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Cosma C, Apostu D, Vilau C, Popan A, Oltean-Dan D, Balc N, Tomoaie G, Benea H. Finite Element Analysis of Different Osseocartilaginous Reconstruction Techniques in Animal Model Knees. MATERIALS (BASEL, SWITZERLAND) 2023; 16:2546. [PMID: 37048840 PMCID: PMC10095518 DOI: 10.3390/ma16072546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/09/2023] [Accepted: 03/14/2023] [Indexed: 06/19/2023]
Abstract
Lesions of the articular cartilage are frequent in all age populations and lead to functional impairment. Multiple surgical techniques have failed to provide an effective method for cartilage repair. The aim of our research was to evaluate the effect of two different compression forces on three types of cartilage repair using finite element analysis (FEA). Initially, an in vivo study was performed on sheep. The in vivo study was prepared as following: Case 0-control group, without cartilage lesion; Case 1-cartilage lesion treated with macro-porous collagen implants; Case 2-cartilage lesion treated with collagen implants impregnated with bone marrow concentrate (BMC); Case 3-cartilage lesion treated with collagen implants impregnated with adipose-derived stem cells (ASC). Using the computed tomography (CT) data, virtual femur-cartilage-tibia joints were created for each Case. The study showed better results in bone changes when using porous collagen implants impregnated with BMC or ASC stem cells for the treatment of osseocartilaginous defects compared with untreated macro-porous implant. After 7 months postoperative, the presence of un-resorbed collagen influences the von Mises stress distribution, total deformation, and displacement on the Z axis. The BMC treatment was superior to ASC cells in bone tissue morphology, resembling the biomechanics of the control group in all FEA simulations.
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Affiliation(s)
- Cosmin Cosma
- Department of Manufacturing Engineering, Technical University of Cluj-Napoca, 400641 Cluj-Napoca, Romania; (C.C.)
| | - Dragos Apostu
- Department of Orthopedics and Traumatology, Iuliu Haţieganu University of Medicine and Pharmacy, 400132 Cluj-Napoca, Romania
| | - Cristian Vilau
- Department of Material Resistance, Technical University of Cluj-Napoca, 400641 Cluj-Napoca, Romania
| | - Alexandru Popan
- Department of Manufacturing Engineering, Technical University of Cluj-Napoca, 400641 Cluj-Napoca, Romania; (C.C.)
| | - Daniel Oltean-Dan
- Department of Orthopedics and Traumatology, Iuliu Haţieganu University of Medicine and Pharmacy, 400132 Cluj-Napoca, Romania
| | - Nicolae Balc
- Department of Manufacturing Engineering, Technical University of Cluj-Napoca, 400641 Cluj-Napoca, Romania; (C.C.)
| | - Gheorghe Tomoaie
- Department of Orthopedics and Traumatology, Iuliu Haţieganu University of Medicine and Pharmacy, 400132 Cluj-Napoca, Romania
- Academy of Romanian Scientists, 050044 Bucharest, Romania
| | - Horea Benea
- Department of Orthopedics and Traumatology, Iuliu Haţieganu University of Medicine and Pharmacy, 400132 Cluj-Napoca, Romania
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2
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Changoor A, Suderman RP, Alshaygy I, Fuhrmann A, Akens MK, Safir O, Grynpas MD, Kuzyk PRT. Irregular porous titanium enhances implant stability and bone ingrowth in an intra-articular ovine model. J Orthop Res 2022; 40:2294-2307. [PMID: 35146795 DOI: 10.1002/jor.25272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 12/02/2021] [Accepted: 01/16/2022] [Indexed: 02/04/2023]
Abstract
Two commercially available porous coatings, Gription and Porocoat, were compared for the first time in a challenging intra-articular, weight-bearing, ovine model. Gription has evolved from Porocoat and has higher porosity, coefficient of friction, and microtextured topography, which are expected to enhance bone ingrowth. Cylindrical implants were press-fit into the weight-bearing regions of ovine femoral condyles and bone ingrowth and fixation strength evaluated 4, 8, and 16 weeks postoperatively. Biomechanical push-out tests were performed on lateral femoral condyles (LFCs) to evaluate the strength of the bone-implant interface. Bone ingrowth was assessed in medial femoral condyles (MFCs) as well as implants retrieved from LFCs following biomechanical testing using backscattered electron microscopy and histology. By 16 weeks, Gription-coated implants exhibited higher force (2455 ± 1362 vs. 1002 ± 1466 N; p = 0.046) and stress (12.60 ± 6.99 vs. 5.14 ± 7.53 MPa; p = 0.046) at failure, and trended towards higher stiffness (11,510 ± 7645 vs. 5010 ± 8374 N/mm; p = 0.061) and modulus of elasticity (591 ± 392 vs. 256 ± 431 MPa; p = 0.061). A strong, positive correlation was detected between bone ingrowth in LFC implants and failure force (r = 0.93, p < 10-13 ). By 16 weeks, bone ingrowth in Gription-coated implants in MFCs was 10.50 ± 6.31% compared to 5.88 ± 2.77% in Porocoat (p = 0.095). Observations of the bone-implant interface, made following push-out testing, showed more bony material consistently adhered to Gription compared to Porocoat at all three time points. Gription provided superior fixation strength and bone ingrowth by 16 weeks.
