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Rajankunte Mahadeshwara M, Al-Jawad M, Hall RM, Pandit H, El-Gendy R, Bryant M. How Do Cartilage Lubrication Mechanisms Fail in Osteoarthritis? A Comprehensive Review. Bioengineering (Basel) 2024; 11:541. [PMID: 38927777 PMCID: PMC11200606 DOI: 10.3390/bioengineering11060541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/02/2024] [Accepted: 05/21/2024] [Indexed: 06/28/2024] Open
Abstract
Cartilage degeneration is a characteristic of osteoarthritis (OA), which is often observed in aging populations. This degeneration is due to the breakdown of articular cartilage (AC) mechanical and tribological properties primarily attributed to lubrication failure. Understanding the reasons behind these failures and identifying potential solutions could have significant economic and societal implications, ultimately enhancing quality of life. This review provides an overview of developments in the field of AC, focusing on its mechanical and tribological properties. The emphasis is on the role of lubrication in degraded AC, offering insights into its structure and function relationship. Further, it explores the fundamental connection between AC mechano-tribological properties and the advancement of its degradation and puts forth recommendations for strategies to boost its lubrication efficiency.
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Affiliation(s)
- Manoj Rajankunte Mahadeshwara
- Institute of Functional Surfaces, Mechanical Engineering, University of Leeds, Leeds LS2 9JT, UK
- Department of Oral Biology, Faculty of Dentistry, University of Leeds, Leeds LS2 9JT, UK; (M.A.-J.); (R.E.-G.)
| | - Maisoon Al-Jawad
- Department of Oral Biology, Faculty of Dentistry, University of Leeds, Leeds LS2 9JT, UK; (M.A.-J.); (R.E.-G.)
| | - Richard M. Hall
- School of Engineering, College of Engineering and Physical Sciences, University of Birmingham, Birmingham B15 2TT, UK;
| | - Hemant Pandit
- Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, Chapel Allerton Hospital, Leeds LS7 4SA, UK;
| | - Reem El-Gendy
- Department of Oral Biology, Faculty of Dentistry, University of Leeds, Leeds LS2 9JT, UK; (M.A.-J.); (R.E.-G.)
- Department of Oral Pathology, Faculty of Dentistry, Suez Canal University, Ismailia 3, Ismailia Governorate 8366004, Egypt
| | - Michael Bryant
- Institute of Functional Surfaces, Mechanical Engineering, University of Leeds, Leeds LS2 9JT, UK
- School of Engineering, College of Engineering and Physical Sciences, University of Birmingham, Birmingham B15 2TT, UK;
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Coefficient of Friction and Height Loss: Two Criteria Used to Determine the Mechanical Property and Stability of Regenerated Versus Natural Articular Cartilage. Biomedicines 2022; 10:biomedicines10112685. [DOI: 10.3390/biomedicines10112685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/28/2022] [Accepted: 10/12/2022] [Indexed: 11/17/2022] Open
Abstract
Background: The coefficient of friction (CoF) serves as an indicator for the mechanical properties of natural and regenerated articular cartilage (AC). After tribological exposure, a height loss (HL) of the cartilage pair specimens can be measured. Our aim was to determine the CoF and HL of regenerated AC tissue and compare them with those of natural AC from non-operated joints and AC from joints where the regenerated tissues had been created after different treatments. Methods: In partial-thickness defects of the trochleae of the stifle joints of 60 Göttingen Minipigs, regenerated AC was created. In total, 40 animals received a Col I matrix, 20 laden with autologous chondrocytes, and 20 without. The defects of 20 animals were left empty. The healing periods were 24 and 48 weeks. A total of 10 not-operated animals, delivered the “external” control specimens. Osteochondral pins were harvested from defect and non-defect areas, the latter serving as “internal” controls. Using a pin-on-plate tribometer, we measured the CoF and the HL. Results: The CoF of the regenerated AC ranged from 0.0393 to 0.0688, and the HL, from 0.22 mm to 0.3 mm. The differences between the regenerated AC of the six groups and the “external” controls were significant. The comparison with the “internal” controls revealed four significant differences for the CoF and one for the HL in the operated groups. No differences were seen within the operated groups. Conclusions: The mechanical quality of the regenerated AC tissue showed inferior behavior with regard to the CoF and HL in comparison with natural AC. The comparison of regenerated AC tissue with AC from untreated joints was more promising than with AC from the treated joints.
