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Khan B, Nippolainen E, Shahini F, Nonappa, Popov A, Töyräs J, Afara IO. Relationship between depth-wise refractive index and biomechanical properties of human articular cartilage. JOURNAL OF BIOMEDICAL OPTICS 2024; 29:095003. [PMID: 39309245 PMCID: PMC11413650 DOI: 10.1117/1.jbo.29.9.095003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 08/26/2024] [Accepted: 08/29/2024] [Indexed: 09/25/2024]
Abstract
Significance Optical properties of biological tissues, such as refractive index (RI), are fundamental properties, intrinsically linked to the tissue's composition and structure. We hypothesize that, as the RI and the functional properties of articular cartilage (AC) are dependent on the tissue's structure and composition, the RI of AC is related to its biomechanical properties. Aim This study aims to investigate the relationship between RI of human AC and its biomechanical properties. Approach Human cartilage samples ( n = 22 ) were extracted from the right knee joint of three cadaver donors (one female, aged 47 years, and two males, aged 64 and 68 years) obtained from a commercial biobank (Science Care, Phoenix, Arizona, United States). The samples were initially subjected to mechanical indentation testing to determine elastic [equilibrium modulus (EM) and instantaneous modulus (IM)] and dynamic [dynamic modulus (DM)] viscoelastic properties. An Abbemat 3200 automatic one-wavelength refractometer operating at 600 nm was used to measure the RI of the extracted sections. Similarly, Spearman's and Pearson's correlation coefficients were employed for non-normal and normal datasets, respectively, to determine the correlation between the depth-wise RI and biomechanical properties of the cartilage samples as a function of the collagen fibril orientation. Results A positive correlation with statistically significant relations ( p - values < 0.05 ) was observed between the RI and the biomechanical properties (EM, IM, and DM) along the tissue depth for each zone, e.g., superficial, middle, and deep zones. Likewise, a lower positive correlation with statistically significant relations ( p - values < 0.05 ) was also observed for collagen fibril orientation of all zones with the biomechanical properties. Conclusions The results indicate that, although the RI exhibits different levels of correlation with different biomechanical properties, the relationship varies as a function of the tissue depth. This knowledge paves the way for optically monitoring changes in AC biomechanical properties nondestructively via changes in the RI. Thus, the RI could be a potential biomarker for assessing the mechanical competency of AC, particularly in degenerative diseases, such as osteoarthritis.
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Affiliation(s)
- Bilour Khan
- University of Eastern Finland, Department of Technical Physics, Kuopio, Finland
| | - Ervin Nippolainen
- University of Eastern Finland, Department of Technical Physics, Kuopio, Finland
| | - Fatemeh Shahini
- University of Eastern Finland, Department of Technical Physics, Kuopio, Finland
| | - Nonappa
- Tampere University, Faculty of Engineering and Natural Sciences, Tampere, Finland
| | - Alexey Popov
- VTT Technical Research Center of Finland, Oulu, Finland
| | - Juha Töyräs
- University of Eastern Finland, Department of Technical Physics, Kuopio, Finland
- Kuopio University Hospital, Science Service Center, Kuopio, Finland
- The University of Queensland, School of Electrical Engineering and Computer Science, Brisbane, Australia
| | - Isaac O. Afara
- University of Eastern Finland, Department of Technical Physics, Kuopio, Finland
- The University of Queensland, School of Electrical Engineering and Computer Science, Brisbane, Australia
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2
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Shahini F, Oskouei S, Nippolainen E, Mohammadi A, Sarin JK, Moller NCRT, Brommer H, Shaikh R, Korhonen RK, van Weeren PR, Töyräs J, Afara IO. Infrared Spectroscopy Can Differentiate Between Cartilage Injury Models: Implication for Assessment of Cartilage Integrity. Ann Biomed Eng 2024; 52:2521-2533. [PMID: 38902468 PMCID: PMC11329391 DOI: 10.1007/s10439-024-03540-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 05/08/2024] [Indexed: 06/22/2024]
Abstract
In order to improve the ability of clinical diagnosis to differentiate articular cartilage (AC) injury of different origins, this study explores the sensitivity of mid-infrared (MIR) spectroscopy for detecting structural, compositional, and functional changes in AC resulting from two injury types. Three grooves (two in parallel in the palmar-dorsal direction and one in the mediolateral direction) were made via arthrotomy in the AC of the radial facet of the third carpal bone (middle carpal joint) and of the intermediate carpal bone (the radiocarpal joint) of nine healthy adult female Shetland ponies (age = 6.8 ± 2.6 years; range 4-13 years) using blunt and sharp tools. The defects were randomly assigned to each of the two joints. Ponies underwent a 3-week box rest followed by 8 weeks of treadmill training and 26 weeks of free pasture exercise before being euthanized for osteochondral sample collection. The osteochondral samples underwent biomechanical indentation testing, followed by MIR spectroscopic assessment. Digital densitometry was conducted afterward to estimate the tissue's proteoglycan (PG) content. Subsequently, machine learning models were developed to classify the samples to estimate their biomechanical properties and PG content based on the MIR spectra according to injury type. Results show that MIR is able to discriminate healthy from injured AC (91%) and between injury types (88%). The method can also estimate AC properties with relatively low error (thickness = 12.7% mm, equilibrium modulus = 10.7% MPa, instantaneous modulus = 11.8% MPa). These findings demonstrate the potential of MIR spectroscopy as a tool for assessment of AC integrity changes that result from injury.