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Affiliation(s)
- Adele Changoor
- Department of Surgery and Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Lunenfeld Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada
| | - R Peter Suderman
- Department of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
| | - Ibrahim Alshaygy
- Division of Orthopaedic Surgery, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.,Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Ariel Fuhrmann
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada.,Department of Orthopedic Surgery, Barzilai Medical Centre, Ashkelon, Israel
| | - Margarete K Akens
- Department of Surgery and Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.,Techna Institute, University Health Network, Toronto, Ontario, Canada
| | - Oleg Safir
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Marc D Grynpas
- Lunenfeld Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada.,Department of Laboratory Medicine & Pathobiology and Department of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
| | - Paul R T Kuzyk
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
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de Roy L, Warnecke D, Hacker SP, Simon U, Dürselen L, Ignatius A, Seitz AM. Meniscus Injury and its Surgical Treatment Does not Increase Initial Whole Knee Joint Friction. Front Bioeng Biotechnol 2021; 9:779946. [PMID: 34957074 PMCID: PMC8702854 DOI: 10.3389/fbioe.2021.779946] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 11/09/2021] [Indexed: 11/30/2022] Open
Abstract
While it is generally accepted that traumatic meniscus pathologies lead to degenerative articular cartilage changes in the mid-to long-term and consecutively to post-traumatic osteoarthritis (PTOA), very little is known about how such injuries initiate tribological changes within the knee and their possible impact on PTOA acceleration. Therefore, the aim of this study was to investigate the influence of three different medial meniscus states (intact, posterior root tear, total meniscectomy) on the initial whole knee joint friction. Six ovine knee joints were tested in a passive pendulum friction testing device under an axial load of 250 N and an initial deflection of 12°, representing swing phase conditions, and under an axial load of 1000 N and an initial deflection of 5°, simulating stance phase conditions. To additionally consider the influence of the time-dependent viscoelastic nature of the knee joint soft tissues on whole joint friction, the tests were performed twice, directly following load application and after 20 min creep loading of either 250 N or 1000 N axial load. On the basis of a three-dimensional joint kinematic analysis, the energy loss during the passive joint motion was analyzed, which allowed considerations on frictional and damping processes within the joint. The so-called “whole knee joint” friction was evaluated using the boundary friction model from Stanton and a viscous friction model from Crisco et al., both analyzing the passive joint flexion-extension motion in the sagittal plane. Significantly lower friction coefficients were observed in the simulated swing phase after meniscectomy (p < 0.05) compared to the intact state. No initial whole joint friction differences between the three meniscus states (p > 0.05) were found under stance phase conditions. Soft tissue creeping significantly increased all the determined friction coefficients (p < 0.05) after resting under load for 20 min. The exponential decay function of the viscous friction model provided a better fit (R2∼0.99) to the decaying flexion-extension data than the linear decay function of the boundary friction model (R2∼0.60). In conclusion, this tribological in vitro study on ovine knee joints indicated that neither a simulated posterior medial meniscus root tear nor the removal of the medial meniscus resulted in an initially increased whole joint friction.
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Affiliation(s)
- Luisa de Roy
- Institute of Orthopedic Research and Biomechanics, Center for Trauma Research Ulm, Ulm University Medical Center, Ulm, Germany
| | - Daniela Warnecke
- Institute of Orthopedic Research and Biomechanics, Center for Trauma Research Ulm, Ulm University Medical Center, Ulm, Germany
| | - Steffen Paul Hacker
- Institute of Orthopedic Research and Biomechanics, Center for Trauma Research Ulm, Ulm University Medical Center, Ulm, Germany
| | - Ulrich Simon
- Scientific Computing Center Ulm (UZWR), Ulm University, Ulm, Germany
| | - Lutz Dürselen
- Institute of Orthopedic Research and Biomechanics, Center for Trauma Research Ulm, Ulm University Medical Center, Ulm, Germany
| | - Anita Ignatius
- Institute of Orthopedic Research and Biomechanics, Center for Trauma Research Ulm, Ulm University Medical Center, Ulm, Germany
| | - Andreas Martin Seitz
- Institute of Orthopedic Research and Biomechanics, Center for Trauma Research Ulm, Ulm University Medical Center, Ulm, Germany
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Oláh T, Cai X, Michaelis JC, Madry H. Comparative anatomy and morphology of the knee in translational models for articular cartilage disorders. Part I: Large animals. Ann Anat 2021; 235:151680. [PMID: 33548412 DOI: 10.1016/j.aanat.2021.151680] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 01/08/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND The human knee is a complex joint, and affected by a variety of articular cartilage disorders. Large animal models are critical to model the complex disease mechanisms affecting a functional joint. Species-dependent differences highly affect the results of a pre-clinical study and need to be considered, necessitating specific knowledge not only of macroscopic and microscopic anatomical and pathological aspects, but also characteristics of their individual gait and joint movements. METHODS Literature search in Pubmed. RESULTS AND DISCUSSION This narrative review summarizes the most relevant anatomical structural and functional characteristics of the knee (stifle) joints of the major translational large animal species, comprising dogs, (mini)pigs, sheep, goats, and horses in comparison with humans. Specific characteristics of each species, including kinematical gait parameters are provided. Considering these multifactorial dimensions will allow to select the appropriate model for answering the research questions in a clinically relevant fashion.
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Affiliation(s)
- Tamás Oláh
- Center of Experimental Orthopaedics, Saarland University, Homburg, Germany
| | - Xiaoyu Cai
- Center of Experimental Orthopaedics, Saarland University, 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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Cheong VS, Fromme P, Coathup MJ, Mumith A, Blunn GW. Partial Bone Formation in Additive Manufactured Porous Implants Reduces Predicted Stress and Danger of Fatigue Failure. Ann Biomed Eng 2019; 48:502-514. [PMID: 31549330 PMCID: PMC6928091 DOI: 10.1007/s10439-019-02369-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 09/14/2019] [Indexed: 11/25/2022]
Abstract
New porous implant designs made possible by additive manufacturing allow for increased osseointegration, potentially improving implant performance and longevity for patients that require massive bone implants. The aim of this study was to evaluate how implantation and the strain distribution in the implant affect the pattern of bone ingrowth and how changes in tissue density within the pores alter the stresses in implants. The hypothesis was that porous metal implants are susceptible to fatigue failure, and that this reduces as osteointegration occurs. A phenomenological, finite element analysis (FEA) bone remodelling model was used to predict partial bone formation for two porous (pore sizes of 700 μm and 1500 μm), laser sintered Ti6Al4V implants in an ovine condylar defect model, and was compared and verified against in vivo, histology results. The FEA models predicted partial bone formation within the porous implants, but over-estimated the amount of bone-surface area compared to histology results. The stress and strain in the implant and adjacent tissues were assessed before, during bone remodelling, and at equilibrium. Results showed that partial bone formation improves the stress distribution locally by reducing stress concentrations for both pore sizes, by at least 20%. This improves the long-term fatigue resistance for the larger pore implant, as excessively high stress is reduced to safer levels (86% of fatigue strength) as bone forms. The stress distribution only changed slightly in regions without bone growth. As the extent of bone formation into extensively porous bone implants depends on the level of stress shielding, the design of the implant and stiffness have significant influence on bone integration and need to be considered carefully to ensure the safety of implants with substantial porous regions. To our knowledge this is the first time that the effect of bone formation on stress distribution within a porous implant has been described and characterised.
