Effects of temperature, concentration and articular surface removal on transient solute diffusion in articular cartilage

Kinetics and Retention of Polystyrenesulfonate for Proteoglycan Replacement in Cartilage

Tissue hydration provides articular cartilage with dynamic viscoelastic properties. Early stage osteoarthritis (OA) is marked by loss of proteoglycans and glycosaminoglycans (GAG), lowering fixed charge density, and impairing tissue osmotic function. The most common GAG replacement, chondroitin sulfate (CS), has failed to show effectiveness. Here, we investigated a synthetic polyelectrolyte, poly(styrenesulfonate) (PSS), both as a model compound to investigate polyelectrolyte transport in cartilage, and as a potential candidate to restore bulk fixed charge density in cartilage with GAG loss. Through bovine explants and histology, we determined zonal-based effective diffusion coefficients for three different molecular weights of PSS. Compared to CS, PSS was retained longer in GAG-depleted cartilage in static and compression-based desorption experiments. We explained enhanced solute performance of PSS by its more compact morphology and higher charge density by small-angle X-ray scattering. This study may improve design of GAG mimetic molecules for repairing osmotic function in OA cartilage.

Effect of molecular weight and tissue layer on solute partitioning in the knee meniscus

Objective

Knee meniscus tissue is partly vascularized, meaning that nutrients must be transported through the extracellular matrix of the avascular portion to reach resident cells. Similarly, drugs used as therapeutic agents to treat meniscal pathologies rely on transport through the tissue. The driving force of diffusive transport is the gradient of concentration, which depends on molecular solubility. The meniscus is organized into a core region sandwiched between the tibial and femoral superficial layers. Structural differences exist across meniscal regions; therefore, regional differences in solubility are also hypothesized.

Methods

Samples from the core, tibial and femoral layers were obtained from 5 medial and 5 lateral porcine menisci. The partition coefficient (K) of fluorescein, 3 ​kDa and 40 ​kDa dextrans in the layers of the meniscus was measured using an equilibration experiment. The effect of meniscal compartment, layer, and solute molecular weight on K was analyzed using a three-way ANOVA.

Results

K ranged from a high of ∼2.9 in fluorescein to a low of ∼0.1 in 40 ​kDa dextran and was inversely related to the solute molecular weight across all tissue regions. Tissue layer only had a significant effect on partitioning of 40k Dex solute, which was lower in the tibial surface layer relative to the core (p ​= ​0.032).

Conclusion

This study provides insight into depth-dependent partitioning in the meniscus, indicating the limiting effect of the meniscus superficial layer on solubility increases with solute molecular size. This illustrates how the surface layers could potentially reduce the effectiveness of drug delivery therapies incorporating large molecules (>40 ​kDa).

Effect of Strain, Region, and Tissue Composition on Glucose Partitioning in Meniscus Fibrocartilage

A nearly avascular tissue, the knee meniscus relies on diffusive transport for nutritional supply to cells. Nutrient transport depends on solute partitioning in the tissue, which governs the amount of nutrients that can enter a tissue. The purpose of the present study was to investigate the effects of mechanical strain, tissue region, and tissue composition on the partition coefficient of glucose in meniscus fibrocartilage. A simple partitioning experiment was employed to measure glucose partitioning in porcine meniscus tissues from two regions (horn and central), from both meniscal components (medial and lateral), and at three levels of compression (0%, 10%, and 20%). Partition coefficient values were correlated to strain level, water volume fraction, and glycosaminoglycan (GAG) content of tissue specimens. Partition coefficient values ranged from 0.47 to 0.91 (n = 48). Results show that glucose partition coefficient is significantly (p < 0.001) affected by compression, decreasing with increasing strain. Furthermore, we did not find a statistically significant effect of tissue when comparing medial versus lateral (p = 0.181) or when comparing central and horn regions (p = 0.837). There were significant positive correlations between tissue water volume fraction and glucose partitioning for all groups. However, the correlation between GAG content and partitioning was only significant in the lateral horn group. Determining how glucose partitioning is affected by tissue composition and loading is necessary for understanding nutrient availability and related tissue health and/or degeneration. Therefore, this study is important for better understanding the transport and nutrition-related mechanisms of meniscal degeneration.

Region-media coupling in characterization and modelling of the disc annulus single lamella swelling

The annulus fibrosus (AF) swelling property, which is correlated with its rheological and viscoelastic properties, plays a significant role in disc nutrition and mechanical loading justification during daily activities as well as designing scaffolds for tissue engineering applications. The objective of this study was twofold: firstly to characterize the AF single lamella swelling kinetics in different regions and solutions at the temperature range of 35-40 °C and secondly to use the swelling results as a baseline to model (independent to swelling media and anatomic region) the AF single lamella swelling. It was found that the AF single lamella swelling kinetics (equilibrium swelling ratio and swelling rate) depends on anatomic region and swelling media; however, its trend for different swelling media (ionic and molecular solution) is similar and the majority of hydration occurs during first 20% of equilibrium swelling time (about 20 min). Change in swelling rate constant in circumferential direction depends on the solution type. It decreases from anterior to lateral regions for water, PBS and glucose solution and remains constant-or its change is negligible-from lateral to posterolateral regions. The effect of temperature (in the range of 35-40 °C) on swelling kinetics was seen to be negligible. It was also understood that it is possible to present a model (independent to swelling media type) to predict the swelling kinetics of posterior and posterolateral AF single lamella, as these locations are less sensitive to the swelling media.

