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

Study on the poroelastic behaviors of the defected articular cartilage

This article presented the possible mechanism of arthritis damaged changes in cartilage's interstitial fluid flowing behavior. Firstly, the analytical solutions for the pore fluid pressure and velocity in the idealized cartilage defect model were obtained, which are employed to validate the finite element (FE) method. Then according to the MRI data, an articular cartilage FE model was developed to study the effects of defect characteristics on its poroelastic behaviors. The results showed the interstitial fluid pressure and velocity in defected articular cartilage is diminished, moreover, this trend is even more severe as the defect radius or thickness increased. As the development of osteoarthritis goes, the fluid velocity is decreased and cause the even serious nutrients loss.

Stabilization of Damaged Articular Cartilage with Hydrogel-Mediated Reinforcement and Sealing

Cartilage injuries and subsequent tissue deterioration impact millions of patients. Since the regeneration of functional hyaline cartilage remains elusive, methods to stabilize the remaining tissue, and prevent further deterioration, would be of significant clinical utility and prolong joint function. Finite element modeling shows that fortification of the degenerate cartilage (Reinforcement) and reestablishment of a superficial zone (Sealing) are both required to restore fluid pressurization within the tissue and restrict fluid flow and matrix loss from the defect surface. Here, a hyaluronic acid (HA) hydrogel system is designed to both interdigitate with and promote the sealing of the degenerated cartilage. Interdigitating fortification restores both bulk and local pericellular tissue mechanics, reestablishing the homeostatic mechanotransduction of endogenous chondrocytes within the tissue. This HA therapy is further functionalized to present chemo mechanical cues that improve the attachment and direct the response of mesenchymal stem/stromal cells at the defect site, guiding localized extracellular matrix deposition to "seal" the defect. Together, these results support the therapeutic potential, across cell and tissue length scales, of an innovative hydrogel therapy for the treatment of damaged cartilage.

Apparatus and Method for Rapid Detection of Acoustic Anisotropy in Cartilage

Purpose

Articular cartilage is known to be mechanically anisotropic. In this paper, the acoustic anisotropy of bovine articular cartilage and the effects of freeze-thaw cycling on acoustic anisotropy were investigated.

Methods

We developed apparatus and methods that use a magnetic L-shaped sample holder, which allowed minimal handling of a tissue, reduced the number of measurements compared to previous studies, and produced highly reproducible results.

Results

SOS was greater in the direction perpendicular to the articular surface compared to the direction parallel to the articular surface (N=17, P = 0.00001). Average SOS was 1,758 ± 107 m/s perpendicular to the surface, and 1,617 ± 55 m/s parallel to it. The average percentage difference in SOS between the perpendicular and parallel directions was 8.2% (95% CI: 5.4% to 11%). Freeze-thaw cycling did not have a significant effect on SOS (P>0.4).

Conclusion

Acoustic measurement of tissue properties is particularly attractive for work in our laboratory since it has the potential for nondestructive characterization of the properties of developing engineered cartilage. Our approach allowed us to observe acoustic anisotropy of articular cartilage rapidly and reproducibly. This property was not significantly affected by freeze-thawing of the tissue samples, making cryopreservation practical for these assays.

Shock absorbing ability in healthy and damaged cartilage-bone under high-rate compression