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Affiliation(s)
- Vee San Cheong
- John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, Royal National Orthopaedics Hospital, University College London, Stanmore, HA7 4LP, UK
- Department of Mechanical Engineering, University College London, London, WC1E 7JE, UK
| | - Paul Fromme
- Department of Mechanical Engineering, University College London, London, WC1E 7JE, UK.
| | - Melanie J Coathup
- John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, Royal National Orthopaedics Hospital, University College London, Stanmore, HA7 4LP, UK
- College of Medicine, University of Central Florida, Orlando, FL, 32827-08, USA
| | - Aadil Mumith
- John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, Royal National Orthopaedics Hospital, University College London, Stanmore, HA7 4LP, UK
| | - Gordon W Blunn
- John Scales Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, Royal National Orthopaedics Hospital, University College London, Stanmore, HA7 4LP, UK
- School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, PO1 2DT, UK
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Hontoir F, Pirson R, Simon V, Clegg P, Nisolle JF, Kirschvink N, Vandeweerd JME. Age-related morphometric changes of the tidemark in the ovine stifle. Anat Histol Embryol 2019; 48:366-374. [PMID: 31106466 DOI: 10.1111/ahe.12449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 05/03/2019] [Indexed: 01/17/2023]
Abstract
Though the ovine stifle is commonly used to study osteoarthritis, there is limited information about the age-related morphometric changes of the tidemark. The objective of this study was to document the number of tidemarks in the stifle of research sheep without clinical signs of osteoarthritis and of various ages (n = 80). Articular cartilage of the medial and lateral tibial condyles and of the medial and lateral femoral condyles was assessed by histology: (a) to count the number of tidemark; and (b) to assess the OARSI (Osteoarthritis Research Society International) score for structural changes of cartilage. The number of tidemarks varied between anatomical regions, respectively, from 4.2 in the medial femoral condyle to 5.0 in the lateral tibial condyle. The axial part showed a significant higher number of tidemarks than the abaxial part, for all regions except the medial tibial condyle. Whilst the tidemark count strongly correlated with age (Spearman's correlation coefficient = 0.70; 95% confidence interval (95% CI): 0.67-0.73; p < 0.0001), the OARSI score was weakly correlated with age in our cohort of sheep (Spearman's correlation coefficient = 0.25; 95% CI: 0.19-0.30; p < 0.0001). Interestingly, no tidemark was seen in the three animals aged 6 months. Our data indicate that the number of tidemarks increases with age and vary with anatomical region. The regional variation also revealed a higher number of tidemarks in the tibia than in the femur. This could be attributed to the local variation in cartilage response to strain and to the difference in chondrocyte biology and density.
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Affiliation(s)
- Fanny Hontoir
- Department of Veterinary Medicine, Integrated Veterinary Research Unit (IVRU) -Namur Research Institute for Life Sciences (NARILIS), Faculty of Sciences, University of Namur, Namur, Belgium
| | - Romain Pirson
- Department of Veterinary Medicine, Integrated Veterinary Research Unit (IVRU) -Namur Research Institute for Life Sciences (NARILIS), Faculty of Sciences, University of Namur, Namur, Belgium
| | - Vincent Simon
- Department of Veterinary Medicine, Integrated Veterinary Research Unit (IVRU) -Namur Research Institute for Life Sciences (NARILIS), Faculty of Sciences, University of Namur, Namur, Belgium
| | - Peter Clegg
- Department of Musculoskeletal Biology, Institute of Ageing and Chronic disease, University of Liverpool, Liverpool, UK
| | - Jean-François Nisolle
- Centre Hospitalier Universitaire (CHU) UCL Namur Mont Godinne, Université Catholique de Louvain, Yvoir, Belgium
| | - Nathalie Kirschvink
- Department of Veterinary Medicine, Integrated Veterinary Research Unit (IVRU) -Namur Research Institute for Life Sciences (NARILIS), Faculty of Sciences, University of Namur, Namur, Belgium
| | - Jean-Michel E Vandeweerd
- Department of Veterinary Medicine, Integrated Veterinary Research Unit (IVRU) -Namur Research Institute for Life Sciences (NARILIS), Faculty of Sciences, University of Namur, Namur, Belgium
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Poncery B, Arroyave-Tobón S, Picault E, Linares JM. Effects of realistic sheep elbow kinematics in inverse dynamic simulation. PLoS One 2019; 14:e0213100. [PMID: 30835751 PMCID: PMC6400409 DOI: 10.1371/journal.pone.0213100] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 02/14/2019] [Indexed: 12/04/2022] Open
Abstract
Looking for new opportunities in mechanical design, we are interested in studying the kinematic behaviour of biological joints. The real kinematic behaviour of the elbow of quadruped animals (which is submitted to high mechanical stresses in comparison with bipeds) remains unexplored. The sheep elbow joint was chosen because of its similarity with a revolute joint. The main objective of this study is to estimate the effects of elbow simplifications on the prediction of joint reaction forces in inverse dynamic simulations. Rigid motions between humerus and radius-ulna were registered during full flexion-extension gestures on five cadaveric specimens. The experiments were initially conducted with fresh specimens with ligaments and repeated after removal of all soft tissue, including cartilage. A digital image correlation system was used for tracking optical markers fixed on the bones. The geometry of the specimens was digitized using a 3D optical scanner. Then, the instantaneous helical axis of the joint was computed for each acquisition time. Finally, an OpenSim musculoskeletal model of the sheep forelimb was used to quantify effects of elbow joint approximations on the prediction of joint reaction forces. The motion analysis showed that only the medial-lateral translation is sufficiently large regarding the measuring uncertainty of the experiments. This translation assimilates the sheep elbow to a screw joint instead of a revolute joint. In comparison with fresh specimens, the experiments conducted with dry bone specimens (bones without soft tissue) provided different kinematic behaviour. From the results of our inverse dynamic simulations, it was noticed that the inclusion of the medial-lateral translation to the model made up with the mean flexion axis does not affect the predicted joint reaction forces. A geometrical difference between the axis of the best fitting cylinder and the mean flexion axis (derived from the motion analysis) of fresh specimens was highlighted. This geometrical difference impacts slightly the prediction of joint reactions.