Environmental temperature impact on bone and cartilage growth

Environmental temperature can have a surprising impact on extremity growth in homeotherms, but the underlying mechanisms have remained elusive for over a century. Limbs of animals raised at warm ambient temperature are significantly and permanently longer than those of littermates housed at cooler temperature. These remarkably consistent lab results closely resemble the ecogeographical tenet described by Allen's "extremity size rule," that appendage length correlates with temperature and latitude. This phenotypic growth plasticity could have adaptive significance for thermal physiology. Shortened extremities help retain body heat in cold environments by decreasing surface area for potential heat loss. Homeotherms have evolved complex mechanisms to maintain tightly regulated internal temperatures in challenging environments, including "facultative extremity heterothermy" in which limb temperatures can parallel ambient. Environmental modulation of tissue temperature can have direct and immediate consequences on cell proliferation, metabolism, matrix production, and mineralization in cartilage. Temperature can also indirectly influence cartilage growth by modulating circulating levels and delivery routes of essential hormones and paracrine regulators. Using an integrated approach, this article synthesizes classic studies with new data that shed light on the basis and significance of this enigmatic growth phenomenon and its relevance for treating human bone elongation disorders. Discussion centers on the vasculature as a gateway to understanding the complex interconnection between direct (local) and indirect (systemic) mechanisms of temperature-enhanced bone lengthening. Recent advances in imaging modalities that enable the dynamic study of cartilage growth plates in vivo will be key to elucidating fundamental physiological mechanisms of long bone growth regulation.

Effect of mechanical convection on the partitioning of an anionic iodinated contrast agent in intact patellar cartilage

To determine if mechanical convection accelerates partitioning of an anionic contrast agent into cartilage while maintaining its ability to reflect the glycosaminoglycan (GAG) content in contrast-enhanced computed tomography (CECT) of cartilage. Bovine patellae (N = 4) were immersed in iothalamate and serially imaged over 24 h of passive diffusion at 34°C. Following saline washing for 14 h, each patella was serially imaged over 2.5 h of mechanical convection by cyclic compressive loading (120N, 1 Hz) while immersed in iothalamate at 34°C. After similar saline washing, each patella was sectioned into 15 blocks (n = 60) and contrast concentration per time point as well as GAG content were determined for each cartilage block. Mechanical convection produced 70.6%, 34.4%, and 16.4% higher contrast concentration at 30, 60, and 90 min, respectively, compared to passive diffusion (p < 0.001) and boosted initial contrast flux 330%. The correlation between contrast concentration and GAG content was significant at all time points and correlation coefficients improved with time, reaching R(2)  = 0.60 after 180 min of passive diffusion and 22.5 min of mechanical convection. Mechanical convection significantly accelerated partitioning of a contrast agent into healthy cartilage while maintaining strong correlations with GAG content, providing an evidence-based rationale for adopting walking regimens in CECT imaging protocols.

Hindlimb heating increases vascular access of large molecules to murine tibial growth plates measured by in vivo multiphoton imaging

Advances in understanding the molecular regulation of longitudinal growth have led to development of novel drug therapies for growth plate disorders. Despite progress, a major unmet challenge is delivering therapeutic agents to avascular-cartilage plates. Dense extracellular matrix and lack of penetrating blood vessels create a semipermeable "barrier," which hinders molecular transport at the vascular-cartilage interface. To overcome this obstacle, we used a hindlimb heating model to manipulate bone circulation in 5-wk-old female mice (n = 22). Temperatures represented a physiological range of normal human knee joints. We used in vivo multiphoton microscopy to quantify temperature-enhanced delivery of large molecules into tibial growth plates. We tested the hypothesis that increasing hindlimb temperature from 22°C to 34°C increases vascular access of large systemic molecules, modeled using 10, 40, and 70 kDa dextrans that approximate sizes of physiological regulators. Vascular access was quantified by vessel diameter, velocity, and dextran leakage from subperichondrial plexus vessels and accumulation in growth plate cartilage. Growth plate entry of 10 kDa dextrans increased >150% at 34°C. Entry of 40 and 70 kDa dextrans increased <50%, suggesting a size-dependent temperature enhancement. Total dextran levels in the plexus increased at 34°C, but relative leakage out of vessels was not temperature dependent. Blood velocity and vessel diameter increased 118% and 31%, respectively, at 34°C. These results demonstrate that heat enhances vascular carrying capacity and bioavailability of large molecules around growth plates, suggesting that temperature could be a noninvasive strategy for modulating delivery of therapeutics to impaired growth plates of children.