Articular cartilage is a soft tissue that distributes the loads in joints and transfers the compressive load to the underlying bone. At high rate and magnitudes of mechanical loading, cartilage and subchondral bone together are susceptible to damage. In addition, any disruption to the cartilage's structure, caused by injury, trauma or disorder such as osteoarthritis (OA), can alter the mechanism of load transfer from the cartilage to the underlying bone. Changes in the cartilage structure can also alter the ability of cartilage-bone to absorb and dissipate the impact energy. To investigate the effects of cartilage degradation on cartilage-bone shock absorption ability, the top 50% of the cartilage thickness was removed (modified cartilage) to mimic the cartilage thickness reduction in Grade III cartilage lesion and the remaining cartilage-bone unit (modified cartilage-bone) was compressed at high-rate (4% strain at 5 Hz). High-speed camera and microscope were used to capture microscopic deformation, and digital image correlation technique (DIC) employed to quantify the deformation of cartilage and bone. The mechanical properties (i.e. stiffness, strain, absorbed and dissipated energies) of cartilage and bone were calculated before and after the removal of the top 50% of the cartilage thickness, consisting of both the superficial tangential zone (STZ) and part of the middle zone of the cartilage. The results showed a significant degradation in the mechanical properties of the cartilage-bone unit after the removal of the top 50% cartilage thickness. The stiffness of the modified cartilage reduced significantly (by ~39%) and energy absorption in underlying bone increased by 32%, which can make the bone more vulnerable to damage in the modified cartilage-bone unit. In addition, the energy dissipation in the modified cartilage-bone unit was also increased by approximately 14%. These changes in mechanical properties suggest a crucial role of the STZ and middle zone (within the top 50% cartilage thickness) in protecting the underlying bone from the severe compressive impact loading. Results also indicated that under physiological contact stress of 7 MPa, strain in damaged cartilage was increased by 3.22% without affecting the mechanical behaviour of the underlying bone.

On mechanical mechanism of damage evolution in articular cartilage

Superficial lesions of cartilage are the direct indication of osteoarthritis. To investigate the mechanical mechanism of cartilage with micro-defect under external loading, a new plain strain numerical model with micro-defect was proposed and damage evolution progression in cartilage over time has been simulated, the parameter were studied including load style, velocity of load and degree of damage. The new model consists of the hierarchical structure of cartilage and depth-dependent arched fibers. The numerical results have shown that not only damage of the cartilage altered the distribution of the stress but also matrix and fiber had distinct roles in affecting cartilage damage, and damage in either matrix or fiber could promote each other. It has been found that the superficial cracks in cartilage spread preferentially along the tangent direction of the fibers. It is the arched distribution form of fibers that affects the crack spread of cartilage, which has been verified by experiment. During the process of damage evolution, its extension direction and velocity varied constantly with the damage degree. The rolling load could cause larger stress and strain than sliding load. Strain values of the matrix initially increased and then decreased gradually with the increase of velocity, and velocity had a greater effect on matrix than fibers. Damage increased steadily before reaching 50%, sharply within 50 to 85%, and smoothly and slowly after 85%. The finding of the paper may help to understand the mechanical mechanism why the cracks in cartilage spread preferentially along the tangent direction of the fibers.

Resurfacing damaged articular cartilage to restore compressive properties

Surface damage to articular cartilage is recognized as the initial underlying process causing the loss of mechanical function in early-stage osteoarthritis. In this study, we developed structure-modifying treatments to potentially prevent, stabilize or reverse the loss in mechanical function. Various polymers (chondroitin sulfate, carboxymethylcellulose, sodium hyaluronate) and photoinitiators (riboflavin, irgacure 2959) were applied to the surface of collagenase-degraded cartilage and crosslinked in situ using UV light irradiation. While matrix permeability and deformation significantly increased following collagenase-induced degradation of the superficial zone, resurfacing using tyramine-substituted sodium hyaluronate and riboflavin decreased both values to a level comparable to that of intact cartilage. Repetitive loading of resurfaced cartilage showed minimal variation in the mechanical response over a 7 day period. Cartilage resurfaced using a low concentration of riboflavin had viable cells in all zones while a higher concentration resulted in a thin layer of cell death in the uppermost superficial zone. Our approach to repair surface damage initiates a new therapeutic advance in the treatment of injured articular cartilage with potential benefits that include enhanced mechanical properties, reduced susceptibility to enzymatic degradation and reduced adhesion of macrophages.

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

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

Effects of in vitro low oxygen tension preconditioning of adipose stromal cells on their in vivo chondrogenic potential: application in cartilage tissue repair

Purpose

Multipotent stromal cell (MSC)-based regenerative strategy has shown promise for the repair of cartilage, an avascular tissue in which cells experience hypoxia. Hypoxia is known to promote the early chondrogenic differentiation of MSC. The aim of our study was therefore to determine whether low oxygen tension could be used to enhance the regenerative potential of MSC for cartilage repair.