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Affiliation(s)
- Fatemeh Shahini
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland.
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland.
| | - Soroush Oskouei
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Ervin Nippolainen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Ali Mohammadi
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Jaakko K Sarin
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- Department of Medical Physics, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland
| | - Nikae C R Te Moller
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Harold Brommer
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Rubina Shaikh
- Centre for Radiation and Environmental Science, FOCAS Research Institute, Technological University Dublin, Dublin, Ireland
| | - Rami K Korhonen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - P René van Weeren
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
- Regenerative Medicine Utrecht, Utrecht, The Netherlands
| | - Juha Töyräs
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- School of Electrical Engineering and Computer Science, The University of Queensland, Brisbane, Australia
- Science Service Center, Kuopio University Hospital, Kuopio, Finland
| | - Isaac O Afara
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- School of Electrical Engineering and Computer Science, The University of Queensland, Brisbane, Australia
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3
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Tuppurainen J, Paakkari P, Jäntti J, Nissinen MT, Fugazzola MC, van Weeren R, Ylisiurua S, Nieminen MT, Kröger H, Snyder BD, Joenathan A, Grinstaff MW, Matikka H, Korhonen RK, Mäkelä JTA. Revealing Detailed Cartilage Function Through Nanoparticle Diffusion Imaging: A Computed Tomography & Finite Element Study. Ann Biomed Eng 2024; 52:2584-2595. [PMID: 39012563 PMCID: PMC11329549 DOI: 10.1007/s10439-024-03552-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 05/23/2024] [Indexed: 07/17/2024]
Abstract
The ability of articular cartilage to withstand significant mechanical stresses during activities, such as walking or running, relies on its distinctive structure. Integrating detailed tissue properties into subject-specific biomechanical models is challenging due to the complexity of analyzing these characteristics. This limitation compromises the accuracy of models in replicating cartilage function and impacts predictive capabilities. To address this, methods revealing cartilage function at the constituent-specific level are essential. In this study, we demonstrated that computational modeling derived individual constituent-specific biomechanical properties could be predicted by a novel nanoparticle contrast-enhanced computer tomography (CECT) method. We imaged articular cartilage samples collected from the equine stifle joint (n = 60) using contrast-enhanced micro-computed tomography (µCECT) to determine contrast agents' intake within the samples, and compared those to cartilage functional properties, derived from a fibril-reinforced poroelastic finite element model. Two distinct imaging techniques were investigated: conventional energy-integrating µCECT employing a cationic tantalum oxide nanoparticle (Ta2O5-cNP) contrast agent and novel photon-counting µCECT utilizing a dual-contrast agent, comprising Ta2O5-cNP and neutral iodixanol. The results demonstrate the capacity to evaluate fibrillar and non-fibrillar functionality of cartilage, along with permeability-affected fluid flow in cartilage. This finding indicates the feasibility of incorporating these specific functional properties into biomechanical computational models, holding potential for personalized approaches to cartilage diagnostics and treatment.
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Affiliation(s)
- Juuso Tuppurainen
- Department of Technical Physics, University of Eastern Finland, POB 1627, 70211, Kuopio, Finland.
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland.
| | - Petri Paakkari
- Department of Technical Physics, University of Eastern Finland, POB 1627, 70211, Kuopio, Finland
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Jiri Jäntti
- Department of Technical Physics, University of Eastern Finland, POB 1627, 70211, Kuopio, Finland
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Mikko T Nissinen
- Department of Technical Physics, University of Eastern Finland, POB 1627, 70211, Kuopio, Finland
| | - Maria C Fugazzola
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - René van Weeren
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Sampo Ylisiurua
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Miika T Nieminen
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Heikki Kröger
- Department of Orthopaedics and Traumatology, Kuopio University Hospital, Kuopio, Finland
- Kuopio Musculoskeletal Research Unit, University of Eastern Finland, Kuopio, Finland
| | - Brian D Snyder
- Department of Orthopedic Surgery, Boston Children's Hospital, Boston, USA
| | - Anisha Joenathan
- Departments of Biomedical Engineering and Chemistry, Boston University, Boston, USA
| | - Mark W Grinstaff
- Departments of Biomedical Engineering and Chemistry, Boston University, Boston, USA
| | - Hanna Matikka
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Rami K Korhonen
- Department of Technical Physics, University of Eastern Finland, POB 1627, 70211, Kuopio, Finland
| | - Janne T A Mäkelä
- Department of Technical Physics, University of Eastern Finland, POB 1627, 70211, Kuopio, Finland
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
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4
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Szabo NE, Johnson JE, Brouillette MJ, Goetz JE. Implications of using simplified finite element meshes to identify material parameters of articular cartilage. Med Eng Phys 2024; 131:104200. [PMID: 39284645 DOI: 10.1016/j.medengphy.2024.104200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 06/10/2024] [Accepted: 06/27/2024] [Indexed: 09/19/2024]
Abstract
The objective of this work was to determine the effects of using simplified finite element (FE) mesh geometry in the process of performing reverse iterative fitting to estimate cartilage material parameters from in situ indentation testing. Six bovine tibial osteochondral explants were indented with sequential 5 % step-strains followed by a 600 s hold while relaxation force was measured. Three sets of porous viscohyperelastic material parameters were estimated for each specimen using reverse iterative fitting of the indentation test with (1) 2D axisymmetric, (2) 3D idealized, and (3) 3D specimen-specific FE meshes. Variable material parameters were identified using the three different meshes, and there were no systematic differences, correlation to basic geometric features, nor distinct patterns of variation based on the type of mesh used. Implementing the three material parameter sets in a separate 3D FE model of 40 % compressive strain produced differences in von Mises stresses and pore pressures up to 25 % and 50 %, respectively. Accurate material parameters are crucial in any FE model, and parameter differences influenced by idealized assumptions in initial material property determination have the potential to alter subsequent FE models in unpredictable ways and hinder the interpretation of their results.