Pharmaceutical nanocarrier association with chondrocytes and cartilage explants: influence of surface modification and extracellular matrix depletion

OBJECTIVE

To evaluate cartilage diffusion and isolated chondrocyte association of micelles and liposomes and to determine the effect of cell-penetrating peptide (CPP) surface functionalization and extracellular matrix depletion on chondrocyte association and cartilage diffusion, respectively.

METHODS

Rhodamine-labeled micelles and liposomes were incubated with bovine chondrocytes and cell-associated fluorescence was quantified using flow cytometry. Rhodamine-labeled CPP-modified micelles and liposomes were incubated with chondrocytes and cell-associated fluorescence was compared to unmodified nanocarriers. Rhodamine-labeled micelles and liposomes were incubated with bovine cartilage explants for 1, 2 and 4 h and cartilage-associated fluorescence was compared across groups. Cartilage explants were treated with interleukin-1 alpha (IL-1α) or with 0.25% trypsin. Rhodamine-labeled micelles and liposomes were incubated with control, IL-1 and trypsin-treated explants and cartilage-associated fluorescence was compared across groups.

RESULTS

Chondrocyte-associated fluorescence following treatment with micelles was significantly higher (P < 0.001) than fluorescence in the cells treated with liposomes while there was no difference between cell-associated fluorescence in the liposomes-treated and untreated controls. CPP-modified nanocarriers exhibited a significant increase in chondrocyte association compared to unmodified nanocarriers (P < 0.001). Micelles exhibited a time and concentration-dependent diffusion in cartilage explants while liposomes showed no diffusion. Following IL-1 and trypsin treatments, micelle diffusion in articular cartilage was significantly higher (P < 0.001) than their diffusion in untreated explants.

CONCLUSION

Micelles exhibit superior association with isolated chondrocytes compared to liposomes. Surface modification with a CPP enhances chondrocyte association of both nanocarriers. 15 nm diameter micelles are better than 138 nm diameter liposomes in penetrating articular cartilage and extracellular matrix depletion enhances micelle penetration.

How the structural integrity of the matrix can influence the microstructural response of articular cartilage to compression

This study investigated how the structural integrity of healthy, surface-removed (healthy), and degenerate matrices can modify the response of cartilage to compression. Six groups of specimens were loaded up to the onset of consolidation or at full consolidation (N = 30, 5 per group, respectively) and then subsequently chemically fixed to capture the deformed state of the tissues. Creep compression was applied through an 8 mm flat-ended indenter containing a 450 μm diameter central pore, providing a region of high stress that also allowed the tissue samples to deform freely around the indenter pore during compression. Differential interference contrast microscopy was used in order to explore the microstructural responses of the tissues. The results demonstrated that superficial layer removal or tissue degeneration can reduce the observed deformation within the tissue region corresponding to the central pore of the loading indenter. Fibril crimping within the central pore matrix and matrix shear at the indenter edge regions are also reduced by both superficial layer removal and by tissue degeneration. These findings suggest that surface removal or tissue degeneration renders the matrix more susceptible to deformation and can also reduce the tissue's ability to transfer forces over a greater surface area and induce stress within the matrix.

Transport of anti-IL-6 antigen binding fragments into cartilage and the effects of injury

The efficacy of biological therapeutics against cartilage degradation in osteoarthritis is restricted by the limited transport of macromolecules through the dense, avascular extracellular matrix. The availability of biologics to cell surface and matrix targets is limited by steric hindrance of the matrix, and the microstructure of matrix itself can be dramatically altered by joint injury and the subsequent inflammatory response. We studied the transport into cartilage of a 48 kDa anti-IL-6 antigen binding fragment (Fab) using an in vitro model of joint injury to quantify the transport of Fab fragments into normal and mechanically injured cartilage. The anti-IL-6 Fab was able to diffuse throughout the depth of the tissue, suggesting that Fab fragments can have the desired property of achieving local delivery to targets within cartilage, unlike full-sized antibodies which are too large to penetrate beyond the cartilage surface. Uptake of the anti-IL-6 Fab was significantly increased following mechanical injury, and an additional increase in uptake was observed in response to combined treatment with TNFα and mechanical injury, a model used to mimic the inflammatory response following joint injury. These results suggest that joint trauma leading to cartilage degradation can further alter the transport of such therapeutics and similar-sized macromolecules.

The role of the superficial region in determining the dynamic properties of articular cartilage

OBJECTIVE

The objective of this study was to elucidate the role of the superficial region of articular cartilage in determining the dynamic properties of the tissue. It is hypothesised that removal of the superficial region will influence both the flow dependent and independent properties of articular cartilage, leading to a reduction in the dynamic modulus of the tissue.

METHODS

Osteochondral cores from the femoropatellar groove of three porcine knee joints were subjected to static and dynamic loading in confined or unconfined compression at increasing strain increments with and without their superficial regions. Equilibrium moduli and dynamic moduli were measured and the tissue permeability was estimated by fitting experimental data to a biphasic model.