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Affiliation(s)
| | | | - Elia Picault
- Aix Marseille Univ, CNRS, ISM, Marseille, France
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Stein SEC, von Luebken F, Warnecke D, Gentilini C, Skaer N, Walker R, Kessler O, Ignatius A, Duerselen L. The challenge of implant integration in partial meniscal replacement: an experimental study on a silk fibroin scaffold in sheep. Knee Surg Sports Traumatol Arthrosc 2019; 27:369-380. [PMID: 30264241 PMCID: PMC6394547 DOI: 10.1007/s00167-018-5160-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 09/24/2018] [Indexed: 02/03/2023]
Abstract
PURPOSE To restore meniscal function after excessive tissue damage, a silk fibroin implant for partial meniscal replacement was developed and investigated in an earlier sheep model. After 6 months implantation, it showed promising results in terms of chondroprotection and biocompatibility. To improve surgical fixation, the material was subjected to optimisation and a fibre mesh was integrated into the porous matrix. The aim of the study was the evaluation of this second generation of silk fibroin implants in a sheep model. METHODS Nine adult merino sheep received subtotal meniscal replacement using the silk fibroin scaffold. In nine additional animals, the defect was left untreated. Sham surgery was performed in another group of nine animals. After 6 months of implantation macroscopic, biomechanical and histological evaluations of the scaffold, meniscus, and articular cartilage were conducted. RESULTS Macroscopic evaluation revealed no signs of inflammation of the operated knee joint and most implants were located in the defect. However, there was no solid connection to the remaining peripheral meniscal rim and three devices showed a radial rupture at the middle zone. The equilibrium modulus of the scaffold increased after 6 months implantation time as identified by biomechanical testing (before implantation 0.6 ± 0.3 MPa; after implantation: 0.8 ± 0.3 MPa). Macroscopically and histologically visible softening and fibrillation of the articular cartilage in the meniscectomy- and implant group were confirmed biomechanically by indentation testing of the tibial cartilage. CONCLUSIONS In the current study, biocompatibility of the silk fibroin scaffold was reconfirmed. The initial mechanical properties of the silk fibroin implant resembled native meniscal tissue. However, stiffness of the scaffold increased considerably after implantation. This might have prevented integration of the device and chondroprotection of the underlying cartilage. Furthermore, the increased stiffness of the material is likely responsible for the partial destruction of some implants. Clinically, we learn that an inappropriate replacement device might lead to similar cartilage damage as seen after meniscectomy. Given the poor acceptance of the clinically available partial meniscal replacement devices, it can be speculated that development of a total meniscal replacement device might be the less challenging option.
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Affiliation(s)
- Svenja Emmi Catherine Stein
- Institute of Orthopaedic Research and Biomechanics, Centre for Trauma Research Ulm, Ulm University Medical Centre, Helmholtzstraße 14, 89081 Ulm, Germany
| | - Falk von Luebken
- Department of Trauma and Orthopaedic Surgery, Hospital of the German Armed Forces Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany
| | - Daniela Warnecke
- Institute of Orthopaedic Research and Biomechanics, Centre for Trauma Research Ulm, Ulm University Medical Centre, Helmholtzstraße 14, 89081 Ulm, Germany
| | - Cristina Gentilini
- Orthox Ltd., 66 Innovation Drive, Milton Park, Abingdon, Oxfordshire OX14 4RQ UK
| | - Nick Skaer
- Orthox Ltd., 66 Innovation Drive, Milton Park, Abingdon, Oxfordshire OX14 4RQ UK
| | - Robert Walker
- Orthox Ltd., 66 Innovation Drive, Milton Park, Abingdon, Oxfordshire OX14 4RQ UK
| | - Oliver Kessler
- Centre of Orthopaedics and Sports, Albisriederstraße 243 A, 8047 Zurich, Switzerland
| | - Anita Ignatius
- Institute of Orthopaedic Research and Biomechanics, Centre for Trauma Research Ulm, Ulm University Medical Centre, Helmholtzstraße 14, 89081 Ulm, Germany
| | - Lutz Duerselen
- Institute of Orthopaedic Research and Biomechanics, Centre for Trauma Research Ulm, Ulm University Medical Centre, Helmholtzstraße 14, 89081 Ulm, Germany
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9
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A Hydrogel Meniscal Replacement: Knee Joint Pressure and Distribution in an Ovine Model Compared to Native Tissue. Ann Biomed Eng 2018; 46:1785-1796. [PMID: 29922953 DOI: 10.1007/s10439-018-2069-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 06/06/2018] [Indexed: 10/28/2022]
Abstract
Pressure distribution of the native ovine knee meniscus was compared to a medial meniscectomy and three treatment conditions including a suture reattachment of the native tissue, an allograft, and a novel thermoplastic elastomer hydrogel (TPE) construct. The objective of this study was to assess the efficacy of a novel TPE hydrogel construct at restoring joint pressure and distribution. Limbs were loaded in uniaxial compression at 45°, 60°, and 75° flexion and from 0 to 181 kg. The medial meniscectomy decreased contact area by approximately 50% and doubled the mean and maximum pressure reading for the medial hemijoint. No treatment condition tested within this study was able to fully restore medial joint contact area and pressures to the native condition. A decrease in lateral contact area and increase in pressures with the meniscectomy was also seen; and to some degree, all reattachment and replacement conditions including the novel TPE hydrogel replacement helped to restore lateral pressures. Although the TPE construct did not perform as well as hoped in the medial compartment, it performed as well as, if not better, than the other reattachment and replacement options in the lateral. Further work is necessary to determine the best anchoring and attachment methods.