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Affiliation(s)
- Nicole E Szabo
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA, 52242, USA; Department of Biomedical Engineering, University of Iowa, Iowa City, IA, 52242, USA
| | - Joshua E Johnson
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA, 52242, USA
| | - Marc J Brouillette
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA, 52242, USA
| | - Jessica E Goetz
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA, 52242, USA; Department of Biomedical Engineering, University of Iowa, Iowa City, IA, 52242, USA.
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5
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Krakowski P, Rejniak A, Sobczyk J, Karpiński R. Cartilage Integrity: A Review of Mechanical and Frictional Properties and Repair Approaches in Osteoarthritis. Healthcare (Basel) 2024; 12:1648. [PMID: 39201206 PMCID: PMC11353818 DOI: 10.3390/healthcare12161648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2024] [Revised: 08/09/2024] [Accepted: 08/14/2024] [Indexed: 09/02/2024] Open
Abstract
Osteoarthritis (OA) is one of the most common causes of disability around the globe, especially in aging populations. The main symptoms of OA are pain and loss of motion and function of the affected joint. Hyaline cartilage has limited ability for regeneration due to its avascularity, lack of nerve endings, and very slow metabolism. Total joint replacement (TJR) has to date been used as the treatment of end-stage disease. Various joint-sparing alternatives, including conservative and surgical treatment, have been proposed in the literature; however, no treatment to date has been fully successful in restoring hyaline cartilage. The mechanical and frictional properties of the cartilage are of paramount importance in terms of cartilage resistance to continuous loading. OA causes numerous changes in the macro- and microstructure of cartilage, affecting its mechanical properties. Increased friction and reduced load-bearing capability of the cartilage accelerate further degradation of tissue by exerting increased loads on the healthy surrounding tissues. Cartilage repair techniques aim to restore function and reduce pain in the affected joint. Numerous studies have investigated the biological aspects of OA progression and cartilage repair techniques. However, the mechanical properties of cartilage repair techniques are of vital importance and must be addressed too. This review, therefore, addresses the mechanical and frictional properties of articular cartilage and its changes during OA, and it summarizes the mechanical outcomes of cartilage repair techniques.
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Affiliation(s)
- Przemysław Krakowski
- Department of Trauma Surgery and Emergency Medicine, Medical University, 20-059 Lublin, Poland
- Orthopaedic and Sports Traumatology Department, Carolina Medical Center, Pory 78, 02-757 Warsaw, Poland; (A.R.); (J.S.)
| | - Adrian Rejniak
- Orthopaedic and Sports Traumatology Department, Carolina Medical Center, Pory 78, 02-757 Warsaw, Poland; (A.R.); (J.S.)
| | - Jakub Sobczyk
- Orthopaedic and Sports Traumatology Department, Carolina Medical Center, Pory 78, 02-757 Warsaw, Poland; (A.R.); (J.S.)
| | - Robert Karpiński
- Department of Machine Design and Mechatronics, Faculty of Mechanical Engineering, University of Technology, 20-618 Lublin, Poland
- Department of Psychiatry, Psychotherapy and Early Intervention, Medical University, 20-059 Lublin, Poland
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6
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Linus A, Tanska P, Nippolainen E, Tiitu V, Töyras J, Korhonen RK, Afara IO, Mononen ME. Site-specific elastic and viscoelastic biomechanical properties of healthy and osteoarthritic human knee joint articular cartilage. J Biomech 2024; 169:112135. [PMID: 38744145 DOI: 10.1016/j.jbiomech.2024.112135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 04/07/2024] [Accepted: 05/02/2024] [Indexed: 05/16/2024]
Abstract
Articular cartilage exhibits site-specific biomechanical properties. However, no study has comprehensively characterized site-specific cartilage properties from the same knee joints at different stages of osteoarthritis (OA). Cylindrical osteochondral explants (n = 381) were harvested from donor-matched lateral and medial tibia, lateral and medial femur, patella, and trochlea of cadaveric knees (N = 17). Indentation test was used to measure the elastic and viscoelastic mechanical properties of the samples, and Osteoarthritis Research Society International (OARSI) grading system was used to categorize the samples into normal (OARSI 0-1), early OA (OARSI 2-3), and advanced OA (OARSI 4-5) groups. OA-related changes in cartilage mechanical properties were site-specific. In the lateral and medial tibia and trochlea sites, equilibrium, instantaneous and dynamic moduli were higher (p < 0.001) in normal tissue than in early and advanced OA tissue. In lateral and medial femur, equilibrium, instantaneous and dynamic moduli were smaller in advanced OA, but not in early OA, than in normal tissue. The phase difference (0.1-0.25 Hz) between stress and strain was significantly smaller (p < 0.05) in advanced OA than in normal tissue across all sites except medial tibia. Our results indicated that in contrast to femoral and patellar cartilage, equilibrium, instantaneous and dynamic moduli of the tibia and trochlear cartilage decreased in early OA. These may suggest that the tibia and trochlear cartilage degrades faster than the femoral and patellar cartilage. The information is relevant for developing site-specific computational models and engineered cartilage constructs.