RESULTS

Biochemical analysis confirmed a zonal gradient in the tissue composition and organisation. Histological and PLM analysis demonstrated intense collagen staining in the superficial region of the tissue with alignment of the collagen fibres parallel to the articular surface. Mechanical testing revealed that the superficial region is less stiff than the remainder of the tissue in compression, however removal of this region from intact cores was found to significantly reduce the dynamic modulus of the remaining tissue, suggesting decreased fluid load support within the tissue during transient loading upon removal of the superficial region. Data fits to a biphasic model predict a significantly lower permeability in the superficial region compared to the remainder of the tissue.

CONCLUSIONS

It is postulated that the observed decrease in the dynamic moduli is due at least in part to the superficial region acting as a low permeability barrier, where its removal decreases the tissue's ability to maintain fluid load support. This result emphasises the impact that degeneration of the superficial region has on the functionality of the remaining tissue.

Detection of mechanical injury of articular cartilage using contrast enhanced computed tomography

OBJECTIVE

Osteoarthritic degeneration may be initiated by mechanical overloading of articular cartilage. Mechanical injury increases the permeability of tissue, thereby probably affecting the diffusion of contrast agents in articular cartilage. We investigated whether it is possible to detect acute cartilage injury by measuring contrast agent diffusion into articular cartilage using contrast enhanced computed tomography (CECT).

METHODS

Osteochondral plugs (Ø=6.0 mm, n=36) were prepared from intact bovine patellae (n=9). Two of the adjacent samples were injured by impact loading, using a drop tower, while the others served as paired controls. The samples were imaged before immersion in contrast agent solution [ioxaglate (Hexabrix™) or sodium iodide (NaI)] and 1, 3, 5, 7, 10, 15, 20 and 25 h after immersion using a MicroCT-instrument. Contrast agent content, diffusion coefficient and diffusion flux were determined for each sample.

RESULTS

Already after 1 h the penetration of contrast agents into cartilage was significantly (P<0.05) greater in the injured samples. The diffusion coefficient was not altered by the injury, which suggests that reaching the diffusion equilibrium takes the same time in injured and intact cartilage. However, the diffusion flux of ioxaglate through the articular surface was significantly higher in injured samples at 30-60 min after immersion.

CONCLUSIONS

To conclude, CECT could diagnose articular cartilage injuries, and determination of the diffusion flux of ioxaglate helped to detect tissue injury without waiting for the diffusion equilibrium. These results are encouraging, however, in vivo application of CECT is challenging and systematic further studies are needed to reveal its clinical potential.

Diffusion coefficients of articular cartilage for different CT and MRI contrast agents

In contrast enhanced magnetic resonance imaging (MRI) and computed tomography (CT), the equilibrium distribution of anionic contrast agent is expected to reflect the fixed charged density (FCD) of articular cartilage. Diffusion is mainly responsible for the transport of contrast agents into cartilage. In osteoarthritis, cartilage composition changes at early stages of disease, and solute diffusion is most likely affected. Thus, investigation of contrast agent diffusion could enable new methods for imaging of cartilage composition. The aim of this study was to determine the diffusion coefficient of four contrast agents (ioxaglate, gadopentetate, iodide, gadodiamide) in bovine articular cartilage. The contrast agents were different in molecular size and charge. In peripheral quantitative CT experiments, penetration of contrast agent into the tissue was allowed either through the articular surface or through deep cartilage. To determine diffusion coefficients, a finite element model based on Fick's law was fitted to experimental data. Diffusion through articular surface was faster than through deep cartilage with every contrast agent. Iodide, being of atomic size, diffused into the cartilage significantly faster (q<0.05) than the other three contrast agents, for either transport direction. The diffusion coefficients of all clinical contrast agents (ioxaglate, gadopentetate and gadodiamide) were relatively low (142.8-253.7 μm(2)/s). In clinical diagnostics, such slow diffusion may not reach equilibrium and this jeopardizes the determination of FCD by standard methods. However, differences between diffusion through articular surface and deep cartilage, that are characterized by different tissue composition, suggest that diffusion coefficients may correlate with cartilage composition. Present method could therefore enable image-based assessment of cartilage composition by determination of diffusion coefficients within cartilage tissue.

Anisotropic solute diffusion tensor in porcine TMJ discs measured by FRAP with spatial Fourier analysis

A new method solely based on spatial Fourier analysis (SFA) was developed to completely determine a two-dimensional (2D) anisotropic diffusion tensor in fibrous tissues using fluorescence recovery after photobleaching (FRAP). The accuracy and robustness of this method was validated using computer-simulated FRAP experiments. This method was applied to determine the region-dependent anisotropic diffusion tensor in porcine temporomandibular joint (TMJ) discs. The average characteristic diffusivity of 4 kDa FITC-Dextran across the disc was 26.05 ± 4.32 μm²/s which is about 16% of its diffusivity in water. In the anteroposterior direction, the anterior region (30.99 ± 5.93 μm²/s) had significantly higher characteristic diffusivity than the intermediate region (20.49 ± 5.38 μm²/s) and posterior region (20.97 ± 2.46 μm²/s). The ratio of the two principal diffusivities represents the anisotropy of the diffusion and ranged between 0.45 and 0.51 (1.0 = isotropic). Our results indicated that the solute diffusion in TMJ discs is inhomogeneous and anisotropic. These findings suggested that diffusive transport in the TMJ disc is dependent on tissue composition (e.g., water content) and structure (e.g., collagen orientation). This study provides a new method to quantitatively investigate the relationship between solute transport properties and tissue composition and structure.