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10
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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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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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12
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Hontoir F, Clegg P, Simon V, Kirschvink N, Nisolle JF, Vandeweerd JM. Accuracy of computed tomographic arthrography for assessment of articular cartilage defects in the ovine stifle. Vet Radiol Ultrasound 2017; 58:512-523. [PMID: 28429403 DOI: 10.1111/vru.12504] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 12/30/2016] [Accepted: 01/16/2017] [Indexed: 01/30/2023] Open
Abstract
Articular cartilage defects are one of the features of osteoarthritis in animals and humans. Early detection of cartilage defects is a challenge in clinical veterinary practice and also in translational research studies. An accurate, diagnostic imaging method would be desirable for detecting and following up lesions in specific anatomical regions of the articular surface. The current prospective experimental study aimed to describe the accuracy of computed tomographic arthrography (CTA) for detecting cartilage defects in a common animal model used for osteoarthritis research, the ovine stifle (knee, femoropatellar/femorotibial) joint. Joints in cadaver limbs (n = 42) and in living animals under anesthesia (n = 13) were injected with a contrast medium and imaged using a standardized CT protocol. Gross anatomy and histological assessment of specific anatomic regions were used as a gold standard for the evaluation of sensitivity, specificity, negative predictive value, and positive predictive value for CTA identification of articular cartilage defects in those regions. Pooled estimated sensitivity and specificity were 90.32% and 97.30%, respectively, in cadaver limbs, and 81.82% and 95.24%, respectively, in living animals. Pooled estimated positive predictive value and negative predictive values were 98.25% and 85.71%, respectively, in cadaver limbs, and 81.82% and 95.24%, respectively, in living animals. The delineation of cartilage surface was good for anatomical regions most frequently affected by cartilage defects in the ovine stifle: medial femoral condyle, medial tibial condyle, and patella. This study supported the use of CTA as an imaging technique for detecting and monitoring articular cartilage defects in the ovine stifle joint.
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Affiliation(s)
- Fanny Hontoir
- Department of Veterinary Medicine, Integrated Veterinary Research Unit-Namur Research Institute for Life Science (IVRU-NARILIS), Faculty of Sciences, University of Namur, 5000, Namur, Belgium
| | - Peter Clegg
- Department of Musculoskeletal Biology, Faculty of Health and Life Sciences, University of Liverpool, Leahurst Campus, Neston, CH64 7TE, UK
| | - Vincent Simon
- Department of Veterinary Medicine, Integrated Veterinary Research Unit-Namur Research Institute for Life Science (IVRU-NARILIS), Faculty of Sciences, University of Namur, 5000, Namur, Belgium
| | - Nathalie Kirschvink
- Department of Veterinary Medicine, Integrated Veterinary Research Unit-Namur Research Institute for Life Science (IVRU-NARILIS), Faculty of Sciences, University of Namur, 5000, Namur, Belgium
| | | | - Jean-Michel Vandeweerd
- Department of Veterinary Medicine, Integrated Veterinary Research Unit-Namur Research Institute for Life Science (IVRU-NARILIS), Faculty of Sciences, University of Namur, 5000, Namur, Belgium
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13
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Lee WD, Hurtig MB, Pilliar RM, Stanford WL, Kandel RA. Engineering of hyaline cartilage with a calcified zone using bone marrow stromal cells. Osteoarthritis Cartilage 2015; 23:1307-15. [PMID: 25891750 DOI: 10.1016/j.joca.2015.04.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 03/19/2015] [Accepted: 04/08/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE In healthy joints, a zone of calcified cartilage (ZCC) provides the mechanical integration between articular cartilage and subchondral bone. Recapitulation of this architectural feature should serve to resist the constant shear force from the movement of the joint and prevent the delamination of tissue-engineered cartilage. Previous approaches to create the ZCC at the cartilage-substrate interface have relied on strategic use of exogenous scaffolds and adhesives, which are susceptible to failure by degradation and wear. In contrast, we report a successful scaffold-free engineering of ZCC to integrate tissue-engineered cartilage and a porous biodegradable bone substitute, using sheep bone marrow stromal cells (BMSCs) as the cell source for both cartilaginous zones. DESIGN BMSCs were predifferentiated to chondrocytes, harvested and then grown on a porous calcium polyphosphate substrate in the presence of triiodothyronine (T3). T3 was withdrawn, and additional predifferentiated chondrocytes were placed on top of the construct and grown for 21 days. RESULTS This protocol yielded two distinct zones: hyaline cartilage that accumulated proteoglycans and collagen type II, and calcified cartilage adjacent to the substrate that additionally accumulated mineral and collagen type X. Constructs with the calcified interface had comparable compressive strength to native sheep osteochondral tissue and higher interfacial shear strength compared to control without a calcified zone. CONCLUSION This protocol improves on the existing scaffold-free approaches to cartilage tissue engineering by incorporating a calcified zone. Since this protocol employs no xenogeneic material, it will be appropriate for use in preclinical large-animal studies.
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Affiliation(s)
- W D Lee
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, 164 College St., Toronto, Ontario M5S 3G9, Canada
| | - M B Hurtig
- Ontario Veterinary College, University of Guelph, 50 McGilvray Street, Guelph, Ontario N1G 2W1, Canada
| | - R M Pilliar
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, 164 College St., Toronto, Ontario M5S 3G9, Canada; Faculty of Dentistry, University of Toronto, 124 Edward St., Toronto, Ontario M5G 1G6, Canada
| | - W L Stanford
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, 164 College St., Toronto, Ontario M5S 3G9, Canada; Sprott Centre for Stem Cell Research, Ottawa Hospital Research Institute, University of Ottawa, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada; Department of Cellular & Molecular Medicine, University of Ottawa, 501 Smyth Road, Box 511, Ottawa, Ontario K1H 8L6, Canada; Department of Biochemistry, Microbiology and Immunology, University of Ottawa, 501 Smyth Road, Box 511, Ottawa, Ontario K1H 8L6, Canada.
| | - R A Kandel
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, 164 College St., Toronto, Ontario M5S 3G9, Canada; Department of Pathology and Laboratory Medicine, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, 600 University Ave., Toronto, Ontario M5G 1X5, Canada.
