Light and electron microscopic studies of callagen fibers under strain

Remodeling of extracellular matrix in the urinary bladder of paraplegic rats results in increased compliance and delayed fiber recruitment 16 weeks after spinal cord injury

The ability of the urinary bladder to maintain low intravesical pressures while storing urine is key in ensuring proper organ function and highlights the key role that tissue mechanics plays in the lower urinary tract. Loss of supraspinal neuronal connections to the bladder after spinal cord injury can lead to remodeling of the structure of the bladder wall, which may alter its mechanical characteristics. In this study, we investigate if the morphology and mechanical properties of the bladder extracellular matrix are altered in rats 16 weeks after spinal cord injury as compared to animals who underwent sham surgery. We measured and quantified the changes in bladder geometry and mechanical behavior using histological analysis, tensile testing, and constitutive modeling. Our results suggest bladder compliance is increased in paraplegic animals 16 weeks post-injury. Furthermore, constitutive modeling showed that increased distensibility was driven by an increase in collagen fiber waviness, which altered the distribution of fiber recruitment during loading. STATEMENT OF SIGNIFICANCE: The ability of the urinary bladder to store urine under low pressure is key in ensuring proper organ function. This highlights the important role that mechanics plays in the lower urinary tract. Loss of control of neurologic connection to the bladder from spinal cord injury can lead to changes of the structure of the bladder wall, resulting in altered mechanical characteristics. We found that the bladder wall's microstructure in rats 16 weeks after spinal cord injury is more compliant than in healthy animals. This is significant since it is the longest time post-injury analyzed, to date. Understanding the extreme remodeling capabilities of the bladder in pathological conditions is key to inform new possible therapies.

Dynamic tensile properties of porcine knee ligament

BACKGROUND

The knee plays an essential role in movement. There are four major ligaments in the knee which all have crucial functionalities for human activities. The anterior cruciate ligament (ACL) is the most commonly injured ligament in the knee, especially in athletes.

OBJECTIVE

The aim of this study was to investigate the dynamic tensile response of the porcine ACL at strain rates from 800 to 1500 s-1 for simulations of acute injury from sudden impact or collision.

METHODS

Split Hopkinson Tension Bar (SHTB) was utilized to create a dynamic tensile wave on the ACL. Stress-strain curves of strain rates between 800 s-1 to 1500 s-1 were recorded.

RESULTS

The results demonstrated that the elastic modulus of the porcine ACL at higher strain rates was six to eight times higher than that of porcine and human specimens at quasi-static strain rate. However, the failure stress was quite similar while the strain was much smaller than that at the lower strain rate.

CONCLUSIONS

ACL is highly strain rate sensitive and easier to break with lower failure strain when the strain rates increased to more than 1000 s-1. The stress-strain curves indicated that the sketching crimps at the slack region did not happen but switched to the sliding process of collagen fibers and was accompanied by some ruptures, which can develop into tears when strain and stress were large enough. On the other hand, the viscoelastic properties of the ligament, depending on the proteoglycan matrix and the cross-link, showed a limited value in the studied strain rate range.

An integrated approach to investigate age-related modifications of morphological, mechanical and structural properties of type I collagen

The main propose of this study is to characterize the impact of chronological aging on mechanical, structural, biochemical, and morphological properties of type I collagen. We have developed an original approach combining a stress-strain measurement device with a portable Raman spectrometer to enable simultaneous measurement of Raman spectra during stress vs strain responses of young adult, adult and old rat tail tendon fascicles (RTTFs). Our data showed an increase in all mechanical properties such as Young's modulus, yield strength, and ultimate tensile strength with aging. At the molecular level, Raman data revealed that the most relevant frequency shift was observed at 938 cm^-1 in Old RTTFs, which is assigned to the C-C. This suggested a long axis deformation of the peptide chains in Old RTTFs during tensile stress. In addition, the intensity of the band at 872 cm^-1, corresponding to hydroxyproline decreased for young adult RTTFs and increased for the adult ones, while it remained unchanged for Old RTTFs during tensile stress. The amide III band (1242 and 1265 cm^-1) as well as the band ratios I₁₆₃₁/ I₁₆₆₃ and I₁₆₄₅ / I₁₆₆₃ responses to tensile stress were depending on mechanical phases (toe, elastic and plastic). The quantification of advanced glycation end-products by LC-MS/MS and spectrofluorometry showed an increase in their content with aging. This suggested that the accumulation of such products was correlated to the alterations observed in the mechanical and molecular properties of RTTFs. Analysis of the morphological properties of RTTFs by SHG combined with CT-FIRE software revealed an increase in length and straightness of collagen fibers, whereas their width and wavy fraction decreased. Our integrated study model could be useful to provide additional translational information to monitor progression of diseases related to collagen remodeling in musculoskeletal disorders. STATEMENT OF SIGNIFICANCE: Type I collagen is the major component of the extracellular matrix. Its architectural and structural organization plays an important role in the mechanical properties of many tissues at the physiological and pathological levels. The objective of this work is to develop an integrated approach to bring a new insight on the impact of chronological aging on the structural organization and mechanical properties of type I collagen. We combined a portable Raman spectrometer with a mechanical tensile testing device in order to monitor in real time the changes in the Raman fingerprint of type I collagen fibers during the mechanical stress. Raman spectroscopy allowed the identification of the type I collagen bonds that were affected by mechanical stress in a differential manner with aging.

Investigation of Fiber-Driven Mechanical Behavior of Human and Porcine Bladder Tissue Tested Under Identical Conditions

The urinary bladder is a highly dynamic organ that undergoes large deformations several times per day. Mechanical characteristics of the tissue are crucial in determining the function and dysfunction of the organ. Yet, literature reporting on the mechanical properties of human bladder tissue is scarce and, at times, contradictory. In this study, we focused on mechanically testing tissue from both human and pig bladders using identical protocols to validate the use of pigs as a model for the human bladder. Furthermore, we tested the effect of two treatments on tissue mechanical properties. Namely, elastase to digest elastin fibers, and oxybutynin to reduce smooth muscle cell spasticity. Additionally, mechanical properties based on the anatomical direction of testing were evaluated. We implemented two different material models to aid in the interpretation of the experimental results. We found that human tissue behaves similarly to pig tissue at high deformations (collagen-dominated behavior) while we detected differences between the species at low deformations (amorphous matrix-dominated behavior). Our results also suggest that elastin could play a role in determining the behavior of the fiber network. Finally, we confirmed the anisotropy of the tissue, which reached higher stresses in the transverse direction when compared to the longitudinal direction.