Transport and equilibrium uptake of a peptide inhibitor of PACE4 into articular cartilage is dominated by electrostatic interactions

The availability of therapeutic molecules to targets within cartilage depends on transport through the avascular matrix. We studied equilibrium partitioning and non-equilibrium transport into cartilage of Pf-pep, a 760 Da positively charged peptide inhibitor of the proprotein convertase PACE4. Competitive binding measurements revealed negligible binding of Pf-pep to sites within cartilage. Uptake of Pf-pep depended on glycosaminoglycan charge density, and was consistent with predictions of Donnan equilibrium given the known charge of Pf-pep. In separate transport experiments, the diffusivity of Pf-pep in cartilage was measured to be approximately 1 x 10(-6) cm(2)/s, close to other similarly-sized non-binding solutes. These results suggest that small positively charged therapeutics will have a higher concentration within cartilage than in the surrounding synovial fluid, a desired property for local delivery; however, such therapeutics may rapidly diffuse out of cartilage unless there is additional specific binding to intra-tissue substrates that can maintain enhanced intra-tissue concentration for local delivery.

Articular cartilage compression: how microstructural response influences pore pressure in relation to matrix health

Our research investigated the influence of degeneration on both the pore-pressure development and microstructural response of cartilage during indentation with a flat-porous-indenter. Experiments were conducted to link the mechanical and structural responses of normal and degenerate articular cartilage. We found that from the instant of loading the degenerate matrix generated a higher peak hydrostatic excess pore pressure in a shorter period of time than the normal matrix. Following the attainment of this peak value the pore pressure in both tissue groups then gradually decayed toward zero over time, thus demonstrating a classical consolidation response. The microstructural analysis provided a unique insight into the influence of degeneration on the mechanisms of internal stress-sharing within the loaded matrix. Both disruption of the articular surface and general matrix destructuring results in an altered deformation field in both the directly loaded and nondirectly loaded regions. It is argued that the higher levels of matrix shear combined with less of the applied load being redirected into the wider cartilage continuum accounts for the elevated levels of peak hydrostatic pore pressure generated in the degenerate matrix.

Temperature alters solute transport in growth plate cartilage measured by in vivo multiphoton microscopy

Solute delivery to avascular cartilaginous plates is critical to bone elongation, and impaired transport of nutrients and growth factors in cartilage matrix could underlie many skeletal abnormalities. Advances in imaging technology have revolutionized our ability to visualize growth plates in vivo, but quantitative methods are still needed. We developed analytical standards for measuring solute delivery, defined by amount and rate of intravenous tracer entry, in murine growth plates using multiphoton microscopy. We employed an acute temperature model because of its well-established impact on bone circulation and tested the hypothesis that solute delivery changes positively with limb temperature when body core and respiration are held constant (36 degrees C, 120 breaths/min). Tibial growth plates were surgically exposed in anesthetized 5-wk-old mice, and their hindlimbs were immersed in warm (36 degrees C) or cool (23 degrees C) saline (n = 6/group). After 30 min of thermal equilibration, we administered an intracardiac injection of fluorescein (50 microl, 0.5%) and captured sequentially timed growth plate images spanning 10 min at standardized depth. Absolute growth plate fluorescence was normalized to vascular concentrations for interanimal comparisons. As predicted, more fluorescein infiltrated growth plates at 36 degrees C, with standardized values nearly double those at 23 degrees C. Changing initial limb temperature did not alter baseline values, suggesting a sustained response period. These data validate the sensitivity of our system and have relevance to strategies for enhancing localized delivery of therapeutic agents to growth plates of children. Applications of this technique include assessment of solute transport in models of growth plate dysfunction, particularly chondrodysplasias with matrix irregularities.

Microscale diffusion properties of the cartilage pericellular matrix measured using 3D scanning microphotolysis