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Affiliation(s)
- Awuniji Linus
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland.
| | - Petri Tanska
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Ervin Nippolainen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Virpi Tiitu
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
| | - Juha Töyras
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland; Science Service Center, Kuopio University Hospital, Kuopio, Finland; School of Electrical Engineering and Computer Science, The University of Queensland, Brisbane, Australia
| | - Rami K Korhonen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Isaac O Afara
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Mika E Mononen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
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7
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Berni M, Marchiori G, Baleani M, Giavaresi G, Lopomo NF. Biomechanics of the Human Osteochondral Unit: A Systematic Review. MATERIALS (BASEL, SWITZERLAND) 2024; 17:1698. [PMID: 38612211 PMCID: PMC11012636 DOI: 10.3390/ma17071698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/17/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024]
Abstract
The damping system ensured by the osteochondral (OC) unit is essential to deploy the forces generated within load-bearing joints during locomotion, allowing furthermore low-friction sliding motion between bone segments. The OC unit is a multi-layer structure including articular cartilage, as well as subchondral and trabecular bone. The interplay between the OC tissues is essential in maintaining the joint functionality; altered loading patterns can trigger biological processes that could lead to degenerative joint diseases like osteoarthritis. Currently, no effective treatments are available to avoid degeneration beyond tissues' recovery capabilities. A thorough comprehension on the mechanical behaviour of the OC unit is essential to (i) soundly elucidate its overall response to intra-articular loads for developing diagnostic tools capable of detecting non-physiological strain levels, (ii) properly evaluate the efficacy of innovative treatments in restoring physiological strain levels, and (iii) optimize regenerative medicine approaches as potential and less-invasive alternatives to arthroplasty when irreversible damage has occurred. Therefore, the leading aim of this review was to provide an overview of the state-of-the-art-up to 2022-about the mechanical behaviour of the OC unit. A systematic search is performed, according to PRISMA standards, by focusing on studies that experimentally assess the human lower-limb joints' OC tissues. A multi-criteria decision-making method is proposed to quantitatively evaluate eligible studies, in order to highlight only the insights retrieved through sound and robust approaches. This review revealed that studies on human lower limbs are focusing on the knee and articular cartilage, while hip and trabecular bone studies are declining, and the ankle and subchondral bone are poorly investigated. Compression and indentation are the most common experimental techniques studying the mechanical behaviour of the OC tissues, with indentation also being able to provide information at the micro- and nanoscales. While a certain comparability among studies was highlighted, none of the identified testing protocols are currently recognised as standard for any of the OC tissues. The fibril-network-reinforced poro-viscoelastic constitutive model has become common for describing the response of the articular cartilage, while the models describing the mechanical behaviour of mineralised tissues are usually simpler (i.e., linear elastic, elasto-plastic). Most advanced studies have tested and modelled multiple tissues of the same OC unit but have done so individually rather than through integrated approaches. Therefore, efforts should be made in simultaneously evaluating the comprehensive response of the OC unit to intra-articular loads and the interplay between the OC tissues. In this regard, a multidisciplinary approach combining complementary techniques, e.g., full-field imaging, mechanical testing, and computational approaches, should be implemented and validated. Furthermore, the next challenge entails transferring this assessment to a non-invasive approach, allowing its application in vivo, in order to increase its diagnostic and prognostic potential.
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Affiliation(s)
- Matteo Berni
- Laboratorio di Tecnologia Medica, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy; (M.B.); (M.B.)
| | - Gregorio Marchiori
- Scienze e Tecnologie Chirurgiche, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy;
| | - Massimiliano Baleani
- Laboratorio di Tecnologia Medica, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy; (M.B.); (M.B.)