Tissue Engineering for Periodontal Ligament Regeneration: Biomechanical Specifications

The periodontal biomechanical environment is very difficult to investigate. By the complex geometry and composition of the periodontal ligament (PDL), its mechanical behavior is very dependent on the type of loading (compressive versus tensile loading; static versus cyclic loading; uniaxial versus multiaxial) and the location around the root (cervical, middle, or apical). These different aspects of the PDL make it difficult to develop a functional biomaterial to treat periodontal attachment due to periodontal diseases. This review aims to describe the structural and biomechanical properties of the PDL. Particular importance is placed in the close interrelationship that exists between structure and biomechanics: the PDL structural organization is specific to its biomechanical environment, and its biomechanical properties are specific to its structural arrangement. This balance between structure and biomechanics can be explained by a mechanosensitive periodontal cellular activity. These specifications have to be considered in the further tissue engineering strategies for the development of an efficient biomaterial for periodontal tissues regeneration.

Biaxial biomechanical properties of the nonpregnant murine cervix and uterus

From a biomechanical perspective, female reproductive health is an understudied area of research. There is an incomplete understanding of the complex function and interaction between the cervix and uterus. This, in part, is due to the limited research into multiaxial biomechanical functions and geometry of these organs. Knowledge of the biomechanical function and interaction between these organs may elucidate etiologies of conditions such as preterm birth. Therefore, the objective of this study was to quantify the multiaxial biomechanical properties of the murine cervix and uterus using a biaxial testing set-up. To accomplish this, an inflation-extension testing protocol (n = 15) was leveraged to quantify biaxial biomechanical properties while preserving native matrix interactions and geometry. Ultrasound imaging and histology (n = 10) were performed to evaluate regional geometry and microstructure, respectively. Histological analysis identified a statistically significant greater collagen content and significantly smaller smooth muscle content in the cervix as compared to the uterus. No statistically significant differences in elastic fibers were identified. Analysis of bilinear fits revealed a significantly stiffer response from the circumferentially orientated ECM fibers compared to axially orientated fibers in both organs. Bilinear fits and a two-fiber family constitutive model showed that the cervix was significantly less distensible than the uterus. We submit that the regional biaxial information reported in this study aids in establishing an appropriate reference configuration for mathematical models of the uterine-cervical complex. Thus, may aid future work to elucidate the biomechanical mechanisms leading to cervical or uterine conditions.

Tendon Remodeling in Response to Resistance Training, Anabolic Androgenic Steroids and Aging

Exercise training (ET), anabolic androgenic steroids (AAS), and aging are potential factors that affect tendon homeostasis, particularly extracellular matrix (ECM) remodeling. The goal of this review is to aggregate findings regarding the effects of resistance training (RT), AAS, and aging on tendon homeostasis. Data were gathered from our studies regarding the impact of RT, AAS, and aging on the calcaneal tendon (CT) of rats. We demonstrated a series of detrimental effects of AAS and aging on functional and biomechanical parameters, including the volume density of blood vessel cells, adipose tissue cells, tendon calcification, collagen content, the regulation of the major proteins related to the metabolic/development processes of tendons, and ECM remodeling. Conversely, RT seems to mitigate age-related tendon dysfunction. Our results suggest that AAS combined with high-intensity RT exert harmful effects on ECM remodeling, and also instigate molecular and biomechanical adaptations in the CT. Moreover, we provide further information regarding the harmful effects of AAS on tendons at a transcriptional level, and demonstrate the beneficial effects of RT against the age-induced tendon adaptations of rats. Our studies might contribute in terms of clinical approaches in favor of the benefits of ET against tendinopathy conditions, and provide a warning on the harmful effects of the misuse of AAS on tendon development.

Mechanical Considerations for Electrospun Nanofibers in Tendon and Ligament Repair

Electrospun nanofibers possess unique qualities such as nanodiameter, high surface area to volume ratio, biomimetic architecture, and tunable chemical and electrical properties. Numerous studies have demonstrated the potential of nanofibrous architecture to direct cell morphology, migration, and more complex biological processes such as differentiation and extracellular matrix (ECM) deposition through topographical guidance cues. These advantages have created great interest in electrospun fibers for biomedical applications, including tendon and ligament repair. Electrospun nanofibers, despite their nanoscale size, generally exhibit poor mechanical properties compared to larger conventionally manufactured polymer fiber materials. This invites the question of what role electrospun polymer nanofibers can play in tendon and ligament repair applications that have both biological and mechanical requirements. At first glance, the strength and stiffness of electrospun nanofiber grafts appear to be too low to fill the rigorous loading conditions of these tissues. However, there are a number of strategies to enhance and tune the mechanical properties of electrospun nanofiber grafts. As researchers design the next-generation electrospun tendon and ligament grafts, it is critical to consider numerous physiologically relevant mechanical criteria and to evaluate graft mechanical performance in conditions and loading environments that reflect in vivo conditions and surgical fixation methods.

Native Bovine and Porcine Pericardia Respond to Load With Additive Recruitment of Collagen Fibers

Bovine and porcine pericardia are currently used for manufacturing prosthetic heart valves: their design has become an increasingly important area of investigation in parallel with progressively expanding indications for the transcutaneous approach to heart valves replacement. Before being cut and shaped, pericardial tissues are expected to be properly characterized. Actually, the mechanical assessment of these biomaterials lacks standardized protocols. In particular, the role of preconditioning for achieving a constant mechanical response of tissue samples is still controversial. In the present work, the mechanical response to uniaxial load of native bovine and porcine pericardia, with and without preconditioning was assessed; moreover, the mechanical behavior of pericardia was investigated and explained. It was demonstrated that: (i) pericardial tissue samples hold memory of the loading history but just within the extent of the deformation applied; (ii) the behavior of native bovine and porcine pericardia in response to load is explained by a mechanism based on the additive recruitment of collagen fibers; (iii) the current concept that plasticity is absent in pericardium has to be at least in part reconsidered.

MAPS - a Magic Angle Positioning System for Enhanced Imaging in High-Field Small-Bore MRI

The "magic angle" MRI effect can enhance signal intensity in aligned collagenous structures oriented at approximately 55° with respect to the main magnetic field. The difficulty of positioning tissue inside closed-bore scanners has hampered magic angle use in research and clinics. An MRI-conditional mechatronic system has been developed to control sample orientation inside a 9.4T small bore MRI scanner. The system orients samples to within 0.5° and enables a 600% increase in tendon signal intensity.