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Engelhardt JP, Schütte A, Hetjens S, Reisig G, Schwarz ML. Resilience to height loss of articular cartilage of osteoarthritic stifle joints of old pigs, compared with healthy cartilage from young pigs in a tribological pin-on-plate exposure, revealing similar friction forces. PLoS One 2021; 16:e0250244. [PMID: 33891624 PMCID: PMC8064609 DOI: 10.1371/journal.pone.0250244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 04/04/2021] [Indexed: 12/04/2022] Open
Abstract
Introduction We saw a lack of data on the biomechanical behavior of degenerated articular cartilage (OA) compared with that of healthy cartilage, even though the susceptibility to wear and tear of articular cartilage plays a key role in the progression of osteoarthritis (OA). Therefore, we performed a comparison between naturally occurring OA and healthy cartilage from pigs, before and after tribological stress. Aim The aim of the study was to compare OA-cartilage with healthy cartilage and to analyze the resilience to tribological shear stress, which will be measured as height loss (HL), and to friction forces of the cartilage layers. The findings will be substantiated in macro- and microscopical evaluations before and after tribological exposure. Methods We assessed stifle joints of fifteen old and sixteen young pigs from the local abattoir radiologically, macroscopically and histologically to determine possible OA alterations. We put pins from the femoral part of the joints and plates from the corresponding tibial plateaus in a pin-on-plate tribometer under stress for about two hours with about 1108 reciprocating cycles under a pressure of approximately 1 MPa. As a surrogate criterion of wear and tear, the HL was recorded in the tribometer. The heights of the cartilage layers measured before and after the tribological exposure were compared histologically. The condition of the cartilage before and after the tribological exposure was analyzed both macroscopically with an adapted ICRS score and microscopically according to Little et al. (2010). We assessed the friction forces acting between the surfaces of the cartilage pair–specimens. Results Articular cartilage taken from old pigs showed significant degenerative changes compared to that taken from the young animals. The macroscopic and microscopic scores showed strong alterations of the cartilage after the tribological exposure. There was a noticeable HL of the cartilage specimens after the first 100 to 300 cycles. The HL after tribological exposure was lower in the group of the old animals with 0.52 mm ± 0.23 mm than in the group of the young animals with 0.86 mm ± 0.26 mm (p < 0.0001). The data for the HL was validated by the histological height measurements with 0.50 mm ± 0.82 mm for the old and 0.79 mm ±0.53 mm for the young animals (p = 0.133). The friction forces measured at the cartilage of the old animals were 2.25 N ± 1.15 N and 1.89 N ± 1.45 N of the young animals (p = 0.3225). Conclusion Unlike articular cartilage from young pigs, articular cartilage from old pigs showed OA alterations. Tribological shear stress exposure revealed that OA cartilage showed less HL than healthy articular cartilage. Tribological stress exposure in a pin–on–plate tribometer seemed to be an appropriate way to analyze the mechanical stability of articular cartilage, and the applied protocol could reveal weaknesses of the assessed cartilage tissue. Friction and HL seemed to be independent parameters when degenerated and healthy articular cartilage were assessed under tribological exposure in a pin–on- plate tribometer.
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Affiliation(s)
- Jan P. Engelhardt
- Department of Experimental Orthopedics and Trauma Surgery, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
| | - Andy Schütte
- Department of Experimental Orthopedics and Trauma Surgery, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
| | - Svetlana Hetjens
- Department of Medical Statistics, University Medicine Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
| | - Gregor Reisig
- Department of Experimental Orthopedics and Trauma Surgery, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
| | - Markus L. Schwarz
- Department of Experimental Orthopedics and Trauma Surgery, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
- * E-mail:
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Knee-to-Talus Donor-Site Morbidity Following Autologous Osteochondral Transplantation: A Meta-Analysis with Best-case and Worst-case Analysis. Clin Orthop Relat Res 2019; 477:1915-1931. [PMID: 31135553 PMCID: PMC7000024 DOI: 10.1097/corr.0000000000000719] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Despite the promising clinical results of autologous osteochondral transplantation in the treatment of osteochondral lesions of the talus, the occurrence of knee donor-site morbidity remains a concern. However, the proportion of patients experiencing donor-site morbidity is not well established because of important variations in estimates drawn by heterogeneous studies with loss to followup, often made at short-term (< 1 year). Therefore, both a meta-analysis of studies that assumed no patients lost to followup had donor-site morbidity and assumed all patients lost to followup had donor-site morbidity may help to estimate the true risk of donor-site morbidity. QUESTIONS/PURPOSES To evaluate the proportion of patients who developed knee donor-site morbidity after autologous osteochondral transplantation for osteochondral lesion of the talus, by (1) meta-analysis of the proportion of