| | - Gianluca Giavaresi
- Scienze e Tecnologie Chirurgiche, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy;
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8
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Abusara Z, Moo EK, Haider I, Timmermann C, Miller S, Timmermann S, Herzog W. Functional Assessment of Human Articular Cartilage Using Second Harmonic Generation (SHG) Imaging: A Feasibility Study. Ann Biomed Eng 2024; 52:1009-1020. [PMID: 38240956 DOI: 10.1007/s10439-023-03437-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 12/26/2023] [Indexed: 03/16/2024]
Abstract
Many arthroscopic tools developed for knee joint assessment are contact-based, which is challenging for in vivo application in narrow joint spaces. Second harmonic generation (SHG) laser imaging is a non-invasive and non-contact method, thus presenting an attractive alternative. However, the association between SHG-based measures and cartilage quality has not been established systematically. Here, we investigated the feasibility of using image-based measures derived from SHG microscopy for objective evaluation of cartilage quality as assessed by mechanical testing. Human tibial plateaus harvested from nine patients were used. Cartilage mechanical properties were determined using indentation stiffness (Einst) and streaming potential-based quantitative parameters (QP). The correspondence of the cartilage electromechanical properties (Einst and QP) and the image-based measures derived from SHG imaging, tissue thickness and cell viability were evaluated using correlation and logistic regression analyses. The SHG-related parameters included the newly developed volumetric fraction of organised collagenous network (Φcol) and the coefficient of variation of the SHG intensity (CVSHG). We found that Φcol correlated strongly with Einst and QP (ρ = 0.97 and - 0.89, respectively). CVSHG also correlated, albeit weakly, with QP and Einst, (|ρ| = 0.52-0.58). Einst and Φcol were the most sensitive predictors of cartilage quality whereas CVSHG only showed moderate sensitivity. Cell viability and tissue thickness, often used as measures of cartilage health, predicted the cartilage quality poorly. We present a simple, objective, yet effective image-based approach for assessment of cartilage quality. Φcol correlated strongly with electromechanical properties of cartilage and could fuel the continuous development of SHG-based arthroscopy.
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Affiliation(s)
- Ziad Abusara
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada.
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada.
| | - Eng Kuan Moo
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada
- Department of Mechanical and Aerospace Engineering, Faculty of Engineering and Design, Carleton University, Ottawa, Canada
| | - Ifaz Haider
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Claire Timmermann
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Sue Miller
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Section of Orthopaedic Surgery, Department of Surgery, University of Calgary, Calgary, Canada
- Taylor Institute for Teaching and Learning, University of Calgary, Calgary, Canada
| | - Scott Timmermann
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Section of Orthopaedic Surgery, Department of Surgery, University of Calgary, Calgary, Canada
| | - Walter Herzog
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
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9
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Orava H, Paakkari P, Jäntti J, Honkanen MKM, Honkanen JTJ, Virén T, Joenathan A, Tanska P, Korhonen RK, Grinstaff MW, Töyräs J, Mäkelä JTA. Triple contrast computed tomography reveals site-specific biomechanical differences in the human knee joint-A proof of concept study. J Orthop Res 2024; 42:415-424. [PMID: 37593815 DOI: 10.1002/jor.25683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/05/2023] [Accepted: 08/14/2023] [Indexed: 08/19/2023]
Abstract
Cartilage and synovial fluid are challenging to observe separately in native computed tomography (CT). We report the use of triple contrast agent (bismuth nanoparticles [BiNPs], CA4+, and gadoteridol) to image and segment cartilage in cadaveric knee joints with a clinical CT scanner. We hypothesize that BiNPs will remain in synovial fluid while the CA4+ and gadoteridol will diffuse into cartilage, allowing (1) segmentation of cartilage, and (2) evaluation of cartilage biomechanical properties based on contrast agent concentrations. To investigate these hypotheses, triple contrast agent was injected into both knee joints of a cadaver (N = 1), imaged with a clinical CT at multiple timepoints during the contrast agent diffusion. Knee joints were extracted, imaged with micro-CT (µCT), and biomechanical properties of the cartilage surface were determined by stress-relaxation mapping. Cartilage was segmented and contrast agent concentrations (CA4+ and gadoteridol) were compared with the biomechanical properties at multiple locations (n = 185). Spearman's correlation between cartilage thickness from clinical CT and reference µCT images verifies successful and reliable segmentation. CA4+ concentration is significantly higher in femoral than in tibial cartilage at 60 min and further timepoints, which corresponds to the higher Young's modulus observed in femoral cartilage. In this pilot study, we show that (1) large BiNPs do not diffuse into cartilage, facilitating straightforward segmentation of human knee joint cartilage in a clinical setting, and (2) CA4+ concentration in cartilage reflects the biomechanical differences between femoral and tibial cartilage. Thus, the triple contrast agent CT shows potential in cartilage morphology and condition estimation in clinical CT.