Quantification of strain induced damage in medial collateral ligaments

In the past years, there have been several experimental studies that aimed at quantifying the material properties of articular ligaments such as tangent modulus, tensile strength, and ultimate strain. Little has been done to describe their response to mechanical stimuli that lead to damage. The purpose of this experimental study was to characterize strain-induced damage in medial collateral ligaments (MCLs). Displacement-controlled tensile tests were performed on 30 MCLs harvested from Sprague Dawley rats. Each ligament was monotonically pulled to several increasing levels of displacement until complete failure occurred. The stress-strain data collected from the mechanical tests were analyzed to determine the onset of damage and its evolution. Unrecoverable changes such as increase in ligament's elongation at preload and decrease in the tangent modulus of the linear region of the stress-strain curves indicated the occurrence of damage. Interestingly, these changes were found to appear at two significantly different threshold strains (P<0.05). The mean threshold strain that determined the increase in ligament's elongation at preload was found to be 2.84% (standard deviation (SD) = 1.29%) and the mean threshold strain that caused the decrease in the tangent modulus of the linear region was computed to be 5.51% (SD = 2.10%), respectively. The findings of this study suggest that the damage mechanisms associated with the increase in ligament's elongation at preload and decrease in the tangent modulus of the linear region in the stress-strain curves in MCLs are likely different.

Crimp morphology in the ovine anterior cruciate ligament

While the crimp morphology in ligaments and tendons has been described in detail in the literature, its relative distribution within the tissue has not been studied, especially in relation to the complex multi-bundle arrangement as is found in the anterior cruciate ligament (ACL). In this study, the crimp morphology of the ovine ACL was examined topologically and with respect to its double-bundle structure. The crimp morphologies were compared with the knee in three knee positions, namely stance, maximum extension and maximum flexion. As a control, the crimp morphology of the ACL free from its bony attachments was determined. In the control samples, the anterior-medial (AM) bundle contained a combination of coarse and fine crimp, whereas the posterior-lateral (PL) bundle manifested only a coarse crimp. Using the extent of crimp loss observed when subjecting the knee to the respective positions, and comparing with the controls, the crimp morphologies show that the AM bundle of the ACL is most active in the stance position, whereas for the maximum extension and flexion positions the PL bundle is most active. We propose that these differences in crimp morphologies have relevance to ACL design and function.

Magic angle-enhanced MRI of fibrous microstructures in sclera and cornea with and without intraocular pressure loading

PURPOSE

The structure and biomechanics of the sclera and cornea are central to several eye diseases such as glaucoma and myopia. However, their roles remain unclear, partly because of limited noninvasive techniques to assess their fibrous microstructures globally, longitudinally, and quantitatively. We hypothesized that magic angle-enhanced magnetic resonance imaging (MRI) can reveal the structural details of the corneoscleral shell and their changes upon intraocular pressure (IOP) elevation.

METHODS

Seven ovine eyes were extracted and fixed at IOP = 50 mm Hg to mimic ocular hypertension, and another 11 eyes were unpressurized. The sclera and cornea were scanned at different angular orientations relative to the main magnetic field inside a 9.4-Tesla MRI scanner. Relative MRI signal intensities and intrinsic transverse relaxation times (T2 and T2*) were determined to quantify the magic angle effect on the corneoscleral shells. Three loaded and eight unloaded tendon samples were scanned as controls.

RESULTS

At magic angle, high-resolution MRI revealed distinct scleral and corneal lamellar fibers, and light/dark bands indicative of collagen fiber crimps in the sclera and tendon. Magic angle enhancement effect was the strongest in tendon and the least strong in cornea. Loaded sclera, cornea, and tendon possessed significantly higher T2 and T2* than unloaded tissues at magic angle.

CONCLUSIONS

Magic angle-enhanced MRI can detect ocular fibrous microstructures without contrast agents or coatings and can reveal their MR tissue property changes with IOP loading. This technique may open up new avenues for assessment of the biomechanical and biochemical properties of ocular tissues in aging and in diseases involving the corneoscleral shell.

Microscopic analysis of the iliofemoral and ischiofemoral ligaments in the hip joint: collagen fiber direction and crimp distribution

Since no previous studies have described the functional significance of the iliofemoral and ischiofemoral ligaments on the basis of microscopic analyses, we examined the direction of collagen fiber alignment and crimp distribution of the collagen fibers in sections cut in different directions. Polarized microscopic images of sections along the longitudinal (L) and transverse (T) planes of each ligament were obtained from 20 cadavers (8 males and 12 females, age at death 81.7 ± 9.4 years old). Results showed that the microscopic direction of collagen fibers in the iliofemoral ligament was parallel to the macroscopic direction, suggesting that this ligament may play a part in restricting extension of the hip joint. In contrast, the microscopic direction of collagen fibers in the ischiofemoral ligament was not parallel to the macroscopic direction, suggesting that this ligament may contribute not only to the restriction of medial rotation but also retstriction of flexion of the hip joint. From the low density of the crimp distribution in the L plane, the iliofemoral ligament may contribute to stability of the hip joint in the standing position in the living body. In conclusion, the microscopic observations of the direction of collagen fibers as well as the crimp distribution shown in the present study provide a better understanding of the functional significance of the iliofemoral and ischiofemoral ligaments.

Tendon and ligament fibrillar crimps give rise to left-handed helices of collagen fibrils in both planar and helical crimps

Collagen fibres in tendons and ligaments run straight but in some regions they show crimps which disappear or appear more flattened during the initial elongation of tissues. Each crimp is formed of collagen fibrils showing knots or fibrillar crimps at the crimp top angle. The present study analyzes by polarized light microscopy, scanning electron microscopy, transmission electron microscopy the 3D morphology of fibrillar crimp in tendons and ligaments of rat demonstrating that each fibril in the fibrillar region always twists leftwards changing the plane of running and sharply bends modifying the course on a new plane. The morphology of fibrillar crimp in stretched tendons fulfills the mechanical role of the fibrillar crimp acting as a particular knot/biological hinge in absorbing tension forces during fibril strengthening and recoiling collagen fibres when stretching is removed. The left-handed path of fibrils in the fibrillar crimp region gives rise to left-handed fibril helices observed both in isolated fibrils and sections of different tendons and ligaments (flexor digitorum profundus muscle tendon, Achilles tendon, tail tendon, patellar ligament and medial collateral ligament of the knee). The left-handed path of fibrils represents a new final suprafibrillar level of the alternating handedness which was previously described only from the molecular to the microfibrillar level. When the width of the twisting angle in the fibrillar crimp is nearly 180 degrees the fibrils appear as left-handed flattened helices forming crimped collagen fibres previously described as planar crimps. When fibrils twist with different subsequent rotational angles (< 180 degrees ) they always assume a left-helical course but, running in many different nonplanar planes, they form wider helical crimped fibres.