patients experiencing donor-site morbidity in the best-case scenario as reported, in which no patients lost to followup were assumed to have donor-site morbidity and (2) meta-analysis of the percentage of patients who had donor-site morbidity in the worst-case scenario, in which all patients lost to followup were assumed to have donor-site morbidity and (3) present the characteristics of studies associated with the reporting of donor-site morbidity. METHODS A systematic search of the PubMed, Embase and The Cochrane Library databases was performed from their inception to October 2017 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The inclusion criteria were clinical studies that reported knee donor-site morbidity after autologous osteochondral transplantation for osteochondral lesion of the talus, mean followup ≥ 1 year, full-text studies published in a peer-review journal and written in English. Quality of evidence (Case Series Quality Appraisal Checklist), sample size, mean patient age, study design, mean followup time, and observed rate of knee donor-site morbidity were evaluated. Twenty-six studies with 915 ankles (904 patients) were included in the systematic review and meta-analysis. Approximately half of the included studies were of small cohort (n < 30, 12 studies), and 12 of 26 studies did not report at all on loss to followup. In the studies that reported loss to followup (14 of 26), a total of 32 patients (35 ankles) were reported lost. Random-effects models were used to estimate the risk of donor-site morbidity as between-study heterogeneity was determined to be high in both meta-analyses that assumed that no patients lost to followup experienced donor-site morbidity (I = 82.1%) and the one that assumed all patients lost to followup experienced donor-site morbidity (I = 88.7%). Multivariable metaregression was used to estimate the association between study characteristics and the observed proportion of patients who experienced of donor-site morbidity. If there was evidence of an association between a study characteristic and proportion, a subgroup analysis was performed. RESULTS The estimated proportion of donor-site morbidity was 6.7% (95% confidence interval [CI], 2.8-11.8), assuming that no patients lost to followup experienced donor-site morbidity and 10.8% (95% CI, 4.8-18.3) assuming that all patients lost to followup experienced donor-site morbidity after a mean followup of 43.8 ± 24.7 months (range, 15.9-120 months). There was a negative association between study sample size and proportion of donor-site morbidity (β = -0.26; 95% CI, -0.39 to -0.12; p < 0.001 assuming that no patients lost to followup experienced donor-site morbidity and β = -0.31; 95% CI, -0.48 to -0.13; p < 0.001 assuming that all patients lost to followup experienced donor-site morbidity); that is, as study size increased, the proportion of patients reported with donor-site morbidity decreased. In larger studies (n ≥ 30), the estimated percentage of donor-site morbidity was 2.8% (95% CI, 1.2%-5.0%; I = 47.6%) assuming that no patients lost to followup experienced donor-site morbidity, and 5.0% (95% CI, 2.1%-9.0%; I = 74.5%) assuming all patients lost to followup experienced donor-site morbidity. High between-study heterogeneity (differences in methodology) could not be completely explained by variability in study sample size, mean patient age, design, or mean followup time, and may be attributable to other factors such as inconsistent definitions of donor-site morbidity. CONCLUSIONS The estimated proportion of donor-site morbidity after autologous osteochondral transplantation for osteochondral lesion of the talus ranged from 6.7% to 10.8% in the current meta-analysis. However, subgroup analysis demonstrated that larger studies (n ≥ 30) estimated a lower donor-site morbidity risk (< 5.0%) than smaller studies (n < 30). This estimate should be interpreted in light of the fact that nearly half of the included studies did not report on loss to followup, and so their estimates of donor-site morbidity may be low. In addition, high between-study heterogeneity and the inclusion of predominantly retrospective studies with small sample sizes likely contributed to estimates that suffered from a high risk of bias, probably in favor of the surgical treatment being studied. LEVEL OF EVIDENCE Level IV, therapeutic study.
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Shimozono Y, Donders JCE, Yasui Y, Hurley ET, Deyer TW, Nguyen JT, Kennedy JG. Effect of the Containment Type on Clinical Outcomes in Osteochondral Lesions of the Talus Treated With Autologous Osteochondral Transplantation. Am J Sports Med 2018; 46:2096-2102. [PMID: 29869915 DOI: 10.1177/0363546518776659] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Uncontained-type osteochondral lesions of the talus (OLTs) have been shown to have inferior clinical outcomes after treatment with bone marrow stimulation. While autologous osteochondral transplantation (AOT) is indicated for larger lesions, no study has reported on the prognostic significance of the containment of OLTs treated with the AOT procedure. PURPOSE To clarify the effect of the containment of OLTs on clinical and radiological outcomes in patients who underwent AOT for OLTs. STUDY DESIGN Case control study; Level of evidence, 3. METHODS A retrospective cohort study comparing patients with contained-type and uncontained-type OLTs was undertaken to include all patients who underwent AOT for the treatment of OLTs between 2006 and 2014. Analyses were performed by grouping the patients according to the containment type. Clinical outcomes were