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Affiliation(s)
- Heta Orava
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Petri Paakkari
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Jiri Jäntti
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Miitu K M Honkanen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | | | - Tuomas Virén
- Center of Oncology, Kuopio University Hospital, Kuopio, Finland
| | - Anisha Joenathan
- Departments of Biomedical Engineering, Chemistry, and Medicine, Boston University, Boston, Massachusetts, USA
| | - Petri Tanska
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Rami K Korhonen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Mark W Grinstaff
- Departments of Biomedical Engineering, Chemistry, and Medicine, Boston University, Boston, Massachusetts, USA
| | - Juha Töyräs
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- Science Service Center, Kuopio University Hospital, Kuopio, Finland
- School of Electrical Engineering and Computer Science, The University of Queensland, Brisbane, Australia
| | - Janne T A Mäkelä
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
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10
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Ristaniemi A, Šećerović A, Grad S, Ferguson SJ. A Novel Fiber-Reinforced Poroviscoelastic Bovine Intervertebral Disc Finite Element Model for Organ Culture Experiment Simulations. J Biomech Eng 2023; 145:121006. [PMID: 37773639 DOI: 10.1115/1.4063557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 08/28/2023] [Indexed: 10/01/2023]
Abstract
Intervertebral disc (IVD) degeneration and methods for repair and regeneration have commonly been studied in organ cultures with animal IVDs under compressive loading. With the recent establishment of a novel multi-axial organ culture system, accurate predictions of the global and local mechanical response of the IVD are needed for control system development and to aid in experiment planning. This study aimed to establish a finite element model of bovine IVD capable of predicting IVD behavior at physiological and detrimental load levels. A finite element model was created based on the dimensions and shape of a typical bovine IVD used in the organ culture. The nucleus pulposus (NP) was modeled as a neo-Hookean poroelastic material and the annulus fibrosus (AF) as a fiber-reinforced poroviscoelastic material. The AF consisted of 10 lamella layers and the material properties were distributed in the radial direction. The model outcome was compared to a bovine IVD in a compressive stress-relaxation experiment. A parametric study was conducted to investigate the effect of different material parameters on the overall IVD response. The model was able to capture the equilibrium response and the relaxation response at physiological and higher strain levels. Permeability and elastic stiffness of the AF fiber network affected the overall response most prominently. The established model can be used to evaluate the response of the bovine IVD at strain levels typical for organ culture experiments, to define relevant boundaries for such studies, and to aid in the development and use of new multi-axial organ culture systems.
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Affiliation(s)
- Aapo Ristaniemi
- AO Research Institute Davos, Clavadelerstrasse 8, Davos 7270, Switzerland
| | - Amra Šećerović
- AO Research Institute Davos, Clavadelerstrasse 8, Davos 7270, Switzerland
| | - Sibylle Grad
- AO Research Institute Davos, Clavadelerstrasse 8, Davos 7270, Switzerland
| | - Stephen J Ferguson
- Institute for Biomechanics, ETH Zürich, Hönggerbergring 64, Zürich 8093, Switzerland
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11
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Pala S, Hänninen NE, Mohammadi A, Ebrahimi M, Te Moller NCR, Brommer H, René van Weeren P, Mäkelä JTA, Korhonen RK, Afara IO, Töyräs J, Mikkonen S, Nissi MJ, Nykänen O. 3D T 1 relaxation time measurements in an equine model of subtle post-traumatic osteoarthritis using MB-SWIFT. J Orthop Res 2023; 41:2657-2666. [PMID: 37203565 DOI: 10.1002/jor.25629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 05/16/2023] [Indexed: 05/20/2023]
Abstract
The aim of this study is to assess whether articular cartilage changes in an equine model of post-traumatic osteoarthritis (PTOA), induced by surgical creation of standard (blunt) grooves, and very subtle sharp grooves, could be detected with ex vivo T1 relaxation time mapping utilizing three-dimensional (3D) readout sequence with zero echo time. Grooves were made on the articular surfaces of the middle carpal and radiocarpal joints of nine mature Shetland ponies and osteochondral samples were harvested at 39 weeks after being euthanized under respective ethical permissions. T1 relaxation times of the samples (n = 8 + 8 for experimental and n = 12 for contralateral controls) were measured with a variable flip angle 3D multiband-sweep imaging with Fourier transform sequence. Equilibrium and instantaneous Young's moduli and proteoglycan (PG) content from OD of Safranin-O-stained histological sections were measured and utilized as reference parameters for the T1 relaxation times. T1 relaxation time was significantly (p < 0.05) increased in both groove areas, particularly in the blunt grooves, compared with control samples, with the largest changes observed in the superficial half of the cartilage. T1 relaxation times correlated weakly (Rs ≈ 0.33) with equilibrium modulus and PG content (Rs ≈ 0.21). T1 relaxation time in the superficial articular cartilage is sensitive to changes induced by the blunt grooves but not to the much subtler sharp grooves, at the 39-week timepoint post-injury. These findings support that T1 relaxation time has potential in detection of mild PTOA, albeit the most subtle changes could not be detected.
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Affiliation(s)
- Swetha Pala
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Nina E Hänninen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - Ali Mohammadi
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Mohammadhossein Ebrahimi
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - Nikae C R Te Moller
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Harold Brommer
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - P René van Weeren
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Janne T A Mäkelä
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Rami K Korhonen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Isaac O Afara
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Juha Töyräs
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- Science Service Center, Kuopio University Hospital, Kuopio, Finland
- School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Queensland, USA
| | - Santtu Mikkonen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Mikko J Nissi
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Olli Nykänen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
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12
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Jahangir S, Esrafilian A, Ebrahimi M, Stenroth L, Alkjær T, Henriksen M, Englund M, Mononen ME, Korhonen RK, Tanska P. Sensitivity of simulated knee joint mechanics to selected human and bovine fibril-reinforced poroelastic material properties. J Biomech 2023; 160:111800. [PMID: 37797566 DOI: 10.1016/j.jbiomech.2023.111800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 08/25/2023] [Accepted: 09/12/2023] [Indexed: 10/07/2023]
Abstract
Fibril-reinforced poroviscoelastic material models are considered state-of-the-art in modeling articular cartilage biomechanics. Yet, cartilage material parameters are often based on bovine tissue properties in computational knee joint models, although bovine properties are distinctly different from those of humans. Thus, we aimed to investigate how cartilage mechanical responses are affected in the knee joint model during walking when fibril-reinforced poroviscoelastic properties of cartilage are based on human data instead of bovine. We constructed a finite element knee joint model in which tibial and femoral cartilages were modeled as fibril-reinforced poroviscoelastic material using either human or bovine data. Joint loading was based on subject-specific gait data. The resulting mechanical responses of knee cartilage were compared between the knee joint models with human or bovine fibril-reinforced poroviscoelastic cartilage properties. Furthermore, we conducted a sensitivity analysis to determine which fibril-reinforced poroviscoelastic material parameters have the greatest impact on cartilage mechanical responses in the knee joint during walking. In general, bovine cartilage properties yielded greater maximum principal stresses and fluid pressures (both up to 30%) when compared to the human cartilage properties during the loading response in both femoral and tibial cartilage sites. Cartilage mechanical responses were very sensitive to the collagen fibril-related material parameter variations during walking while they were unresponsive to proteoglycan matrix or fluid flow-related material parameter variations. Taken together, human cartilage material properties should be accounted for when the goal is to compare absolute mechanical responses of knee joint cartilage as bovine material parameters lead to substantially different cartilage mechanical responses.