Methods

MSC from rabbit or human adipose stromal cells (ASC) were preconditioned in vitro in control or chondrogenic (ITS and TGF-β) medium and in 21 or 5% O₂. Chondrogenic commitment was monitored by measuring COL2A1 and ACAN expression (real-time PCR). Preconditioned rabbit and human ASC were then incorporated into an Si-HPMC hydrogel and injected (i) into rabbit articular cartilage defects for 18 weeks or (ii) subcutaneously into nude mice for five weeks. The newly formed tissue was qualitatively and quantitatively evaluated by cartilage-specific immunohistological staining and scoring. The phenotype of ASC cultured in a monolayer or within Si-HPMC in control or chondrogenic medium and in 21 or 5% O₂ was finally evaluated using real-time PCR.

Results/Conclusions

5% O₂ increased the in vitro expression of chondrogenic markers in ASC cultured in induction medium. Cells implanted within Si-HPMC hydrogel and preconditioned in chondrogenic medium formed a cartilaginous tissue, regardless of the level of oxygen. In addition, the 3D in vitro culture of ASC within Si-HPMC hydrogel was found to reinforce the pro-chondrogenic effects of the induction medium and 5% O₂. These data together indicate that although 5% O₂ enhances the in vitro chondrogenic differentiation of ASC, it does not enhance their in vivo chondrogenesis. These results also highlight the in vivo chondrogenic potential of ASC and their potential value in cartilage repair.

The effect of moving point of contact stimulation on chondrocyte gene expression and localization in tissue engineered constructs

Tissue engineering is a promising approach for articular cartilage repair. However, using current technologies, the developed engineered constructs generally do not possess an organized superficial layer, which contributes to the tissue's durability and unique mechanical properties. In this study, we investigated the efficacy of applying a moving point of contract-type stimulation (MPS) to stimulate the production of a superficial-like layer in the engineered constructs. MPS was applied to chondrocyte-agarose hydrogels at a frequency of 0.5, 1 or 2 Hz, under a constant compressive load of 10 mN for durations between 5 and 60 min over 3 consecutive days. Expression and localization of superficial zone constituents was conducted by qRT-PCR and in situ hybridization. Finite element modeling was also constructed to gain insight into the relationship between the applied stimulus and superficial zone constituent expression. Gene expression of superficial zone markers were affected in a frequency dependent manner with a physiologic frequency of 1 Hz producing maximal expression of PRG4, biglycan, decorin and collagen II. In situ hybridization revealed that localization of these markers predominantly occurred at 500-1000 μm below the construct surface which correlated to sub-surface strains between 10 and 25% as determined by finite element modeling. These results indicate that while mechanical stimuli can be used to enhance the expression of superficial zone constituents in engineered cartilage constructs, the resultant subsurface loading is a critical factor for localizing expression. Future studies will investigate altering the applied stimulus to further localize superficial zone constituent expression at the construct surface.

Hydromechanical stimulator for chondrocyte-seeded constructs in articular cartilage tissue engineering applications

Mechanical stimulation is a key technique used for controlling the mechanical properties of tissue engineered articular cartilage constructs proposed for defect repair. The present study introduces a new technical method and device for ‘hydromechanical’ stimulation of tissue engineered articular cartilage constructs. The stimulation consists of simultaneous cyclic compression, frictional shear from a sliding indenter contact and direct pressurized fluid perfusion. Each of these modes of mechanical loading has been shown by other research groups to effectively stimulate tissue engineered constructs. A device for applying these conditions was designed, developed and tested. Two sets (high and low perfusion flow rates) of three experiments were performed, each with two samples subjected to hydromechanical stimulation conditions (compression and friction forces along with perfusion). Two other samples from each set were subjected to just compression and dynamic frictional shear forces, and two more were used as controls (not stimulated). The average amount of glycosaminoglycan retained in the constructs after 3 weeks ranked from low to high as follows: controls, hydromechanical conditions with the low-flow rate, hydromechanical conditions with the high-flow rate and just compression plus dynamic frictional shear. Statistically significant differences were not detected. However, future studies would focus on glycosaminoglycan production in the superficial zone, measuring the glycosaminoglycan released to the nutrient media, and address altering the hydromechanical stimulation parameters using the results of the present study as guidance, in attempts to achieve statistically significant increases in glycosaminoglycan production compared with the controls.