evaluated using the Foot and Ankle Outcome Score (FAOS) and the 12-Item Short Form Health Survey (SF-12) preoperatively and at final follow-up. Magnetic resonance imaging (MRI) at 2 years' follow-up was evaluated with the modified magnetic resonance observation of cartilage repair tissue (MOCART) score. Multivariate regression models were used to evaluate factors affecting postoperative FAOS, SF-12, and MOCART scores. RESULTS Ninety-four patients were included: 31 patients with a contained-type OLT and 63 patients with an uncontained-type OLT. The median patient age was 34 years (interquartile range [IQR], 28-48 years) in the contained-type group and 36 years (IQR, 27-46 years) in the uncontained-type group. The median follow-up time was 45 months (IQR, 38-63 months) in the contained-type group and 52 months (IQR, 40-66 months) in the uncontained-type group. The median FAOS and SF-12 scores improved significantly after surgery in both contained-type and uncontained-type lesions ( P < .001). The median postoperative FAOS score of patients with contained-type OLTs was higher than that of patients with uncontained-type OLTs (91.7 vs 85.0, respectively; P = .009), but no significant differences were found between the contained-type and uncontained-type groups for postoperative SF-12 and MOCART scores. The multivariate regression models showed that patients with contained-type OLTs had an approximately 10-point better score on the FAOS compared with patients with uncontained-type OLTs ( P = .006). There was a nonsignificant trend for the rate of cystic occurrence in uncontained-type OLTs to be higher than that of contained-type OLTs (55.6% vs 38.7%, respectively; P = .125). CONCLUSION Patients with contained-type OLTs experienced better clinical outcomes than those with uncontained-type OLTs after AOT for the treatment of OLTs. However, the AOT procedure still provided good clinical and MRI outcomes in both contained-type and uncontained-type OLTs at midterm follow-up.
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Affiliation(s)
- Yoshiharu Shimozono
- Hospital for Special Surgery, New York, New York, USA.,Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan.,Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Johanna C E Donders
- Hospital for Special Surgery, New York, New York, USA.,Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Youichi Yasui
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Eoghan T Hurley
- Hospital for Special Surgery, New York, New York, USA.,Royal College of Surgeons in Ireland, Dublin, Ireland
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Hatcher CC, Collins AT, Kim SY, Michel LC, Mostertz WC, Ziemian SN, Spritzer CE, Guilak F, DeFrate LE, McNulty AL. Relationship between T1rho magnetic resonance imaging, synovial fluid biomarkers, and the biochemical and biomechanical properties of cartilage. J Biomech 2017; 55:18-26. [PMID: 28237185 DOI: 10.1016/j.jbiomech.2017.02.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 01/27/2017] [Accepted: 02/01/2017] [Indexed: 01/01/2023]
Abstract
Non-invasive techniques for quantifying early biochemical and biomechanical changes in articular cartilage may provide a means of more precisely assessing osteoarthritis (OA) progression. The goals of this study were to determine the relationship between T1rho magnetic resonance (MR) imaging relaxation times and changes in cartilage composition, cartilage mechanical properties, and synovial fluid biomarker levels and to demonstrate the application of T1rho imaging to evaluate cartilage composition in human subjects in vivo. Femoral condyles and synovial fluid were harvested from healthy and OA porcine knee joints. Sagittal T1rho relaxation MR images of the condyles were acquired. OA regions of OA joints exhibited an increase in T1rho relaxation times as compared to non-OA regions. Furthermore in these regions, cartilage sGAG content and aggregate modulus decreased, while percent degraded collagen and water content increased. In OA joints, synovial fluid concentrations of sGAG decreased and C2C concentrations increased compared to healthy joints. T1rho relaxation times were negatively correlated with cartilage and synovial fluid sGAG concentrations and aggregate modulus and positively correlated with water content and permeability. Additionally, we demonstrated the application of these in vitro findings to the study of human subjects. Specifically, we demonstrated that walking results in decreased T1rho relaxation times, consistent with water exudation and an increase in proteoglycan concentration with in vivo loading. Together, these findings demonstrate that cartilage MR imaging and synovial fluid biomarkers provide powerful non-invasive tools for characterizing changes in the biochemical and biomechanical environments of the joint.
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Affiliation(s)
- Courtney C Hatcher
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Amber T Collins
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Sophia Y Kim
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Lindsey C Michel
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - William C Mostertz
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Sophia N Ziemian
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Charles E Spritzer
- Department of Radiology, Duke University Medical Center, Durham, NC, USA
| | - Farshid Guilak
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Louis E DeFrate
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Amy L McNulty
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA.
