartilage. A solid subchondral plate and tidemark did not appear until skeletal maturity. From birth to age 6 wk, maximum thickness of the layer identified as primordial articular cartilage increased from 0.13 mm to 0.70 mm, and was 1.5 mm in the adult. Throughout growth, however, the thickness of the tangential layer in the centre of the plateau never exceeded 0.05 micron. In the patella, femoral head and peripheral tibial plateau, cartilage development followed the same general sequence. In contrast to the central tibial plateau, the tangential layer also grew in thickness, but at a slower rate than that of the radial zone. At all ages, the developing articular cartilage was structurally distinct from the deeper hyaline cartilage which contributed to growth of the ossification centre through enchondral ossification. The collagen matrix of articular cartilage acquires a characteristic, orderly 3-dimensional structure soon after birth. Growth in cartilage thickness occurs primarily through enlargement of the radial zone.

Scanning electron microscopy of "fibrillated" and "malacic" human articular cartilage: technical considerations

Specimens of articular cartilage from human knees with gross evidence of malacia (dull appearance and/or softness) or fibrillation (exposed fibrous strands and/or staining with India ink) were prepared for scanning electron microscopy (SEM) and compared to cartilage from apparently intact regions. Vertical cryofractures were made through the center of each specimen, so the matrix collagen structure and its relationship to surface features could be examined. Soft, dull, malacic cartilage was characterized by the presence of numerous clefts among the collagen fibers within the most superficial region of the cartilage. In one form of this condition, these clefts did not extend through the articular surface. In a second form, usually observed where the tangential zone was normally thin or absent, the free ends of radial collagen fibers were exposed, but the deeper layers were intact. Two forms of fibrillation were also identified. The first is created by separation of the superficial lamellae which curl up from the tangential layer and form frondlike projections above the normal plane of the joint surface. In the second, deep radial fibers are exposed by vertical fissures. This second form is associated with advanced damage to the joint. The early stages of cartilage failure are characterized by debonding among the major collagen fiber tracts. This process may initiate in the deep tangential zone where the radial fibers cross into the surface. The patterns of the degenerative changes are dictated by the original architecture of the collagen matrix. The microscopic findings do not correlate adequately with conventional gross grading. SEM provides useful information about injured articular cartilage.