Chondrocytes, the cells in articular cartilage, are enclosed within a pericellular matrix (PCM) whose composition and structure differ from those of the extracellular matrix (ECM). Since the PCM surrounds each cell, molecules that interact with the chondrocyte must pass through the pericellular environment. A quantitative understanding of the diffusional properties of the PCM may help in elucidating the regulatory role of the PCM in controlling transport to and from the chondrocyte. The diffusivities of fluorescently labeled 70 kDa and 500 kDa dextrans were quantified within the PCM of porcine articular cartilage using a newly developed mathematical model of scanning microphotolysis (SCAMP). SCAMP is a rapid line photobleaching method that accounts for out-of-plane bleaching attributable to high magnification. Data were analyzed by a best-fit comparison to simulations generated using a discretization of the diffusion-reaction equation in conjunction with the microscope-specific three-dimensional excitation and detection profiles. The diffusivity of the larger molecule (500 kDa dextran) was significantly lower than that of the smaller molecule (70 kDa dextran), and values were consistent with those reported previously using standard techniques. Furthermore, for both dextran sizes, the diffusion coefficient was significantly lower in the PCM than in the ECM; however, this difference was not detected in early-stage arthritic tissue. We have successfully modified the SCAMP technique to measure diffusion coefficients within the small volume of the PCM using confocal laser scanning microscopy. Our results support the hypothesis that diffusivity within the PCM of healthy articular cartilage is lower than that within the ECM, presumably due to differences in proteoglycan content.

Site-specific effects of compression on macromolecular diffusion in articular cartilage

Articular cartilage is the connective tissue that lines joints and provides a smooth surface for joint motion. Because cartilage is avascular, molecular transport occurs primarily via diffusion or convection, and cartilage matrix structure and composition may affect diffusive transport. Because of the inhomogeneous compressive properties of articular cartilage, we hypothesized that compression would decrease macromolecular diffusivity and increase diffusional anisotropy in a site-specific manner that depends on local tissue strain. We used two fluorescence photobleaching methods, scanning microphotolysis and fluorescence imaging of continuous point photobleaching, to measure diffusion coefficients and diffusional anisotropy of 70 kDa dextran in cartilage during compression, and measured local tissue strain using texture correlation. For every 10% increase in normal strain, the fractional change in diffusivity decreased by 0.16 in all zones, and diffusional anisotropy increased 1.1-fold in the surface zone and 1.04-fold in the middle zone, and did not change in the deep zone. These results indicate that inhomogeneity in matrix structure and composition may significantly affect local diffusive transport in cartilage, particularly in response to mechanical loading. Our findings suggest that high strains in the surface zone significantly decrease diffusivity and increase anisotropy, which may decrease transport between cartilage and synovial fluid during compression.

Diffusional anisotropy in collagenous tissues: fluorescence imaging of continuous point photobleaching

Molecular transport in avascular collagenous tissues such as articular cartilage occurs primarily via diffusion. The presence of ordered structures in the extracellular matrix may influence the local transport of macromolecules, leading to anisotropic diffusion depending on the relative size of the molecule and that of extracellular matrix structures. Here we present what we believe is a novel photobleaching technique for measuring the anisotropic diffusivity of macromolecules in collagenous tissues. We hypothesized that macromolecular diffusion is anisotropic in collagenous tissues, depending on molecular size and the local organization of the collagen structure. A theoretical model and experimental protocol for fluorescence imaging of continuous point photobleaching was developed to measure diffusional anisotropy. Significant anisotropy was observed in highly ordered collagenous tissues such as ligament, with diffusivity ratios>2 along the fiber direction compared to the perpendicular direction. In less-ordered tissues such as articular cartilage, diffusional anisotropy was dependent on site in the tissue and size of the diffusing molecule. Anisotropic diffusion was also dependent on the size of the diffusing molecule, with greatest anisotropy observed for larger molecules. These findings suggest that diffusional transport of macromolecules is anisotropic in collagenous tissues, with higher rates of diffusion along primary orientation of collagen fibers.

Influence of a Superficial Tangential Zone Over Repairing Cartilage Defects: Implications for Tissue Engineering

The superficial tangential zone (STZ) plays a critical role in normal cartilage function but is not yet a focus for designing tissue-engineered constructs for cartilage repair. Without material properties of sufficient quality in this zone, transplanted constructs in vivo may have little chance of survival. This finite element study investigates the impact of the superficial tangential zone on the mechanical function of normal articular surfaces as well as those with transplanted constructs. The zone is modeled as a thin transversely isotropic material with strain dependent permeability. The analyses predict that a normal transversely isotropic STZ placed over a repair region reduces the axial compression (55-68%) of, and the rate of fluid loss (45-82%) from the articular surface. A reduction was also found in von Mises stress (26-57%), axial strain (22-56%), and radial strain (69-73%), and an increase in fluid pressure (19-45%) in repair tissue under the STZ. Incorporating a quality superficial tangential zone in tissue-engineered constructs may be a critical factor in achieving mechanical environments conducive for successful cartilage repairs.