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Tangerino Filho EP, Fachi JL, Vasconcelos IC, Dos Santos GMT, Mendonça FAS, de Aro AA, Pimentel ER, Esquisatto MAM. Effects of microcurrent therapy on excisional elastic cartilage defects in young rats. Tissue Cell 2016; 48:224-34. [PMID: 27138327 DOI: 10.1016/j.tice.2016.03.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Revised: 03/05/2016] [Accepted: 03/06/2016] [Indexed: 01/07/2023]
Abstract
The effects of microcurrent application on the elastic cartilage defects in the outer ear of young animals were analyzed. Sixty male Wistar rats were divided into a control (CG) and a treated group (TG). An excisional lesion was created in the right outer ear of each animal. Daily treatment was started after 24h and consisted of the application of a low-intensity (20μA) continuous electrical current to the site of injury for 5min. The animals were euthanized after 7, 14 and 28 days of injury and the samples were submitted to analyses. In CG, areas of newly formed cartilage and intense basophilia were seen at 28 days, while in TG the same observations were made already at 14 days. The percentage of birefringent collagen fibers was higher in CG at 28 days. The number of connective tissue cells and granulocytes was significantly higher in TG. Ultrastructural analysis revealed the presence of chondrocytes in TG at 14 days, while these cells were observed in CG only at 28 days. Cuprolinic blue staining and the amount of glycosaminoglycans were significantly higher in TG at 14 days and 28 days. The amount of hydroxyproline was significantly higher in TG at all time points studied. The active isoform of MMP-2 was higher activity in TG at 14 days. Immunoblotting for type II collagen and decorin was positive in both groups and at all time points. The treatment stimulated the proliferation and differentiation of connective tissue cells, the deposition of glycosaminoglycans and collagen, and the structural reorganization of these elements during elastic cartilage repair.
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Affiliation(s)
- Edson Pereira Tangerino Filho
- Programa de Pós-graduação em Ciências Biomédicas, Centro Universitário Hermínio Ometto, Av. Dr. Maximiliano Baruto, 500 Jd. Universitário, 13607-339 Araras, SP, Brazil
| | - José Luis Fachi
- Programa de Pós-graduação em Ciências Biomédicas, Centro Universitário Hermínio Ometto, Av. Dr. Maximiliano Baruto, 500 Jd. Universitário, 13607-339 Araras, SP, Brazil
| | - Israel Costa Vasconcelos
- Programa de Pós-graduação em Ciências Biomédicas, Centro Universitário Hermínio Ometto, Av. Dr. Maximiliano Baruto, 500 Jd. Universitário, 13607-339 Araras, SP, Brazil
| | - Glaucia Maria Tech Dos Santos
- Programa de Pós-graduação em Ciências Biomédicas, Centro Universitário Hermínio Ometto, Av. Dr. Maximiliano Baruto, 500 Jd. Universitário, 13607-339 Araras, SP, Brazil
| | - Fernanda Aparecida Sampaio Mendonça
- Programa de Pós-graduação em Ciências Biomédicas, Centro Universitário Hermínio Ometto, Av. Dr. Maximiliano Baruto, 500 Jd. Universitário, 13607-339 Araras, SP, Brazil
| | - Andrea Aparecida de Aro
- Programa de Pós-graduação em Ciências Biomédicas, Centro Universitário Hermínio Ometto, Av. Dr. Maximiliano Baruto, 500 Jd. Universitário, 13607-339 Araras, SP, Brazil
| | - Edson Rosa Pimentel
- Departamento de Biologia Estrutural e Funcional, Instituto de Biologia, Universidade Estadual de Campinas, Rua Charles Darwin, s/n. CxP 6109, 13083-863 Campinas, SP, Brazil
| | - Marcelo Augusto Marretto Esquisatto
- Programa de Pós-graduação em Ciências Biomédicas, Centro Universitário Hermínio Ometto, Av. Dr. Maximiliano Baruto, 500 Jd. Universitário, 13607-339 Araras, SP, Brazil.
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Nitta N, Aoki T, Hyodo K, Misawa M, Homma K. Direct measurement of speed of sound in cartilage in situ using ultrasound and magnetic resonance images. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2013; 2013:6063-6. [PMID: 24111122 DOI: 10.1109/embc.2013.6610935] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This study verified the accuracy of the speed of sound (SOS) measured by the combination method, which calculates the ratio between the thickness values of cartilage measured by using the magnetic resonance imaging (MRI) and the ultrasonic pulse-echo imaging, and investigated in vivo application of this method. SOS specific to an ultrasound imaging device was used as a reference value to calculate the actual SOS from the ratio of cartilage thicknesses obtained from MR and ultrasound images. The accuracy of the thickness measurement was verified by comparing results obtained using MRI and a non-contact laser, and the accuracy of the calculated SOS was confirmed by comparing results of the pulse-echo and transmission methods in vitro. The difference between laser and MRI measurements was 0.05 ± 0.22 mm. SOS values in a human knee measured by the combination method in the medial and lateral femoral condyles were 1650 ± 79 and 1642 ± 78 m/s, respectively (p < 0.05). The results revealed the feasibility of in situ SOS measurement using the combination method.