Influence of tissue- and cell-scale extracellular matrix distribution on the mechanical properties of tissue-engineered cartilage

The insufficient load-bearing capacity of today's tissue- engineered (TE) cartilage limits its clinical application. Generally, cartilage TE studies aim to increase the extracellular matrix (ECM) content, as this is thought to determine the load-bearing properties of the cartilage. However, there are apparent inconsistencies in the literature regarding the correlation between ECM content and mechanical properties of TE constructs. In addition to the amount of ECM, the spatial inhomogeneities in ECM distribution at the tissue scale as well as at the cell scale may affect the mechanical properties of TE cartilage. The relative importance of such structural inhomogeneities on mechanical behavior of TE cartilage is unknown. The aim of the present study was, therefore, to theoretically elucidate the influence of these inhomogeneities on the mechanical behavior of chondrocyte-agarose TE constructs. A validated non-linear fiber-reinforced poro-elastic swelling cartilage model that can accommodate for effects of collagen reinforcement and swelling by proteoglycans was used. At the tissue scale, ECM was gradually varied from predominantly localized in the periphery of the TE construct toward an ECM-rich inner core. The effect of these inhomogeneities in relation to the total amount of ECM was also evaluated. At the cell scale, ECM was gradually varied from localized in the pericellular area, toward equally distributed throughout the interterritorial area. Results from the tissue-scale model indicated that localization of ECM in either the construct periphery or in the inner core may reduce construct stiffness compared with that of constructs with homogeneous ECM. Such effects are more significant at high ECM amounts. At the cell scale, localization of ECM around the cells significantly reduced the overall stiffness, even at low ECM amounts. The compressive stiffness gradually increased when ECM distribution became more homogeneous and the osmotic swelling pressure in the interterritorial area increased. We conclude that for the same amount of ECM content in TE cartilage constructs, superior mechanical properties can be achieved with more homogeneous ECM distribution at both tissue and cell scale. Inhomogeneities at the cell scale are more important than those at the tissue scale.

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.

Computational Investigation of Fibrin Mechanical and Damage Properties at the Interface Between Native Cartilage and Implant

Scaffold-based tissue-engineered constructs as well as cell-free implants offer promising solutions to focal cartilage lesions. However, adequate mechanical stability of these implants in the lesion is required for successful repair. Fibrin is the most common clinically available adhesive for cartilage implant fixation, but fixation quality using fibrin is not well understood. The objectives of this study were to investigate the conditions leading to damage in the fibrin adhesive and to determine which adhesive properties are important in preventing delamination at the interface. An idealized finite element model of the medial compartment of the knee was created, including a circular defect and an osteochondral implant. Damage and failure of fibrin at the interface was represented by a cohesive zone model with coefficients determined from an inverse finite element method and previously published experimental data. Our results demonstrated that fibrin glue alone may not be strong enough to withstand physiologic loads in vivo while fibrin glue combined with chondrocytes more effectively prevents damage at the interface. The results of this study suggest that fibrin fails mainly in shear during off-axis loading and that adhesive materials that are stronger or more compliant than fibrin may be good alternatives due to decreased failure at the interface. The present model may be used to improve design and testing protocols of bioadhesives and give insight into the failure mechanisms of cartilage implant fixation in the knee joint.