Composition and transport properties of human ankle and knee cartilage

The incidence of osteoarthritis is significantly higher in the knee as compared to the ankle, suggesting that differences in the properties of cartilage from these joints may contribute to the development of osteoarthritis. As an avascular tissue, articular cartilage depends primarily upon diffusion for molecular transport. The goal of this study was to determine if differences in the structure and composition between ankle and knee cartilage were also reflected as differences in solute transport properties. The diffusion coefficient and partition coefficient of a 70-kDa dextran molecule were measured in human ankle and knee articular cartilage using fluorescence recovery after photobleaching (FRAP) and were compared to the proteoglycan, collagen, water, and DNA contents within each zone. The mean partition coefficient was significantly lower in the ankle compared to the knee (0.010+/-0.002 vs. 0.022+/-0.003, p<0.01), but no differences in the diffusion coefficients were observed (34.6 +/- 0.9 microm(2)s(-1) vs. 35.4+/-2.4 microm(2)s(-1), p=0.70). Ankle cartilage exhibited higher proteoglycan content as well as a trend toward lower water content, suggesting that ankle cartilage has a smaller effective pore size than knee cartilage. These findings suggest that differences in the composition of ankle and knee cartilage contribute to a difference in the partition coefficient. The results of this study provide further support for the hypothesis that the transport properties of cartilage may play a role in the differences in the incidence of osteoarthritis in these joints by altering the effective concentration of growth factors and cytokines to which chondrocytes are exposed.

Validation of a diffusion chamber as in vitro system for the analysis of compound diffusibility through cartilage tissue

The validation of a diffusion chamber comprising a donor and a receptor side separated by a cartilage membrane was undertaken according to the basic principles described by Peng et al. (1998). The study had three targets: first to evaluate the chamber as in vitro system by the examination of the diffusibility of compound through bovine cartilage samples; second the analysis of the affinity of compound (RS-130830) to cartilage; third to test the influence of two pre-incubation periods (one or three nights) of the cartilage samples. The validation of the chamber as in vitro system for the analysis of compound diffusibility and affinity to cartilage was performed using membrane slices of fresh bovine cartilage and a hydroxamic acid derivative (RS-130830) known as matrix metalloproteinase inhibitor (MMPI). The influence of the pre-incubation of cartilage was also examined. Compound concentrations in donor, receptor and membrane were determined by high performance liquid chromatography-mass spectrometry (HPLC-MS). Diffusion could be demonstrated after 6 h and finally 24 h incubation: the compound concentration in the receptor increased from 0 to 35 microM (mean) while it decreased in the donor from 200 to 144 microM (mean). We also found compound in the cartilage membrane (approximately 1.2 nmol (mean)). Pre-incubation of cartilage samples in culture buffer is suitable as a storage procedure, since the results on the donor side only were influenced significantly but not for the receptor and the cartilage affinity. Thus, the system could clearly reflect relevant properties of the tested compound with regard to its diffusibility and affinity to cartilage tissue.

Effect of arthroscopy and continuous cryotherapy on the intra-articular temperature of the knee

PURPOSE

The purpose of this study was to determine "in vivo" the intra-articular temperature of the knee in baseline situation, to quantify its variation during the arthroscopic surgery and the repercussion on the body temperature, and to quantify the variation of the intra-articular temperature after the application of topic cold postoperatively.

TYPE OF STUDY

Case series. Experimental study in patients who undergo arthroscopic surgery of the knee monitoring their intra-articular temperature.

METHODS

An intra-articular temperature data acquisition system is used in 30 patients who undergo arthroscopic surgery of the knee using saline solution at room temperature and monitoring their body temperature with a rectal temperature probe. In 23 of these patients, after surgery, a plastic bag with 2 kg of ice is applied on the knee, and the variation of the intra-articular temperature is measured for at least 1 hour.

RESULTS

The basal temperature of the knee (32.22 degrees +/- 0.28 degrees C) decreases during the intervention using saline fluid at room temperature to nearly equalize it (24.49 degrees +/- 0.97 degrees C), and it led to a drop of the body temperature of 0.14 degrees +/- 0.04 degrees C. The continuous external application of ice after the arthroscopy produces a drop of the intra-articular temperature directly related to the time, with a magnitude of almost 4 degrees C in the first hour.

CONCLUSIONS

The intra-articular baseline temperature of the knee is significantly lower than that of the body, and the repercussion of its drop during arthroscopic surgery on the body temperature is insignificant. The external application of ice is an effective and sure method to diminish the intra-articular temperature of the knee.

LEVEL OF EVIDENCE

Level IV, case series with no control group.

Adjacent tissues (cartilage, bone) affect the functional integration of engineered calf cartilage in vitro

OBJECTIVE

An in vitro model was used to test the hypothesis that culture time and adjacent tissue structure and composition affected chondrogenesis and integrative repair in engineered cartilage.

METHOD

Engineered constructs made of bovine calf chondrocytes and hyaluronan benzyl ester non-woven mesh were press-fitted into adjacent tissue rings made of articular cartilage (AC), devitalized bone (DB), or vital bone (VB) and cultured in rotating bioreactors for up to 8 weeks. Structure (light and electron microscopy), biomechanical properties (interfacial adhesive strength, construct compressive modulus), biochemical composition (construct glycosaminoglycans (GAG), collagen, and cells), and adjacent tissue diffusivity were assessed.