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McNulty AL, Rothfusz NE, Leddy HA, Guilak F. Synovial fluid concentrations and relative potency of interleukin-1 alpha and beta in cartilage and meniscus degradation. J Orthop Res 2013; 31:1039-45. [PMID: 23483596 PMCID: PMC4037157 DOI: 10.1002/jor.22334] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Accepted: 02/05/2013] [Indexed: 02/04/2023]
Abstract
Cartilage degeneration with osteoarthritis (OA) is believed to involve the activities of interleukin-1 (IL-1), which exists as alpha and beta isoforms. The goal of this study was to measure the concentrations of both isoforms of IL-1 in the synovial fluid of normal and spontaneously osteoarthritic porcine knees, and to test the hypothesis that physiologic concentrations of IL-1α and IL-1β exhibit different potencies in activating calcium signaling, the production of matrix metalloproteinases and nitric oxide, and the loss of proteoglycans and tissue mechanical properties in cartilage and meniscus. Median concentrations of IL-1α were 0.043 ng/ml with mild OA and 0.288 ng/ml with moderate OA, whereas IL-1β concentrations were 0.109 ng/ml with mild OA and 0.122 ng/ml with moderate OA. Both isoforms induced calcium signaling in chondrocytes and meniscal cells at all concentrations. Overall, cartilage and meniscus catabolism was significantly more sensitive to IL-1α than IL-1β at concentrations of 1 ng/ml or less, while few differences were observed between the two forms at 10 ng/ml. These data provide a range of physiologic IL-1 concentrations that can serve as a framework for the comparison of various in vitro studies, as well as providing further insight for the development of anti-cytokine therapies for OA.
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Affiliation(s)
- Amy L. McNulty
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Nicole E. Rothfusz
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Holly A. Leddy
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Farshid Guilak
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA,Department of Biomedical Engineering, Duke University, Durham, NC, USA,Corresponding author: Farshid Guilak, Ph.D., Duke University Medical Center, Box 3093, Durham, NC 27710, Phone (919) 684-2521, Fax (919) 681-8490,
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Rozen WM, Niumsawatt V, Leong JC, Ek EW. The vascular basis of the hemi-hamate osteochondral free flap. Part 2: surgical anatomy and clinical application. Surg Radiol Anat 2013; 35:595-608. [PMID: 23508928 DOI: 10.1007/s00276-012-1072-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Accepted: 12/31/2012] [Indexed: 11/25/2022]
Abstract
PURPOSE The free vascularised hemi-hamate flap combines the utility of providing a small osteochondral portion of hamate for reconstruction, while providing a means of vascularisation to preserve articular cartilage after transfer. In Part 1 of this series, we highlighted the vascular approaches to such a technique. The current study investigates the bony architecture of the hamate, with particular emphasis on its utility for a range of osteochondral defects in the hand. METHODS A morphometric assessment of the hamate as a potential osteochondral flap donor site for resurfacing digital phalangeal heads (either total or unicondylar) and/or bases was thus undertaken. This anatomic study was undertaken using in vivo imaging performed for a range of clinical indications, with computed tomographic angiography (CTA) and digital subtraction angiography (DSA) of the upper limb included. Bony and vascular measurements and relationships were recorded and assessed both quantitatively and qualitatively. A clinical case is presented, highlighting the application of these measurements. RESULTS The mean digital artery diameter was 0.7 mm with a mean distance between digital artery and interphalangeal joint surface (i.e. pedicle length) of 1.18 mm. Mean hamate dimensions comprised a transverse width 16.62 mm, lateral width of 14.29 mm and ridge height of 1.43 mm. Measurements of the phalangeal bases, condyles and total phalangeal heads were recorded, and the optimal hamate harvest approaches demonstrated. Despite perceived differences, in all cases there was statistical similarity demonstrated between the fragments. CONCLUSION The hemi-hamate osteochondral flap can be applied to a range of osteochondral defects in the hand and may offer new options to the hand surgeon.
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Affiliation(s)
- Warren M Rozen
- The Northern Hospital, 185 Cooper St, Epping, VIC, 3076, Australia.