Relationships between total and non-recoverable strain fields in glenohumeral capsule during shoulder subluxation

Non-recoverable strain in the glenohumeral capsule is of prime clinical significance, but the factors that contribute to non-recoverable strain are largely unknown. This study examined the relationship between total and non-recoverable strain in the antero-inferior glenohumeral capsule using an experimental model. Maximum principal total strain alone explained up to 35% of the variance in non-recoverable strain. A multiple regression model, including variables for lateral position and specimen, explained 50% of the variance in non-recoverable strain. Both linear and quadratic terms for maximum principal total strain were significant predictors of non-recoverable strain. The correlation of total and non-recoverable strain directions exhibited a slope of nearly 1:1. The regression model showed that non-recoverable strain is likely to be low for small levels of total strain, and increase non-linearly with total strain. Non-recoverable strain tended to be higher closer to the glenoid, even when controlling for total strain. Minimum principal total strain was not a significant predictor of non-recoverable strain for the cases examined, indicating that the glenohumeral capsule may demonstrate uniaxial failure behavior even when loaded biaxially. These results are important toward prediction of non-recoverable strain in computational models of glenohumeral subluxation, as well as for theoretical models of ligament failure.

Viscoelastic and failure properties of spine ligament collagen fascicles

The microstructural volume fractions, orientations, and interactions among components vary widely for different ligament types. If these variations are understood, however, it is conceivable to develop a general ligament model that is based on microstructural properties. This paper presents a part of a much larger effort needed to develop such a model. Viscoelastic and failure properties of porcine posterior longitudinal ligament (PLL) collagen fascicles were determined. A series of subfailure and failure tests were performed at fast and slow strain rates on isolated collagen fascicles from porcine lumbar spine PLLs. A finite strain quasi-linear viscoelastic model was used to fit the fascicle experimental data. There was a significant strain rate effect in fascicle failure strain (P < 0.05), but not in failure force or failure stress. The corresponding average fast-rate and slow-rate failure strains were 0.098 ± 0.062 and 0.209 ± 0.081. The average failure force for combined fast and slow rates was 2.25 ± 1.17 N. The viscoelastic and failure properties in this paper were used to develop a microstructural ligament failure model that will be published in a subsequent paper.

Ligaments: a source of musculoskeletal disorders

The mechanical and neurological properties of ligaments are reviewed and updated with recent development from the perspective which evaluates their role as a source of neuromusculoskeletal disorders resulting from exposure to sports and occupational activities. Creep, tension-relaxation, hysteresis, sensitivity to strain rate and strain/load frequency were shown to result not only in mechanical functional degradation but also in the development of sensory-motor disorders with short- and long-term implication on function and disability. The recently exposed relationships between collagen fibers, applied mechanical stimuli, tissue micro-damage, acute and chronic inflammation and neuromuscular disorders are delineated with special reference to sports and occupational stressors such as load duration, rest duration, work/rest ratio, number of repetitions of activity and velocity of movement.

Different crimp patterns in collagen fibrils relate to the subfibrillar arrangement

Collagen fibril ultrastructure and course were examined in different connective tissues by PLM, SEM, TEM, and AFM. In tendons, collagen fibrils were large and heterogeneous with a straight subfibrillar arrangement. They ran densely packed, parallel, and straight changing their direction only in periodic crimps where fibrils showed a local deformation (fibrillar crimps). Other tissues such as aponeurosis, fascia communis, skin, aortic wall, and tendon and nerve sheaths showed thinner uniform fibrils with a helical subfibrillar arrangement. These fibrils appeared in parallel or helical arrangement following a wavy, undulating course. Ligaments showed large fibrils as in tendon, with fibrillar crimps but less packed. Thinner uniform-sized fibrils also were observed. Fibrillar crimps seem to be related to the subfibrillar arrangement being present only in large fibrils with a straight subfibrillar arrangement. These stiffer fibrils respond mainly to unidirectional tensional forces, whereas the flexible thinner fibrils with helical subfibrils can accommodate extreme curvatures without harm, thus responding to multidirectional loadings.

Effects of submaximal and maximal long-lasting contractions on the compliance of vastus lateralis tendon and aponeurosis in vivo

The present study investigated the effects of submaximal sustained and maximal repetitive contractions on the compliance of human vastus lateralis (VL) tendon and aponeurosis in vivo using two different fatiguing protocols. Twelve male subjects performed three maximum voluntary isometric contractions (MVC) of the knee extensors before and after two fatiguing protocols on a dynamometer. The first fatiguing protocol consisted of a long-lasting sustained isometric knee extension contraction at 25% MVC until failure (inability to hold the defined load). The second fatiguing protocol included long-lasting isokinetic (90 degrees/s) knee extension contractions, where maximum moment was exerted and failure was proclaimed when this value fell below 70% of unfatigued maximum isokinetic moment. Ultrasonography was used to determine the elongation and strain of the VL tendon and aponeurosis. Muscle fatigue was indicated by a significant decrease in maximum resultant knee extension moment (p<0.05) observed during the MVCs after both long-lasting contractions. No significant (p>0.05) differences in elongation and strain of the VL tendon and aponeurosis were found, when compared every 300 N (tendon force) before and after the fatiguing protocols. The present data indicate, that the VL tendon and aponeurosis in vivo do not suffer from changes in the compliance neither after long-lasting static mechanical loading (strain approximately 3.2%) nor after long-lasting cyclic mechanical loading (strain 6.2-5.5%).

The mechanobiological aetiopathogenesis of tendinopathy: is it the over-stimulation or the under-stimulation of tendon cells?

While there is a significant amount of information available on the clinical presentation(s) and pathological changes associated with tendinopathy, the precise aetiopathogenesis of this condition remains a topic of debate. Classically, the aetiology of tendinopathy has been linked to the performance of repetitive activities (so-called overuse injuries). This has led many investigators to suggest that it is the mechanobiologic over-stimulation of tendon cells that is the initial stimulus for the degradative processes which have been shown to accompany tendinopathy. Although several studies have been able to demonstrate that the in vitro over-stimulation of tendon cells in monolayer can result in a pattern(s) of gene expression seen in clinical cases of tendinopathy, the strain magnitudes and durations used in these in vitro studies, as well as the model systems, may not be clinically relevant. Using a rat tail tendon model, we have studied the in vitro mechanobiologic response of tendon cells in situ to various tensile loading regimes. These studies have led to the hypothesis that the aetiopathogenic stimulus for the degenerative cascade which precedes the overt pathologic development of tendinopathy is the catabolic response of tendon cells to mechanobiologic under-stimulation as a result of microscopic damage to the collagen fibres of the tendon. In this review, we examine the rationale for this hypothesis and provide evidence in support of this theory.