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Affiliation(s)
- Sana Jahangir
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland.
| | - Amir Esrafilian
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | | | - Lauri Stenroth
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland; Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tine Alkjær
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark; The Parker Institute, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
| | - Marius Henriksen
- The Parker Institute, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
| | - Martin Englund
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Mika E Mononen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Rami K Korhonen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Petri Tanska
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland.
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13
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Mahmood F, Clarke J, Riches P. Is the mechanical function of meniscal tissue altered in osteoarthritic knees? Knee 2023; 44:194-200. [PMID: 37672911 DOI: 10.1016/j.knee.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/27/2023] [Accepted: 08/11/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Deteriorating meniscal function is thought to play a role in knee osteoarthritis. Meniscal proteoglycans maintain mechanical stiffness of the tissue through electrostatic effects. This study aimed to investigate whether the mechanical properties of macroscopically intact meniscus are preserved in osteoarthritis. METHODS Discs of lateral meniscal tissue two millimetres thick and of five millimetres diameter from osteoarthritic knees and from healthy donors were placed within a confined compression chamber, mounted in a materials testing machine and bathed in isotonic 0.14M PBS, hypotonic deionised water or hypertonic 3M PBS. Following equilibrium, a 10% ramp compressive strain was applied followed by a 7200 second hold. Resultant stress relaxation curves were fitted to a nonlinear poroviscoelastic model with strain dependent permeability using finite element modelling to determine mechanical parameters. All samples were assayed for proteoglycan content. Comparison of results was undertaken using multivariate ANOVA. RESULTS Thirty samples from osteoarthritic knees and 18 samples from healthy donors were tested. No significant differences in mechanical parameters or proteoglycan content was observed between groups. In both groups Young's modulus (E) was significantly greater, and zero-strain permeability significantly reduced, in samples tested in deionised water compared to samples tested in 0.14M or 3M PBS (all p < 0.05). CONCLUSION Mechanical parameters of intact lateral meniscus in osteoarthritic knees are similar to those found in healthy knees. Proteoglycan concentration and their electrostatic contribution to mechanical stiffness of the meniscus is maintained in menisci derived from osteoarthritic knees. Whilst macroscopic tears in the meniscal ultrastructure may contribute to osteoarthritis, intact meniscal tissue maintains its function.
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Affiliation(s)
- Fahd Mahmood
- Department of Orthopaedics, Golden Jubilee National Hospital, Agamemnon Street, Clydebank G81 4DY, United Kingdom.
| | - Jon Clarke
- Department of Orthopaedics, Golden Jubilee National Hospital, Agamemnon Street, Clydebank G81 4DY, United Kingdom
| | - Philip Riches
- Department of Biomedical Engineering, Wolfson Centre, University of Strathclyde, 16 Richmond Street, Glasgow G1 1XQ, United Kingdom
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14
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Linus A, Tanska P, Sarin JK, Nippolainen E, Tiitu V, Mäkelä JTA, Töyräs J, Korhonen RK, Mononen ME, Afara IO. Visible and Near-Infrared Spectroscopy Enables Differentiation of Normal and Early Osteoarthritic Human Knee Joint Articular Cartilage. Ann Biomed Eng 2023; 51:2245-2257. [PMID: 37332006 PMCID: PMC10518273 DOI: 10.1007/s10439-023-03261-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 05/27/2023] [Indexed: 06/20/2023]
Abstract
Osteoarthritis degenerates cartilage and impairs joint function. Early intervention opportunities are missed as current diagnostic methods are insensitive to early tissue degeneration. We investigated the capability of visible light-near-infrared spectroscopy (Vis-NIRS) to differentiate normal human cartilage from early osteoarthritic one. Vis-NIRS spectra, biomechanical properties and the state of osteoarthritis (OARSI grade) were quantified from osteochondral samples harvested from different anatomical sites of human cadaver knees. Two support vector machines (SVM) classifiers were developed based on the Vis-NIRS spectra and OARSI scores. The first classifier was designed to distinguish normal (OARSI: 0-1) from general osteoarthritic cartilage (OARSI: 2-5) to check the general suitability of the approach yielding an average accuracy of 75% (AUC = 0.77). Then, the second classifier was designed to distinguish normal from early osteoarthritic cartilage (OARSI: 2-3) yielding an average accuracy of 71% (AUC = 0.73). Important wavelength regions for differentiating normal from early osteoarthritic cartilage were related to collagen organization (wavelength region: 400-600 nm), collagen content (1000-1300 nm) and proteoglycan content (1600-1850 nm). The findings suggest that Vis-NIRS allows objective differentiation of normal and early osteoarthritic tissue, e.g., during arthroscopic repair surgeries.