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14
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Lerner ZF, Gadomski BC, Ipson AK, Haussler KK, Puttlitz CM, Browning RC. Modulating tibiofemoral contact force in the sheep hind limb via treadmill walking: Predictions from an opensim musculoskeletal model. J Orthop Res 2015; 33:1128-33. [PMID: 25721318 DOI: 10.1002/jor.22829] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 01/15/2015] [Indexed: 02/04/2023]
Abstract
Sheep are a predominant animal model used to study a variety of orthopedic conditions. Understanding and controlling the in-vivo loading environment in the sheep hind limb is often necessary for investigations relating to bone and joint mechanics. The purpose of this study was to develop a musculoskeletal model of an adult sheep hind limb and investigate the effects of treadmill walking speed on muscle and joint contact forces. We constructed the skeletal geometry of the model from computed topography images. Dual-energy x-ray absorptiometry was utilized to establish the inertial properties of each model segment. Detailed dissection and tendon excursion experiments established the requisite muscle lines of actions. We used OpenSim and experimentally-collected marker trajectories and ground reaction forces to quantify muscle and joint contact forces during treadmill walking at 0.25 m• s(-1) and 0.75 m• s(-1) . Peak compressive and anterior-posterior tibiofemoral contact forces were 20% (0.38 BW, p = 0.008) and 37% (0.17 BW, p = 0.040) larger, respectively, at the moderate gait speed relative to the slower speed. Medial-lateral tibiofemoral contact forces were not significantly different. Adjusting treadmill speed appears to be a viable method to modulate compressive and anterior-posterior tibiofemoral contact forces in the sheep hind limb. The musculoskeletal model is freely-available at www.SimTK.org.
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Affiliation(s)
- Zachary F Lerner
- School of Biomedical Engineering, Colorado State University, Fort Collins, Colorado
| | - Benjamin C Gadomski
- School of Biomedical Engineering, Colorado State University, Fort Collins, Colorado
| | - Allison K Ipson
- Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado
| | - Kevin K Haussler
- School of Biomedical Engineering, Colorado State University, Fort Collins, Colorado.,College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Christian M Puttlitz
- School of Biomedical Engineering, Colorado State University, Fort Collins, Colorado.,Department of Mechanical Engineering, Colorado State University, Fort Collins, Colorado
| | - Raymond C Browning
- School of Biomedical Engineering, Colorado State University, Fort Collins, Colorado.,Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado
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15
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Peng G, McNary SM, Athanasiou KA, Reddi AH. The distribution of superficial zone protein (SZP)/lubricin/PRG4 and boundary mode frictional properties of the bovine diarthrodial joint. J Biomech 2015; 48:3406-12. [PMID: 26117076 DOI: 10.1016/j.jbiomech.2015.05.032] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 05/27/2015] [Accepted: 05/31/2015] [Indexed: 10/23/2022]
Abstract
The diarthrodial, knee joint is a remarkably efficient bearing system; articulating cartilage surfaces provide nearly frictionless performance with minimal wear. The low friction properties of the cartilage surfaces are due in part to the boundary lubricant, superficial zone protein (SZP); also known as lubricin or proteoglycan 4 (PRG4). In previous work, SZP localization and cartilage friction were examined across the femoral condyles. Studies in the literature have also individually investigated the other tissues that comprise the human knee and four-legged animal stifle joint, such as the meniscus or patella. However, comparisons between individual studies are limited due to the variable testing conditions employed. Friction is a system property that is dependent on the opposing articulating surface, entraining speed, and loading. A cross-comparison of the frictional properties and SZP localization across the knee/stifle joint tissues utilizing a common testing configuration is therefore needed. The objective of this investigation was to determine the friction coefficient and SZP localization of the tissues comprising the three compartments of the bovine stifle joint: patella, patellofemoral groove, femoral condyles, meniscus, tibial plateau, and anterior cruciate ligament. The boundary mode coefficient of friction was greater in tissues of the patellofemoral compartment than the lateral and medial tibiofemoral compartments. SZP immunolocalization followed this trend with reduced depth of staining and intensity in the patella and patellofemoral groove compared to the femoral condyles and tibial plateau. These results illustrate the important role of SZP in reducing friction in the tissues and compartments of the knee/stifle joint.
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Affiliation(s)
- Gordon Peng
- Lawrence Ellison Center for Tissue Regeneration and Repair, Department of Orthopaedic Surgery, School of Medicine, University of California, Davis, Sacramento, CA, United States
| | - Sean M McNary
- Lawrence Ellison Center for Tissue Regeneration and Repair, Department of Orthopaedic Surgery, School of Medicine, University of California, Davis, Sacramento, CA, United States
| | - Kyriacos A Athanasiou
- Lawrence Ellison Center for Tissue Regeneration and Repair, Department of Orthopaedic Surgery, School of Medicine, University of California, Davis, Sacramento, CA, United States; Department of Biomedical Engineering, University of California, Davis, CA, United States
| | - A Hari Reddi
- Lawrence Ellison Center for Tissue Regeneration and Repair, Department of Orthopaedic Surgery, School of Medicine, University of California, Davis, Sacramento, CA, United States.
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16
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Vonk LA, de Windt TS, Kragten AHM, Beekhuizen M, Mastbergen SC, Dhert WJA, Lafeber FPJG, Creemers LB, Saris DBF. Enhanced cell-induced articular cartilage regeneration by chondrons; the influence of joint damage and harvest site. Osteoarthritis Cartilage 2014; 22:1910-7. [PMID: 25151084 DOI: 10.1016/j.joca.2014.08.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 06/30/2014] [Accepted: 08/13/2014] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Interactions between chondrocytes and their native pericellular matrix provide optimal circumstances for regeneration of cartilage. However, cartilage diseases such as osteoarthritis change the pericellular matrix, causing doubt to them as a cell source for autologous cell therapy. METHODS Chondrons and chondrocytes were isolated from stifle joints of goats in which cartilage damage was surgically induced in the right knee. After 4 weeks of regeneration culture, DNA content and proteoglycan and collagen content and release were determined. RESULTS The cartilage regenerated by chondrons isolated from the damaged joint contained less proteoglycans and collagen compared to chondrons from the same harvest site in the nonoperated knee (P < 0.01). Besides, chondrons still reflected whether they were isolated from a damaged joint, even if they where isolated from the opposing or adjacent condyle. Although chondrocytes did not reflect this diseased status of the joint, chondrons always outperformed chondrocytes, even when isolated from the damaged joints (P < 0.0001). Besides increased cartilage production, the chondrons showed less collagenase activity compared to the chondrocytes. CONCLUSION Chondrons still outperform chondrocytes when they were isolated from a damaged joint and they might be a superior cell source for articular cartilage repair and cell-induced cartilage formation.