Crimp morphology in relaxed and stretched rat Achilles tendon

Fibrous extracellular matrix of tendon is considered to be an inextensible anatomical structure consisting of type I collagen fibrils arranged in parallel bundles. Under polarized light microscopy the collagen fibre bundles appear crimped with alternating dark and light transverse bands. This study describes the ultrastructure of the collagen fibrils in crimps of both relaxed and in vivo stretched rat Achilles tendon. Under polarized light microscopy crimps of relaxed Achilles tendons appear as isosceles or scalene triangles of different size. Tendon crimps observed via SEM and TEM show the single collagen fibrils that suddenly change their direction containing knots. The fibrils appear partially squeezed in the knots, bent on the same plane like bayonets, or twisted and bent. Moreover some of them lose their D-period, revealing their microfibrillar component. These particular aspects of collagen fibrils inside each tendon crimp have been termed 'fibrillar crimps' and may fulfil the same functional role. When tendon is physiologically stretched in vivo the tendon crimps decrease in number (46.7%) (P<0.01) and appear more flattened with an increase in the crimp top angle (165 degrees in stretched tendons vs. 148 degrees in relaxed tendons, P<0.005). Under SEM and TEM, the 'fibrillar crimps' are still present, never losing their structural identity in straightened collagen fibril bundles of stretched tendons even where tendon crimps are not detectable. These data suggest that the 'fibrillar crimp' may be the true structural component of the tendon crimp acting as a shock absorber during physiological stretching of Achilles tendon.

Role of the oblique ligament in the integrity of the medial collateral ligament of the canine elbow joint

It was studied the arrangement of the collagen fibrils of the medial collateral ligament of the canine elbow joint and evaluated its diameter, when it was isolated or associated to the oblique ligament and loaded in tension until failure. Eighteen joints were divided in three groups. The first group had the medial collateral ligament collected and not loaded, the second group had the medial collateral ligament tested separately and the third group had both ligaments associately tested. Medial collateral ligament not submitted to strain presented a wavy and reticular pattern of the collagen fibers, which was not totally destroyed when it was loaded associated to the oblique ligament, and totally loses the reticular pattern when stretched separately. When the medial collateral ligament was loaded in tension separately, the mean collagen fibrils diameter increased in relation to the group not submitted to the tensile strain. Associated to the oblique ligament, the mean collagen fibrils diameter was the largest in the insertion area and the smallest in the mid-substance, in relation to the other groups. It was concluded that the oblique ligament could favor the integrity of the medial collateral ligament insertion area, facilitating its reconstruction after lesion with larger efficiency.

Isolated fibrillar damage in tendons stimulates local collagenase mRNA expression and protein synthesis

The etiology of repetitive stress injuries in tendons has not been clearly identified. While minor trauma has been implicated as an inciting factor, the precise magnitude and structural level of tissue injury that initiates this degenerative cascade has not been determined. The purpose of this study was to determine if isolated tendon fibril damage could initiate an upregulation of interstitial collagenase (MMP13) mRNA and protein in tendon cells associated with the injured fibril(s). Rat tail tendon fascicles were subjected to in vitro tensile loading until isolated fibrillar damage was documented. Once fibrillar damage occurred, the tendons were immediately unloaded to 100g and maintained at that displacement for 24h under tissue culture conditions. In addition, non-injured tendon fascicles were maintained under unloaded (stress-deprived) conditions in culture for 24h to act as positive controls. In situ hybridization or immunohistochemistry was then performed to localize collagenase mRNA expression or protein synthesis, respectively. Fibrillar damage occurred at a similar stress (41.13+/-5.94MPa) and strain (13.24+/-1.94%) in the experimental tendons. In situ hybridization and immunohistochemistry demonstrated an upregulation of interstitial collagenase mRNA and protein, respectively, in only those cells associated with the damaged fibril(s). In the control (stress-deprived) specimens, collagenase mRNA expression and protein synthesis were observed throughout the fascicle. The results suggest that isolated fibrillar damage and the resultant upregulation of collagenase mRNA and protein in this damaged area occurs through a mechanobiological understimulation of tendon cells. This collagenase production may weaken the tendon and put more of the extracellular matrix at risk for further damage during subsequent loading.

Three-dimensional finite element modeling of ligaments: technical aspects

The objective of this paper is to describe strategies for addressing technical aspects of the computational modeling of ligaments with the finite element (FE) method. Strategies for FE modeling of ligament mechanics are described, differentiating between whole-joint models and models of individual ligaments. Common approaches to obtain three-dimensional ligament geometry are reviewed, with an emphasis on techniques that rely on volumetric medical image data. Considerations for the three-dimensional constitutive modeling of ligaments are reviewed in the context of ligament composition and structure. A novel approach to apply in situ strain to FE models of ligaments is described, and test problems are presented that demonstrate the efficacy of the approach. Approaches for the verification and validation of ligament FE models are outlined. The paper concludes with a discussion of future research directions.

Viscoelastic properties of the human medial collateral ligament under longitudinal, transverse and shear loading

Ligament viscoelasticity controls viscous dissipation of energy and thus the potential for injury or catastrophic failure. Viscoelasticity under different loading conditions is likely related to the organization and anisotropy of the tissue. The objective of this study was to quantify the strain- and frequency-dependent viscoelastic behavior of the human medial collateral ligament (MCL) in tension along its longitudinal and transverse directions, and under shear along the fiber direction. The overall hypothesis was that human MCL would exhibit direction-dependent viscoelastic behavior, reflecting the composite structural organization of the tissue. Incremental stress relaxation testing was performed, followed by the application of small sinusoidal strain oscillations at three different equilibrium strain levels. The peak and equilibrium stress-strain curves for the longitudinal, transverse and shear tests demonstrate that the instantaneous and long-time stress-strain response of the tissue differs significantly between loading conditions of along-fiber stretch, cross-fiber stretch and along-fiber shear. The reduced relaxation curves demonstrated at least two relaxation times for all three test modes. Relaxation resulted in stresses that were 60-80% of the initial stress after 1000 s. Incremental stress relaxation proceeded faster at the lowest strain level for all three test configurations. Dynamic stiffness varied greatly with test mode and equilibrium strain level, and showed a modest but significant increase with frequency of applied strain oscillations for longitudinal and shear tests. Phase angle was unaffected by strain level (with exception of lowest strain level for longitudinal samples) but showed a significant increase with increasing strain oscillation frequency. There was no effect of test type on the phase angle. The increase in phase and thus energy dissipation at higher frequencies may protect the tissue from injury at faster loading rates. Results suggest that the long-time relaxation behavior and the short-time dynamic energy dissipation of ligament may be governed by different viscoelastic mechanisms, yet these mechanisms may affect tissue viscoelasticity similarly under different loading configurations.