Tissue engineering of functional articular cartilage: the current status

Osteoarthritis is a degenerative joint disease characterized by pain and disability. It involves all ages and 70% of people aged >65 have some degree of osteoarthritis. Natural cartilage repair is limited because chondrocyte density and metabolism are low and cartilage has no blood supply. The results of joint-preserving treatment protocols such as debridement, mosaicplasty, perichondrium transplantation and autologous chondrocyte implantation vary largely and the average long-term result is unsatisfactory. One reason for limited clinical success is that most treatments require new cartilage to be formed at the site of a defect. However, the mechanical conditions at such sites are unfavorable for repair of the original damaged cartilage. Therefore, it is unlikely that healthy cartilage would form at these locations. The most promising method to circumvent this problem is to engineer mechanically stable cartilage ex vivo and to implant that into the damaged tissue area. This review outlines the issues related to the composition and functionality of tissue-engineered cartilage. In particular, the focus will be on the parameters cell source, signaling molecules, scaffolds and mechanical stimulation. In addition, the current status of tissue engineering of cartilage will be discussed, with the focus on extracellular matrix content, structure and its functionality.

Finite element study of a tissue-engineered cartilage transplant in human tibiofemoral joint

Most tissue-engineered cartilage constructs are more compliant than native articular cartilage (AC) and are poorly integrated to the surrounding tissue. To investigate the effect of an implanted tissue-engineered construct (TEC) with these inferior properties on the mechanical environment of both the engineered and adjacent native tissues, a finite element study was conducted. Biphasic swelling was used to model tibial cartilage and an implanted TEC with the material properties of either native tissue or a decreased elastic modulus and fixed charged density. Creep loading was applied with a rigid impermeable indenter that represented the femur. In comparison with an intact joint, compressive strains in the transplant, surface contact stress in the adjacent native AC and load partitioning between different phases of cartilage were affected by inferior properties of TEC. Results of this study may lead to a better understanding of the complex mechanical environment of an implanted TEC.

Chondrogenic differentiation of human mesenchymal stem cells on oriented nanofibrous scaffolds: engineering the superficial zone of articular cartilage

Cell differentiation, adhesion, and orientation are known to influence the functionality of both natural and engineered tissues, such as articular cartilage. Several attempts have been devised to regulate these important cellular behaviors, including application of inexpensive but efficient electrospinning that can produce patterned extracellular matrix (ECM) features. Electrospun and oriented polycaprolactone (PCL) scaffolds (500 or 3000 nm fiber diameter) were created, and human mesenchymal stem cells (hMSCs) were cultured on these scaffolds. Cell viability, morphology, and orientation on the fibrous scaffolds were quantitatively determined as a function of time. While the fiber-guided initial cell orientation was maintained even after 5 weeks, cells cultured in the chondrogenic media proliferated and differentiated into the chondrogenic lineage, suggesting that cell orientation is controlled by the physical cues and minimally influenced by the soluble factors. Based on assessment by the chondrogenic markers, use of the nanofibrous scaffold (500 nm) appears to enhance the chondrogenic differentiation. These findings indicate that hMSCs seeded on a controllable PCL scaffold may lead to an alternate methodology to mimic the cell and ECM organization that is found, for example, in the superficial zone of articular cartilage.

Bioreactor for Biaxial Mechanical Stimulation to Tissue Engineered Constructs

The complex structure and properties of biological tissues as well as their in situ environment often make it difficult to self-heal. A suitable replacement tissue may be created in vitro through tissue engineering approaches and mechanical stimulation of tissue constructs. A new biaxial bioreactor was designed, constructed, and evaluated for the purposes of developing constructs with specific functional characteristics. Once constructed and assembled, the bioreactor was tested for position accuracy and application of strain. Additionally, a tissue construct was tested in the chamber and compared with a nonstimulated construct. Results showed high position accuracy, but some loss between applied strain via grip movement and strain experienced by the scaffold. The tested construct exhibited an increase in cells and matrix deposition in comparison to the nonstimulated construct. This biaxial bioreactor will be useful for mechanically stimulating tissue constructs in two perpendicular directions to create implants for tissues requiring preferred compressive and tensile resistances.