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de Campos Ciccone C, Zuzzi DC, Neves LMG, Mendonça JS, Joazeiro PP, Esquisatto MAM. Effects of microcurrent stimulation on hyaline cartilage repair in immature male rats (Rattus norvegicus). Altern Ther Health Med 2013; 13:17. [PMID: 23331612 PMCID: PMC3554581 DOI: 10.1186/1472-6882-13-17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Accepted: 01/16/2013] [Indexed: 01/06/2023]
Abstract
BACKGROUND In this study, we investigate the effects of microcurrent stimulation on the repair process of xiphoid cartilage in 45-days-old rats. METHODS Twenty male rats were divided into a control group and a treated group. A 3-mm defect was then created with a punch in anesthetized animals. In the treated group, animals were submitted to daily applications of a biphasic square pulse microgalvanic continuous electrical current during 5 min. In each application, it was used a frequency of 0.3 Hz and intensity of 20 μA. The animals were sacrificed at 7, 21 and 35 days after injury for structural analysis. RESULTS Basophilia increased gradually in control animals during the experimental period. In treated animals, newly formed cartilage was observed on days 21 and 35. No statistically significant differences in birefringent collagen fibers were seen between groups at any of the time points. Treated animals presented a statistically larger number of chondroblasts. Calcification points were observed in treated animals on day 35. Ultrastructural analysis revealed differences in cell and matrix characteristics between the two groups. Chondrocyte-like cells were seen in control animals only after 35 days, whereas they were present in treated animals as early as by day 21. The number of cuprolinic blue-stained proteoglycans was statistically higher in treated animals on days 21 and 35. CONCLUSION We conclude that microcurrent stimulation accelerates the cartilage repair in non-articular site from prepuberal animals.
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Wilusz RE, DeFrate LE, Guilak F. Immunofluorescence-guided atomic force microscopy to measure the micromechanical properties of the pericellular matrix of porcine articular cartilage. J R Soc Interface 2012; 9:2997-3007. [PMID: 22675162 DOI: 10.1098/rsif.2012.0314] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The pericellular matrix (PCM) is a narrow region that is rich in type VI collagen that surrounds each chondrocyte within the extracellular matrix (ECM) of articular cartilage. Previous studies have demonstrated that the chondrocyte micromechanical environment depends on the relative properties of the chondrocyte, its PCM and the ECM. The objective of this study was to measure the influence of type VI collagen on site-specific micromechanical properties of cartilage in situ by combining atomic force microscopy stiffness mapping with immunofluorescence imaging of PCM and ECM regions in cryo-sectioned tissue samples. This method was used to test the hypotheses that PCM biomechanical properties correlate with the presence of type VI collagen and are uniform with depth from the articular surface. Control experiments verified that immunolabelling did not affect the properties of the ECM or PCM. PCM biomechanical properties correlated with the presence of type VI collagen, and matrix regions lacking type VI collagen immediately adjacent to the PCM exhibited higher elastic moduli than regions positive for type VI collagen. PCM elastic moduli were similar in all three zones. Our findings provide further support for type VI collagen in defining the chondrocyte PCM and contributing to its biological and biomechanical properties.
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Affiliation(s)
- Rebecca E Wilusz
- Department of Orthopaedic Surgery, Duke University Medical Center, Box 3093, Durham, NC 27710, USA
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Imade S, Kumahashi N, Kuwata S, Iwasa J, Uchio Y. Effectiveness and limitations of autologous osteochondral grafting for the treatment of articular cartilage defects in the knee. Knee Surg Sports Traumatol Arthrosc 2012; 20:160-5. [PMID: 21748393 DOI: 10.1007/s00167-011-1611-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Accepted: 07/04/2011] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate the effectiveness and limitations of autologous osteochondral grafting for the treatment of articular cartilage defects in the knee. METHODS The subjects were 40 patients who had undergone autologous osteochondral grafting. Fifteen knees had cartilage defects combined with anterior cruciate ligament tears (ACL group), 15 knees had cartilage defects combined with osteoarthritis (OA group), and 10 knees had cartilage defects combined with osteochondral dissecans (OCD group). From one to five osteochondral pegs were harvested from the less-weight-bearing periphery of the articular surface of the femoral condyle and grafted to cartilage defects. The clinical results were assessed based on the Lysholm score and radiographic and magnetic resonance imaging (MRI) image assessment. RESULTS The median follow-up duration was 24 months (range from 12 to 41 months). The mean Lysholm score following treatment was improved in all groups. The patients who had cartilage defects combined with OA had a significantly poorer prognosis than did those with cartilage defects combined with ACL or OCD. In the OA group, advanced stage and an alignment abnormality were correlated with poor prognosis. Advanced age was correlated with poor prognosis. Other parameters showed no significant difference in prognosis. CONCLUSION Autologous osteochondral grafting was found to be an effective technique for treating relatively young patients who had cartilage defects combined with ACL injury or OCD, but this technique showed limited results in treating cartilage defects based on advanced patient age and degenerative changes in the cartilage. LEVEL OF EVIDENCE Diagnostic studies-investigating a diagnostic test, Level III.
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Affiliation(s)
- Shinji Imade
- Department of Orthopaedic Surgery, Shimane University School of Medicine, 89-1, Enya, Izumo, Shimane, 693-8501, Japan.