Ligaments: a source of work-related musculoskeletal disorders

The mechanical and neurological properties of ligaments are reviewed and updated with recent development from the perspective which evaluates their role as a source of neuromusculoskeletal disorders resulting from exposure to occupational activities. Creep, tension-relaxation, hysteresis, sensitivity to strain rate and strain/load frequency were shown to result not only in mechanical functional degradation but also in the development of sensory-motor disorders with short- and long-term implication on function and disability. The recently exposed relationships between collagen fibers, applied mechanical stimuli, tissue microdamage, acute and chronic inflammation and neuromuscular disorders is delineated with special reference to occupational stressors.

A nonlinear rheological assessment of muscle recovery from eccentric stretch injury

PURPOSE

To better understand the mechanical behavior of healing skeletal muscle; specifically the tissue's response after acute eccentric stretch injury.

METHODS

Rabbit tibialis anterior (TA) muscle tendon units were subjected to an in vivo single stretch (eccentric) injury and mechanically evaluated (constant rate elongation to failure) at 1, 3, and 7 d postinjury. In addition to a traditional linear analysis (linear stiffness and failure load), an existing nonlinear rheological model was modified to interpret the experimental load-to-failure data. The models' performance were evaluated and discussed.

RESULTS

No significant injury effect was observed, either within or between groups, across the 7-d healing interval, using the linear analysis. However, interpretation of the data using our nonlinear phenomenological model identified significant changes in mechanical behavior that went undetected by linear analyses. Percent differences, between injured and contralateral control limbs, of model parameter estimates were analyzed. Nonparametric statistical analysis illustrated significant changes in the first-order stiffness (k1) throughout the 7-d healing interval. Model simulations using mean values of each parameter revealed increased low-load tissue compliance after injury, with a decrease in linear slope that recovered steadily toward control values by day 7. At 7 d postinjury, virtually no differences were observed between injured and sham control tissues.

CONCLUSIONS

Our findings suggest that acute eccentric injury increases the muscle's compliance 24 h after injury, with a steady recovery to uninjured values by the 7th day, yet these changes went undetected by linear analysis. Therefore, nonlinear analysis is necessary to recognize valuable information contained in the low-load region and to quantify important biomechanical phenomena of stretch-injured healing skeletal muscle.

Optical anisotropy of a pig tendon under compression

The proximal region of the superficial digital flexor tendon of pigs passes under the tibiotarsal joint, where it is subjected to compressional and tensional forces. This region was divided into a surface portion (sp), which is in direct contact with the bone and into a deep portion (dp), which is the layer opposite the articulating surface. The purpose of this work was to analyse the distribution and organisation of the collagen bundles and proteoglycans in the extracellular matrix in sp and dp. Toluidine-blue-stained sections were analysed under a polarising microscope. Strong basophilia and metachromasia were observed in sp, demonstrating accumulation of proteoglycan in a region bearing compression, but the intensity was reduced the further layers were from the bone. Linear dichroism confirmed that the glycosaminoglycan molecules were disposed predominantly parallel to the longest axis of the collagen fibrils. Birefringence analysis showed a higher molecular order and aggregation of the collagen bundles in areas where the tension was more prominent. The crimp pattern was more regular in dp than in sp, probably as a requirement for tendon stretching. The optical anisotropy exhibited by the collagen bundles also confirmed the helical organisation of the collagen bundles in the tendon. Hyaluronidase digestion caused a decrease in the basophilia, but this was not eliminated, supporting the idea that in the matrix, proteoglycans are not completely available to the enzyme action.

In situ cell nucleus deformation in tendons under tensile load; a morphological analysis using confocal laser microscopy

Cell and cell nucleus deformations have been implicated in the mechanotransduction of mechanical loads acting on tissues. While in situ cell nucleus deformation in response to increasing tissue strains has been examined in articular cartilage this phenomenon has not been investigated in tendons. To examine in situ cell nuclei deformation in tendons undergoing tensile strain rat tail tendons were harvested from adult Sprague-Dawley rats and stained with acridine orange to highlight the cell nuclei. The tendons were mounted on a custom-designed, low-load, tensile testing device affixed to the mechanical stage of a confocal laser microscope. Cells within the tendons were isolated for analysis. Images of individual cells were captured at 0% strain as well as sequentially at 2%, 4% and 6% grip-to-grip tendon strain. Digital images of the cell nuclei were then measured in the x (length) and y (height) axis and deformation expressed as a percentage of cell nuclei strain. In addition, centroid-to-centroid distances of adjacent cell nuclei within each image were measured and used to calculate local tissue strain. There was a weak (r2 = 0.34) but significant (p < 0.01) correlation between local tissue strain and cell nucleus strain in the x axis. The results of this study support the hypothesis that in situ cell nucleus deformation does occur during tensile loading of tendons. This deformation may play a significant role in the mechanical signal transduction pathway of this tissue.

Synchronous recording of load-deformation behaviour and polarized light-microscopic images of the rabbit incisor periodontal ligament during tensile loading

Tooth-periodontal ligament-bone segments were cut in the form of rectangular prisms (1.5 mm wide, 0.65 mm thick, and long enough to allow anchorage of the bone and tooth-end portions in a stretching jig) from the mandibular incisors of 10 rabbits. The experimental set-up enabled simultaneous recording, on video, of the changing image brightness under polarizing optics together with extension across the periodontal ligament. Specimens were stretched until failure at a velocity of 0.5 mm/min. The tensile load-deformation curve of the ligament exhibited an initial, non-linear region that was followed by a linear region, a subsequent yielding region preceding the maximum point, and a final descending region. Gradual increases in the intensity of birefringence in the linear and yielding regions indicated that stress concentrations occur in the supporting fibres attached to mineralized tissues. In the final descending region of the curve, progressive breakages of individual fibre bundles occurred, mainly in the middle zone of the ligament. Analysis of the polarized light-microscopic images showed that the increases in brightness and area of birefringent collagen fibre bundles occurred in parallel with the stress generated. These results suggest that the collagen fibre bundles became aligned with the direction of loading and the intensity of their birefringence increased according to the applied tensile force.