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Affiliation(s)
- L A Vonk
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - T S de Windt
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - A H M Kragten
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M Beekhuizen
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - S C Mastbergen
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - W J A Dhert
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands; Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - F P J G Lafeber
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - L B Creemers
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - D B F Saris
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands; Tissue Regeneration, MIRA Institute, University Twente, Enschede, The Netherlands
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17
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Halley SE, Bey MJ, Haladik JA, Lavagnino M, Arnoczky SP. Three dimensional, radiosteriometric analysis (RSA) of equine stifle kinematics and articular surface contact: a cadaveric study. Equine Vet J 2013; 46:364-9. [PMID: 23802689 DOI: 10.1111/evj.12127] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Accepted: 06/20/2013] [Indexed: 11/27/2022]
Abstract
REASONS FOR PERFORMING STUDY Studies examining the effect of stifle joint angle on tibial rotation, adduction-abduction angle and articular contact area are lacking. OBJECTIVES To test the hypothesis that tibial rotation, adduction-abduction angle and articular contact area change with stifle joint angle. STUDY DESIGN Descriptive study of normal kinematics and articular contact patterns of the equine stifle through the functional range of motion using 3 dimensional (3D) radiosteriometric analysis (RSA) and equine cadaver stifles. METHODS Multiple, radiopaque markers were embedded in the distal femur and proximal tibia and sequential, biplanar x-rays captured as the stifle was passively extended from 110° to full extension. Computer-programmed RSA was used to determine changes in abduction-adduction and internal-external rotation angles of the tibia during stifle extension as well as articular contact patterns (total area and areas of high contact) through the range of motion. RESULTS The tibia rotated externally (P < 0.001) as the stifle was extended. Tibial abduction occurred from 110-135° of extension (P < 0.001) and tibial adduction occurred from 135° through full extension (P = 0.009). The centre of joint contact moved cranially on both tibial condyles during extension with the lateral moving a greater distance than the medial (P = 0.003). Articular contact area decreased (P = 0.001) in the medial compartment but not in the lateral compartment (P = 0.285) as the stifle was extended. The area of highest joint contact increased on the lateral tibial condyle (P < 0.001) with extension but decreased (P = 0.001) on the medial tibial condyle. CONCLUSIONS Significant changes occur in tibial rotation, adduction-abduction angle and articular contact area of the equine stifle through the functional range of motion. Understanding the normal kinematics of the equine stifle and the relationship between joint positions and articular contact areas may provide important insight into the aetiology and location of common stifle joint pathologies (articular cartilage and meniscal lesions).
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Affiliation(s)
- S E Halley
- Laboratory for Comparative Orthopaedic Research, Michigan State University, USA
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18
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Koff MF, Shah P, Pownder S, Romero B, Williams R, Gilbert S, Maher S, Fortier LA, Rodeo SA, Potter HG. Correlation of meniscal T2* with multiphoton microscopy, and change of articular cartilage T2 in an ovine model of meniscal repair. Osteoarthritis Cartilage 2013; 21:1083-91. [PMID: 23680878 PMCID: PMC3730276 DOI: 10.1016/j.joca.2013.04.020] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 04/18/2013] [Accepted: 04/25/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To correlate meniscal T2* relaxation times using ultra-short echo time (UTE) magnetic resonance imaging (MRI) with quantitative microscopic methods, and to determine the effect of meniscal repair on post-operative cartilage T2 values. DESIGN A medial meniscal tear was created and repaired in the anterior horn of one limb of 28 crossbred mature ewes. MR scans for morphological evaluation, meniscal T2* values, and cartilage T2 values were acquired at 0, 4 and 8 months post-operatively for the Tear and Non-Op limb. Samples of menisci from both limbs were analyzed using multiphoton microscopy (MPM) analysis and biomechanical testing. RESULTS Significantly prolonged meniscal T2* values were found in repaired limbs than in control limbs, P < 0.0001. No regional differences of T2* were detected for either the repaired or control limbs in the anterior horn. Repaired limbs had prolonged cartilage T2 values, primarily anteriorly, and tended to have lower biomechanical force to failure at 8 months than Non-Op limbs. MPM autofluorescence and second harmonic generation data correlated with T2* values at 8 months (ρ = -0.48, P = 0.06). CONCLUSIONS T2* mapping is sensitive to detecting temporal and zonal differences of meniscal structure and composition. Meniscal MPM and cartilage T2 values indicate changes in tissue integrity in the presence of meniscal repair.
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Affiliation(s)
- Matthew F. Koff
- MRI Research Laboratory, Hospital for Special Surgery, New York, NY, USA
| | - Parina Shah
- MRI Research Laboratory, Hospital for Special Surgery, New York, NY, USA
| | - Sarah Pownder
- MRI Research Laboratory, Hospital for Special Surgery, New York, NY, USA
| | - Bethsabe Romero
- Department of Biomedical Engineering, Cornell University, Ithaca, NY, USA
| | - Rebecca Williams
- Department of Molecular Medicine, Cornell University, Ithaca, NY, USA
| | - Susannah Gilbert
- Department of Biomechanics, Hospital for Special Surgery, New York, NY, USA
| | - Suzanne Maher
- Department of Biomechanics, Hospital for Special Surgery, New York, NY, USA
| | - Lisa A. Fortier
- College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Scott A. Rodeo
- Department of Sports Medicine, Hospital for Special Surgery, New York, NY, USA
| | - Hollis G. Potter
- MRI Research Laboratory, Hospital for Special Surgery, New York, NY, USA
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19
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Vandeweerd JM, Hontoir F, Kirschvink N, Clegg P, Nisolle JF, Antoine N, Gustin P. Prevalence of naturally occurring cartilage defects in the ovine knee. Osteoarthritis Cartilage 2013; 21:1125-31. [PMID: 23707753 DOI: 10.1016/j.joca.2013.05.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 04/22/2013] [Accepted: 05/13/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the prevalence, anatomical location and severity of cartilage defects in the stifle (knee) within a population of adult ewes (N = 65). MATERIALS AND METHODS Articular cartilage (AC) of the distal femur, proximal tibia and patella was assessed using Osteoarthritis Research Society International (OARSI) recommendations for macroscopic and microscopic scoring of ovine cartilage. Synovial fluid analysis and histology of the synovial membrane were performed. All limbs were examined by computed tomography. RESULTS Twenty-eight sheep (n = 28; 43%) presented at least one score 2 or score 3 lesion. Twenty-two (n = 22; 34%) sheep were macroscopically normal. Most frequent localizations of lesions were: axial aspect of the central third of the medial tibial condyle (32.7% of the lesions), middle third of the medial femoral condyle (29.4%), middle third of the articular surface of the patella (9.8%), and axial aspect of the central third of the lateral tibial condyle (9.8%). Grade of macroscopic lesions was significantly (H (3) = 29.31, P 0.000) affected by age. Macroscopic score correlated well with histological changes that can be found in osteoarthritis (OA) (r 0.83; P 0.000). Neither clinical signs of OA, nor cytological and histological signs of inflammation were identified, while imaging abnormalities were very rare. CONCLUSIONS Our data seem to indicate that naturally occurring OA exists in ageing sheep, at least subclinically. It might be useful to take into account prevalent cartilage defects at baseline in studies using ovine models.