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Rai MF, Graeve T, Twardziok S, Schmidt MFG. Evidence for regulated interleukin-4 expression in chondrocyte-scaffolds under in vitro inflammatory conditions. PLoS One 2011; 6:e25749. [PMID: 21991344 PMCID: PMC3185011 DOI: 10.1371/journal.pone.0025749] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2010] [Accepted: 09/11/2011] [Indexed: 12/31/2022] Open
Abstract
Objective To elucidate the anti-inflammatory and anabolic effects of regulated expression of IL-4 in chondrocyte-scaffolds under in vitro inflammatory conditions. Methods Mature articular chondrocytes from dogs (n = 3) were conditioned through transient transfection using pcDNA3.1.cIL-4 (constitutive) or pCOX-2.cIL-4 (cytokine-responsive) plasmids. Conditioned cells were seeded in alginate microspheres and rat-tail collagen type I matrix (CaReS®) to generate two types of tissue-engineered 3-dimensional scaffolds. Inflammatory arthritis was simulated in the packed chondrocytes through exogenous addition of recombinant canine (rc) IL-1β (100 ng/ml) plus rcTNFα (50 ng/ml) in culture media for 96 hours. Harvested cells and culture media were analyzed by various assays to monitor the anti-inflammatory and regenerative (anabolic) properties of cIL-4. Results cIL-4 was expressed from COX-2 promoter exclusively on the addition of rcIL-1β and rcTNFα while its expression from CMV promoter was constitutive. The expressed cIL-4 downregulated the mRNA expression of IL-1β, TNFα, IL-6, iNOS and COX-2 in the cells and inhibited the production of NO and PGE2 in culture media. At the same time, it up-regulated the expression of IGF-1, IL-1ra, COL2a1 and aggrecan in conditioned chondrocytes in both scaffolds along with a diminished release of total collagen and sGAG into the culture media. An increased amount of cIL-4 protein was detected both in chondrocyte cell lysate and in concentrated culture media. Neutralizing anti-cIL-4 antibody assay confirmed that the anti-inflammatory and regenerative effects seen are exclusively driven by cIL-4. There was a restricted expression of IL-4 under COX-2 promoter possibly due to negative feedback loop while it was over-expressed under CMV promoter (undesirable). Furthermore, the anti-inflammatory /anabolic outcomes from both scaffolds were reproducible and the therapeutic effects of cIL-4 were both scaffold- and promoter-independent. Conclusions Regulated expression of therapeutic candidate gene(s) coupled with suitable scaffold(s) could potentially serve as a useful tissue-engineering tool to devise future treatment strategies for osteoarthritis.
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Affiliation(s)
- Muhammad Farooq Rai
- Institute of Immunology and Molecular Biology, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Thomas Graeve
- Institute of Immunology and Molecular Biology, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Sven Twardziok
- Institute of Molecular Biology and Bioinformatics, Charite University of Medicine, Benjamin Franklin Campus, Berlin, Germany
| | - Michael F. G. Schmidt
- Institute of Immunology and Molecular Biology, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
- * E-mail:
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Darling EM, Wilusz RE, Bolognesi MP, Zauscher S, Guilak F. Spatial mapping of the biomechanical properties of the pericellular matrix of articular cartilage measured in situ via atomic force microscopy. Biophys J 2010; 98:2848-56. [PMID: 20550897 DOI: 10.1016/j.bpj.2010.03.037] [Citation(s) in RCA: 110] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2009] [Revised: 02/15/2010] [Accepted: 03/17/2010] [Indexed: 11/15/2022] Open
Abstract
In articular cartilage, chondrocytes are surrounded by a narrow region called the pericellular matrix (PCM), which is biochemically, structurally, and mechanically distinct from the bulk extracellular matrix (ECM). Although multiple techniques have been used to measure the mechanical properties of the PCM using isolated chondrons (the PCM with enclosed cells), few studies have measured the biomechanical properties of the PCM in situ. The objective of this study was to quantify the in situ mechanical properties of the PCM and ECM of human, porcine, and murine articular cartilage using atomic force microscopy (AFM). Microscale elastic moduli were quantitatively measured for a region of interest using stiffness mapping, or force-volume mapping, via AFM. This technique was first validated by means of elastomeric models (polyacrylamide or polydimethylsiloxane) of a soft inclusion surrounded by a stiff medium. The elastic properties of the PCM were evaluated for regions surrounding cell voids in the middle/deep zone of sectioned articular cartilage samples. ECM elastic properties were evaluated in regions visually devoid of PCM. Stiffness mapping successfully depicted the spatial arrangement of moduli in both model and cartilage surfaces. The modulus of the PCM was significantly lower than that of the ECM in human, porcine, and murine articular cartilage, with a ratio of PCM to ECM properties of approximately 0.35 for all species. These findings are consistent with previous studies of mechanically isolated chondrons, and suggest that stiffness mapping via AFM can provide a means of determining microscale inhomogeneities in the mechanical properties of articular cartilage in situ.
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Affiliation(s)
- Eric M Darling
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA
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