Influence of physical exercise on aging rats. III. Life-long exercise modifies the aging changes of the mechanical properties of limb muscle tendons

We have previously shown that long-term regular physical exercise has a systemic influence on the rat by slowing the aging of its connective tissues, measured as thermal stability and biomechanical properties of tail tendons. This paper analyses whether the properties of limb muscle tendons are influenced not only by the aging process and the systemic effects of exercise but also from direct mechanical stimuli from long-term physical exercise. Male Sprague-Dawley rats were trained in a treadmill from the age of 5 to 23 months. The effects of training on muscle tendons were analyzed with respect to biomechanical properties. Also, the viscoelastic activation energies for interactions between collagen and the proteoglycan gel as well as between collagen fibrils were measured. Finally the asymptotes from the creep curves were calculated in order to estimate the magnitude of the viscoelastic creep. The effects of aging were analyzed with respect to the same parameters by comparing the group of 23-month-old sedentary rats with a 5-month-old baseline group. The biomechanical parameters did not change significantly with physical exercise. Neither did the activation energies change, but the asymptotes of the creep curves decreased, showing that there was less viscoelastic creep. Aging rendered the tendons significantly stronger and stiffer, increased the energy-absorbing capacity and decreased the strain values. The activation energies did not change with aging, but the high creep curve asymptote for the flexor tendons decreased. We conclude that aging rendered both types of tendons stiffer, and decreased their strain values at breaking point. Aging also increased the stress value, the energy absorption and the dry weight for the flexor tendon. Further, while physical exercise has a systemic delaying effect on age changes in connective tissues, in tendons subjected to substantial mechanical loads this effect as measured with biomechanical methods is counteracted by the optimization process elicited by the same physical exercise.

A structurally based stress-stretch relationship for tendon and ligament

We propose a mechanical model for tendon or ligament stress-stretch behavior that includes both microstructural and tissue level aspects of the structural hierarchy in its formulation. At the microstructural scale, a constitutive law for collagen fibers is derived based on a strain-energy formulation. The three-dimensional orientation and deformation of the collagen fibrils that aggregate to form fibers are taken into consideration. Fibril orientation is represented by a probability distribution function that is axisymmetric with respect to the fiber. Fiber deformation is assumed to be incompressible and axisymmetric. The matrix is assumed to contribute to stress only through a constant hydrostatic pressure term. At the tissue level, an average stress versus stretch relation is computed by assuming a statistical distribution for fiber straightening during tissue loading. Fiber straightening stretch is assumed to be distributed according to a Weibull probability distribution function. The resulting comprehensive stress-stretch law includes seven parameters, which represent structural and microstructural organization, fibril elasticity, as well as a failure criterion. The failure criterion is stretch based. It is applied at the fibril level for disorganized tissues but can be applied more simply at a fiber level for well-organized tissues with effectively parallel fibrils. The influence of these seven parameters on tissue stress-stretch response is discussed and a simplified form of the model is shown to characterize the nonlinear experimentally determined response of healing medial collateral ligaments. In addition, microstructural fibril organizational data (Frank et al., 1991, 1992) are used to demonstrate how fibril organization affects material stiffness according to the formulation. A simplified form, assuming a linearly elastic fiber stress versus stretch relationship, is shown to be useful for quantifying experimentally determined nonlinear toe-in and failure behavior of tendons and ligaments. We believe this ligament and tendon stress-stretch law can be useful in the elucidation of the complex relationships between collagen structure, fibril elasticity, and mechanical response.

On the deformation of slender filaments with planar crimp: theory, numerical solution and applications to tendon collagen and textile materials

Tensile deformation of a slender filament crimped into the form of a plane wave is analysed in terms of the theory of extensible planar elasticas. The load-extension relation is shown to be expressible in terms of the following dimensionless quantities: crimp level; slenderness (defined by the ratio of thickness to contour length of one wave) and shape function (curvature normalized to its peak value) only. A particular family of shapes is introduced where the shape function is specified by means of a single parameter q. All shapes of practical interest lie between the limits of a wave of circular arcs (q-> — ∞) and a planar zigzag(q - + ∞). A numerical solution is described in which the effects of varying crimp level, slenderness and shape are all examined and normalized forms of load and extension are found which bring together the load-extension curves for wide ranges of crimp and slenderness. This leads to a procedure for fitting experimental load-extension curves to those calculated, by simple shifting of double logarithmic plots. The method is illustrated by applying it to published data for tendon (which consists largely of aligned collagen fibrils with planar crimp). Reasonable agreement is obtained and the significance of this is discussed. Suggestions are made of how the method may be applied to the problems of planar crimp that frequently arise in textile materials.

Elongation mechanism of collagen fibrils and force-strain relations of tendon at each level of structural hierarchy

Tension-induced structural changes in bovine Achilles tendon collagen at each level of the hierarchy structure were investigated by means of the X-ray diffraction method. In order to estimate the straining mechanism in a collagen fibril, three elementary models for molecular elongation and rearrangement of collagen fibril were proposed on the basis of the Hodge-Petruska model: [1] molecular elongation, [2] increase in gap region and [3] relative slippage of laterally adjoining molecules. The characteristic 67 nm D-period of a collagen fibril increases with applied force. A Hookean-type force-strain curve was obtained for the D-period while the force-strain relation for the tendon was non-Hookean. The relative intensity of third-order reflection of the D-period to that of the second-order one, I3/I2, decreased with the applied force. This decrease in I3/I2 indicates a decrease in the ratio of the overlap region of collagen fibril to the D-period, O/D, which was analyzed on the basis of the Hodge-Petruska model. Decomposition of the observed strain in the D-period, epsilon(D), into these three deforming modes revealed that the major contribution to epsilon(D) originated from mode [1], molecular elongation. It was deduced that a fibril is mechanically composed of molecules connected serially to each other.

Changes in the fibre arrangement of the rat incisor periodontal ligament in relation to various loading levels in vitro

The relationship between the fibre arrangement of the periodontal ligament and the load-deformation behaviour was investigated at various loading levels. Transverse sections of the rat incisor were loaded in the eruptive direction in vitro and the deformation fixed at predetermined loads. Sections were prepared at these deformation levels. The periodontal ligaments were examined by polarized-light and scanning-electron microscopy. At the initial ("toe') part of the load-deformation curve, the periodontal fibres were gradually pulled and bent towards the direction of loading; their wavy pattern and periodic dark and bright bands became indistinct. At the next, linear part of the curve, the running direction of the fibres changed gradually until they were straightened and stretched. At the yielding part of the curve, the periodontal fibres began to rupture. Ruptured fibres adhering to the bone surface returned to their original obliquity and showed periodic dark and bright bands. The fibrous components of the rat incisor periodontal ligament thus transmit forces to bone at the linear part of the curve when the tooth is axially loaded.

A scanning electron microscopic study of rabbit ligaments under strain

For the purpose of determining the critical strain level for ligaments submitted to mechanical stimulation, rabbit medial collateral ligaments (MCLs) were subjected to different predetermined strain levels and then examined by scanning electron microscopy (SEM). Below 10% strain no evidence of disruption of the collagenous entities has been found. At about 10% strain, the ligaments were still intact macroscopically but SEM revealed numerous broken thin collagen fibers. At 20% strain, ruptures of thick collagen fibers bundles (5 to 10 mu in diameter) were found. These findings suggest that when using mechanical stimulation of ligaments, care must be taken to not exceed 10% strain level.