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Affiliation(s)
- J-M Vandeweerd
- Integrated Veterinary Research Unit, Namur Research Institute for Life Sciences, Department of Veterinary Medicine, University of Namur, Belgium.
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20
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Taylor WR, Szwedowski TD, Heller MO, Perka C, Matziolis G, Müller M, Janshen L, Duda GN. The difference between stretching and splitting muscle trauma during THA seems not to play a dominant role in influencing periprosthetic BMD changes. Clin Biomech (Bristol, Avon) 2012; 27:813-8. [PMID: 22710281 DOI: 10.1016/j.clinbiomech.2012.05.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2011] [Revised: 05/10/2012] [Accepted: 05/14/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND Periprosthetic bone adaptation in the proximal femur after total hip arthroplasty can result in reduced bone mineral density that may contribute to increased risk of aseptic loosening or fracture. Functional loading of the proximal femur postoperatively may depend upon the type of surgical muscle trauma - splitting or stretching - and is likely to influence the preservation of periprosthetic bone mineral. Since the maintenance of bone is known to be highly age and gender dependent, the aim of this study was to investigate the interplay between muscle trauma and age and gender influences on periprosthetic bone adaptation. METHODS Ninet y-three patients were consecutively recruited into either a transgluteal (splitting) or anterolateral (stretching) surgical approach and examined 7 days and 12 months after an elective primary hip arthroplasty (Zweymüller Alloclassic stem), using dual-energy X-ray absorptiometry measurements to quantify proximal femoral bone mineral density. FINDINGS The results indicate that neither gender, age nor surgical trauma type, but only the combination of age and gender, were significant predictors of postoperative remodelling rate, with younger men (<65) and older women exhibiting the largest bone atrophy. INTERPRETATION This study has demonstrated that the difference between stretching and splitting surgical trauma to the muscles during total hip replacement does not play a dominant role in influencing periprosthetic bone mineral changes. However, this data does suggest that certain patient populations may particularly benefit from muscle and bone preserving procedures.
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Affiliation(s)
- William R Taylor
- Julius Wolff Institute (JWI) and Centrum für Muskuloskeletale Chirurgie (CMSC), Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Charité - Universitätsmedizin Berlin, Centrum für Sportwissenschaft und Sportmedizin Berlin, Philippstr. 13, Haus 11, D-10115 Berlin, Germany.
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21
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Trepczynski A, Kutzner I, Kornaropoulos E, Taylor WR, Duda GN, Bergmann G, Heller MO. Patellofemoral joint contact forces during activities with high knee flexion. J Orthop Res 2012; 30:408-15. [PMID: 22267190 DOI: 10.1002/jor.21540] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2011] [Accepted: 08/01/2011] [Indexed: 02/04/2023]
Abstract
The patellofemoral (PF) joint plays an essential role in knee function, but little is known about the in vivo loading conditions at the joint. We hypothesized that the forces at the PF joint exceed the tibiofemoral (TF) forces during activities with high knee flexion. Motion analysis was performed in two patients with telemetric knee implants during walking, stair climbing, sit-to-stand, and squat. TF and PF forces were calculated using a musculoskeletal model, which was validated against the simultaneously measured in vivo TF forces, with mean errors of 10% and 21% for the two subjects. The in vivo peak TF forces of 2.9-3.4 bodyweight (BW) varied little across activities, while the peak PF forces showed significant variability, ranging from less than 1 BW during walking to more than 3 BW during high flexion activities, exceeding the TF forces. Together with previous in vivo measurements at the hip and knee, the PF forces determined here provide evidence that peak forces across these joints reach values of around 3 BW during high flexion activities, also suggesting that the in vivo loading conditions at the knee can only be fully understood if the forces at the TF and the PF joints are considered together.
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Affiliation(s)
- Adam Trepczynski
- Julius Wolff Institute and Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Centrum für Sportwissenschaft und Sportmedizin Berlin (CSSB), Philippstraße 13, Haus 11, 10115 Berlin, Germany
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Herfat ST, Boguszewski DV, Shearn JT. Applying simulated in vivo motions to measure human knee and ACL kinetics. Ann Biomed Eng 2012; 40:1545-53. [PMID: 22227973 DOI: 10.1007/s10439-011-0500-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Accepted: 12/23/2011] [Indexed: 12/22/2022]
Abstract
Patients frequently experience anterior cruciate ligament (ACL) injuries but current ACL reconstruction strategies do not restore the native biomechanics of the knee, which can contribute to the early onset of osteoarthritis in the long term. To design more effective treatments, investigators must first understand normal in vivo knee function for multiple activities of daily living (ADLs). While the 3D kinematics of the human knee have been measured for various ADLs, the 3D kinetics cannot be directly measured in vivo. Alternatively, the 3D kinetics of the knee and its structures can be measured in an animal model by simulating and applying subject-specific in vivo joint motions to a joint using robotics. However, a suitable biomechanical surrogate should first be established. This study was designed to apply a simulated human in vivo motion to human knees to measure the kinetics of the human knee and ACL. In pursuit of establishing a viable biomechanical surrogate, a simulated in vivo ovine motion was also applied to human knees to compare the loads produced by the human and ovine motions. The motions from the two species produced similar kinetics in the human knee and ACL. The only significant difference was the intact knee compression force produced by the two input motions.
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Affiliation(s)
- Safa T Herfat
- Department of Biomedical Engineering, Tissue Engineering and Biomechanics Laboratories, 2901 Campus Drive, 852 Engineering Research Center, Cincinnati, OH 45221-0012, USA
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