RESULTS

Engineered constructs were comprised predominately of hyaline cartilage, and appeared either closely apposed to adjacent cartilage or functionally interdigitated with adjacent bone due to interfacial deposition of extracellular matrix. An increase in culture time significantly improved construct adhesive strength (P<0.001), modulus (P=0.02), GAG (P=0.04) and cellularity (P<0.001). The type of adjacent tissue significantly affected construct adhesion (P<0.001), modulus (P<0.001), GAG (P<0.001) and collagen (P<0.001). For constructs cultured in rings of cartilage, negative correlations were observed between ring GAG content (log transformed) and construct adhesion (R2=0.66, P<0.005), modulus (R2=0.49, P<0.05) and GAG (R2=0.44, P<0.05). Integrative repair was better for constructs cultured adjacent to bone than cartilage, in association with its solid architectural structure and high GAG content, and best for constructs cultured adjacent to DB, in association with its high diffusivity.

CONCLUSIONS

Chondrogenesis and integrative repair in engineered cartilage improved with time and depended on adjacent tissue architecture, composition, and transport properties.

Modeling of neutral solute transport in a dynamically loaded porous permeable gel: implications for articular cartilage biosynthesis and tissue engineering

A primary mechanism of solute transport in articular cartilage is believed to occur through passive diffusion across the articular surface, but cyclical loading has been shown experimentally to enhance the transport of large solutes. The objective of this study is to examine the effect of dynamic loading within a theoretical context, and to investigate the circumstances under which convective transport induced by dynamic loading might supplement diffusive transport. The theory of incompressible mixtures was used to model the tissue (gel) as a mixture of a gel solid matrix (extracellular matrix/scaffold), and two fluid phases (interstitial fluid solvent and neutral solute), to solve the problem of solute transport through the lateral surface of a cylindrical sample loaded dynamically in unconfined compression with frictionless impermeable platens in a bathing solution containing an excess of solute. The resulting equations are governed by nondimensional parameters, the most significant of which are the ratio of the diffusive velocity of the interstitial fluid in the gel to the solute diffusivity in the gel (Rg), the ratio of actual to ideal solute diffusive velocities inside the gel (Rd), the ratio of loading frequency to the characteristic frequency of the gel (f), and the compressive strain amplitude (epsilon 0). Results show that when Rg > 1, Rd < 1, and f > 1, dynamic loading can significantly enhance solute transport into the gel, and that this effect is enhanced as epsilon 0 increases. Based on representative material properties of cartilage and agarose gels, and diffusivities of various solutes in these gels, it is found that the ranges Rg > 1, Rd < 1, correspond to large solutes, whereas f > 1 is in the range of physiological loading frequencies. These theoretical predictions are thus in agreement with the limited experimental data available in the literature. The results of this study apply to any porous hydrated tissue or material, and it is therefore plausible to hypothesize that dynamic loading may serve to enhance solute transport in a variety of physiological processes.

Diffusive properties of immature articular cartilage

The diffusive properties of immature bovine articular cartilage were determined using two different-sized, uncharged solutes (glucose 180 Da, and dextran 10k Da). Radioactively tagged glucose and dextran were diffused into the cartilage for transport times of 5, 15, and 60 min, and the diffusion and partition coefficients were calculated by fitting the experimental data to a one-dimensional diffusion model. The diffusion and partition coefficients for the two solutes averaged 6.08 +/- 2.19 and 5.09 +/- 2.51 (x 10(-6) cm2/s) and 0.712 +/- 0.149 and 0.615 +/- 0.120, respectively. Both coefficients were significantly greater for glucose compared to the larger dextran. While no statistical differences could be found in the diffusive properties of these solutes in immature cartilage compared to their diffusive properties in mature cartilage, there was some evidence that the larger dextran solute might diffuse faster in the earlier time periods. Finally, the bulk fluid contents between the two types of cartilage were not different even though the immature tissue was significantly thicker (1.6 times) than the mature tissue. Our results indicate that the solute diffusion properties of articular cartilage, at least with respect to uncharged solutes, do not change during skeletal maturation.

Effect of proteoglycan removal on solute mobility in articular cartilage

Transport of nutrients, cytokines, pharmacologic agents, and matrix components through articular cartilage is critical for the viability and structural integrity of the tissue. To understand the role of the extracellular matrix in regulating this process, we measured the diffusivity of three uncharged solutes of different molecular size (glucose, MW 180; inulin, MW 5000; dextran, MW 70,000) into intact cartilage and cartilage that had its proteoglycan (PG) component removed. Solute diffusivity was measured by performing transient (nonsteady state) one-dimensional diffusion tests using radiolabelled solutes. Compared to intact cartilage, the diffusivity of glucose was unchanged after PG removal, inulin was unchanged but dextran increased by 1.7 times after 71% PG removal, and both inulin and dextran increased by 1.6 and 2.0 times, respectively, after 93% PG removal. The diffusivities of inulin and dextran were inversely proportional to the PG content. While no change was found in the tissue's bulk fluid content, PG depletion resulted in an increase in fluid content in the upper regions of the tissue and a decrease in the lower regions. These results indicate that in intact tissue small uncharged solutes have free mobility through the inter-molecular and intra-molecular PG volumes, larger molecules have limited intra-molecular mobility, and very large molecules are excluded from the intra-molecular space.