Two methods of ligament injury: a morphological comparison in a rabbit model

Our purpose in this study was to compare morphologically the reproducibility and control of two common methods of ligament injury. Polarized light and scanning electron microscopy were used to quantify the injury patterns and the extent of ligament damage caused by scalpel division and wire rupture of rabbit medial collateral ligaments. Results demonstrate that the scalpel cut and wire rupture methods of ligament injury are each controllable and reproducible in location, pattern, and extent of ligament damage. The wire rupture technique, however, produced consistently more extensive midsubstance ligament damage than the scalpel cut and thus created an injury pattern that better simulated the extent of damage seen in clinical injuries. Although neither technique was an ideal simulation of clinical injuries, results suggest that the wire rupture technique is a more relevant technique to study ligament injury and healing in this model.

Hierarchical structure in polymeric materials

The diversity of monomers available for synthesis of high polymers makes it possible to prepare a wide variety of long-chain macromolecular compounds. It is instructive to consider a hierarchical organization of structure in polymers at four successive levels--the molecular, nano-, micro-, and macrolevels--and to examine how interactions at and between these various levels of structure have important and often quite specific influences. Examples are drawn from semicrystalline polymers with flexible chains, liquid-crystalline polymers composed of rigid macromolecules, and amorphous polymers. Structural hierarchies in biocomposite systems are also discussed, particularly in soft connective tissues such as tendon and intervertebral disk.

Tendon stiffness: methods of measurement and significance for the control of movement. A review

An appraisal of the role of tendons in transmitting muscle tension to skeletal parts during posture and movement requires accurate knowledge of the mechanical characteristics of the tendon. Here the most important property is tendon stiffness. While it is relatively easy to measure the stiffness of an isolated segment of tendon, more sophisticated methods must be sought to take into account the whole length of tendon, including its intramuscular portion. Two methods are currently available for measurement of whole tendon stiffness: each has a limited range of muscle tensions over which it appears to provide reliable values, one method being better at low tensions, the other at high tensions. Some controversy remains about the precise values obtained in the mid-tension range covered by both methods. Nevertheless it is now possible to achieve reasonable estimates of tendon stiffness over the whole working range of the muscle. An important consideration which has emerged from the discussion is that at low tensions the tendon is much less stiff than at higher tensions.

Constitutive equations for fibrous connective tissues

A general multiaxial theory for the constitutive relations in fibrous connective tissues is developed on the basis of microstructural and thermodynamic considerations. It is compatible with existing general material theories. In elastic tissues, the theory considers the strain-energy function to be the sum of strain-energies of the tissue's components. The stresses are derived from this strain-energy function. Viscoelastic constitutive relations are obtained in an analogous manner. Few examples are developed in detail. The results of the present strain-energy based theory are identical with those of the author's previous structural models (Lanir, 1979a, b) which are based on detailed equilibrium analysis. It turns out, however, that the analytical work involved in solving boundary value problems is considerably shorter if the present theory is used. The advantages of structural theories in avoiding ambiguity in material characterization and in offering an insight into the function, structure and mechanics of tissue components are discussed.

Organization of collagen fibers in the intestine

The characteristic extinction pattern which is observed when the submucosa is viewed in the optical polarizing microscope has been analyzed in terms of the configuration and orientation of the 4 micron diameter collagen fibers. It is shown that the observed polarization effects are produced by periodic variations in orientation of fully birefringent fibers. The fiber configuration required to produce the observed polarization effects is a tilted wave configuration with a crimp period of approximately 20 micron. In the model, the tilted waveform fibers are crimped in register and form parallel arrays. The arrays are oriented in layers at approximately +30 degrees and -30 degrees to the longitudinal direction and are mirror images of each other. Analysis of the extinction pattern shows that the model satisfactorily accounts for the observed polarization effects at several different angles of the crossed polaroids. The calculated strain necessary to straighten the wavy fibers of the model correlates well with the observed strain to uncrimp the collagen fibers in the intestine. This suggests that the initial response to stress is gradual uncrimping of the collagen fibers, and concurrently, a decrease in the angle between biaxially oriented fibers, rather than extension of the straight fibers.

[Hemarthrosis and the cruciate ligaments - morphological studies. 2]

Some morphological investigations were conducted with cruciate ligaments of rabbits which had been exposed to post-traumatic hemarthrosis for different periods of time and submitted to an additional lesion of the synovial sheath. Already one week later, histologic examination under the microscope showed significant modifications of the fibrous structure of these ligaments. These modifications persisted for several months and consisted in bloatings of the individual fibres, disaggregations of the fibrous structure, partly even cystic necrosis. The electron microscope allowed to give a more precise definition of the modifications and to demonstrate morphologically the structure alteration of collagenic fibres caused by hemarthrosis. The visible alterations of the fibrous structure of such cruciate ligaments will partly persist still for a long time after the restitution of their full mechanical loading capacity.

Organization of collagen fibers in rat tail tendon at the optical microscope level

The collagen fibers of tendon have a wavy configuration which is important for the mechanical function of the tissue. An investigation into the organization of collagen fibers in rat tail tendon at the level of the light microscope has led us to propose a new model for the basic tendon unit. This unit, which is termed the fascicle, is usually triangular in cross-section and 150 to 300 microns in diameter. The fibrous entities which comprise the fascicle take the planar waveform configuration seen in the polarized transmission microscope and in longitudinal histology sections. The plane of the waveform is parallel to the long side of the fascicle and adjacent planes are arranged with the waveform in registry. Other structural features observed in the microscope can be produced by defects in this ordered arrangement. Thus slip parallel to the plane of the waveform can produce the crimp reversal observed in through-focus photomicrographs. The ridges and valleys which characterize the surface of the fascicle result from out-of-plane crimping. The surface topology is probably important in maintaining registry between neighboring fascicles.

Polarizing light microscopy of intestine and its relationship to mechanical behaviour

The polarizing optical microscope has been used to observe morphologically the effect of stress on rat and bovine intestine. Collagen fibres about 6 micrometers in diameter were found to be biaxially oriented at approximately +30 degrees and -30 degrees to the longitudinal direction. The fibres are arranged in layers with the fibres in each layer densely packed in parallel undulating arrays. The undulations give rise to the extinction pattern observed in the polarizing optical microscope. The initial response to stress is straightening of the fibres. Gradual straightening of the fibres is related to the increasing stiffness of the tissue observed in the stress--strain relationship. Once the fibres ares straightened, the biaxial orientation of the fibres produces higher strength in the longitudinal direction than in the transverse direction. This organization of intestinal collagen fibres has not been reported previously and is not observed in other biaxial tissues such as skin and aorta. Thus, intestine is a unique tissue for studying the relationship of mechanical behaviour to structure and organization of collagen.