Influence of meniscectomy and meniscus replacement on the stress distribution in human knee joint

Studying the mechanics of the knee joint has direct implications in understanding the state of human health and disease and can aid in treatment of injuries. In this work, we developed an axisymmetric model of the human knee joint using finite element method, which consisted of separate parts representing tibia, meniscus and femoral, and tibial articular cartilages. The articular cartilages were modeled as three separate layers with different material characteristics: top superficial layer, middle layer, and calcified layer. The biphasic characteristic of both meniscus and cartilage layers were included in the computational model. The developed model was employed to investigate several aspects of mechanical response of the knee joint under external loading associated with the standing posture. Specifically, we studied the role of the material characteristic of the articular cartilage and meniscus on the distribution of the shear stresses in the healthy knee joint and the knee joint after meniscectomy. We further employed the proposed computational model to study the mechanics of the knee joint with an artificial meniscus. Our calculations suggested an optimal elastic modulus of about 110 MPa for the artificial meniscus which was modeled as a linear isotropic material. The suggested optimum stiffness of the artificial meniscus corresponds to the stiffness of the physiological meniscus in the circumferential direction.

Knee kinematics, cartilage morphology, and osteoarthritis after ACL injury

This review examines a mechanism for the initiation of osteoarthritis after anterior cruciate ligament (ACL) injury by considering the relationship between reported ambulatory changes after ACL injury, cartilage adaptation to load, and the association between cartilage loads during walking and regional variations in cartilage structure and biology. Taken together, these observations suggest that cartilage degeneration after ACL injury could be caused by a kinematic gait change that shifts ambulatory loading applied to cartilage. Such a shift may cause regions of cartilage to become newly loaded, be subjected to altered levels of compression and tension, or become unloaded. The metabolic sensitivity of chondrocytes to such changes in their mechanical environment, combined with the low adaptation potential of mature cartilage, could lead to cartilage degeneration and premature osteoarthritis after ACL injury. This proposed mechanism demonstrates the value of using the ACL injury model to understand the relationship between mechanics and biology, as well as helping to explain the importance of restoring normal ambulatory kinematics after ACL injury to avoid premature osteoarthritis.

On how degeneration influences load-bearing in the cartilage-bone system: a microstructural and micromechanical study

OBJECTIVE

This study investigated the microanatomical response to compression of intact and degenerate cartilage-on-bone samples with the aim of elucidating the functional consequences of articular surface disruption and related matrix changes.

METHOD

Two groups of mature bovine patellae were identified at the time of harvest; those with intact cartilage and those with cartilage exhibiting mild to severe degeneration. Cartilage-on-bone samples were statically compressed (7 MPa) to near-equilibrium using an 8-mm diameter cylindrical indenter, and then formalin-fixed in this deformed state. Following mild decalcification full-depth cartilage-bone sections, incorporating the indentation profile and beyond, were studied in their fully hydrated state using differential interference contrast optical microscopy (DIC).

RESULTS

Differences in matrix texture, degree of disruption of the articular surface layer (or its complete absence), number of tidemarks and absence or presence of vascularization of the calcified cartilage zone were all observable features that provided clear differentiation between the normal and degenerate tissues. Under load a chevron-type shear discontinuity characterized those samples in which the strain-limiting surface layer was still largely intact. The extent to which this shear discontinuity advanced into the adjacent non-directly loaded cartilage continuum was influenced by the integrity of the cartilage general matrix. For those tissues deficient in a strain-limiting articular surface there was no shear discontinuity, the cartilage deformation field was instead shaped primarily by its osteochondral attachment and a laterally-directed compressive collapse of a much weakened matrix. In the degenerate samples the altered matrix textures associated with different regions of the deformation field are interpreted in terms of an intrinsic fibrillar architecture that is weakened by two fundamental processes: (1) a de-structuring resulting from a reduction in connectivity between fibrils and (2) subsequent aggregation of these now disconnected fibrils.

CONCLUSION

DIC microscopy provides a high-resolution description of the integrated osteochondral tissue system across the full continuum of matrices, from normal to severely degenerate. Our study demonstrates the important functional role played by the strain-limiting articular surface, the consequences associated with its disruption, as well as the loss of effective stress transmission associated with a 'de-structured' general matrix. The study also provides new insights into the integration of cartilage with both its subchondral substrate and the wider continuum of non-directly loaded cartilage.