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Affiliation(s)
- Awuniji Linus
- Department of Technical Physics, University of Eastern Finland, 70211, Kuopio, Finland.
| | - Petri Tanska
- Department of Technical Physics, University of Eastern Finland, 70211, Kuopio, Finland
| | - Jaakko K Sarin
- Department of Medical Physics, Medical Imaging Center, Pirkanmaa Hospital District, Tampere, Finland
| | - Ervin Nippolainen
- Department of Technical Physics, University of Eastern Finland, 70211, Kuopio, Finland
| | - Virpi Tiitu
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
| | - Janne T A Mäkelä
- Department of Technical Physics, University of Eastern Finland, 70211, Kuopio, Finland
- Science Service Center, Kuopio University Hospital, Kuopio, Finland
| | - Juha Töyräs
- Department of Technical Physics, University of Eastern Finland, 70211, Kuopio, Finland
- Science Service Center, Kuopio University Hospital, Kuopio, Finland
- School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Australia
| | - Rami K Korhonen
- Department of Technical Physics, University of Eastern Finland, 70211, Kuopio, Finland
| | - Mika E Mononen
- Department of Technical Physics, University of Eastern Finland, 70211, Kuopio, Finland
| | - Isaac O Afara
- Department of Technical Physics, University of Eastern Finland, 70211, Kuopio, Finland
- School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Australia
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15
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Nakagawa Y, Mori K, Mukai S, Shinya Y, Nakamura R, Takahashi M. Intraoperative Acoustic Evaluation of Living Human Knee Cartilage-Comparison with Respect to Cartilage Degeneration and Aging. Cartilage 2023; 14:261-268. [PMID: 36788438 PMCID: PMC10601570 DOI: 10.1177/19476035231154509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 12/24/2022] [Accepted: 12/26/2022] [Indexed: 02/16/2023] Open
Abstract
OBJECTIVE The objective of the study was to evaluate the mechanical properties of living human knee cartilage using our ultrasonic device, and to compare the measurements with respect to cartilage degeneration and aging. DESIGN A total of 95 knees which had undergone arthroscopic knee surgery, from 88 patients, were included in the study, with informed consent. All procedures were reviewed and approved by the ethical committee of our hospital. In the study group, there were 41 men, 47 women, 39 right knees, and 56 left knees. The conditions primarily included knee osteoarthritis and anterior cruciate ligament rupture. The mean operative age was 44.1 years old (range = 10-83). We compared mechanical properties of the knee cartilage with respect to aging and gender, in comparison with normal cartilage. A P value of <0.05 represented statistical significance. RESULTS In the context of the International Cartilage Repair Society (ICRS) classification of cartilage degeneration (grade 0-3), the signal intensity in grade 0 was significantly larger than that in grade 1, 2, or 3. The thickness in grade 0 was significantly higher than that in grade 1, 2, or 3. Normal cartilage in older women had the lowest signal intensity and the least cartilage thickness among all the groups. CONCLUSION The ultrasonic system we developed was able to detect early degenerative changes in living cartilage in knees. The lowest signal intensity and least cartilage thickness in normal cartilage among older women were correlated to a large prevalence of knee osteoarthritis in women. LEVEL OF EVIDENCE Level IV, case series.
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Affiliation(s)
- Yasuaki Nakagawa
- Clinical Research Center, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
- Department of Orthopaedic Surgery, Japan Baptist Medical Foundation, Kyoto, Japan
| | - Koji Mori
- Department of Applied Medical Engineering Science, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Shogo Mukai
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Yuki Shinya
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Ryota Nakamura
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Motoi Takahashi
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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16
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Ead M, Wu K, Jar C, Duke K, Jomha N, Westover L. Mechanical Properties of Fresh, Frozen and Vitrified Articular Cartilage. Ann Biomed Eng 2023; 51:2001-2012. [PMID: 37129781 DOI: 10.1007/s10439-023-03220-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 04/21/2023] [Indexed: 05/03/2023]
Abstract
Osteochondral allograft transplantations are typically used to treat focal articular cartilage injuries where the damaged cartilage is replaced with fresh cadaveric donor grafts. Despite the notable success rate of this procedure, it is limited by fresh donor tissue availability which can only be stored for approximately 28 days after harvest. Vitrification, a form of cryopreservation, can extend the storage time of cartilage. Although it has shown to preserve chondrocyte viability, its effect on the mechanical properties of the tissue has not been thoroughly investigated. Therefore, in this study, the mechanical properties of fresh, frozen, and vitrified articular cartilage were evaluated through unconfined compression testing. Results showed that the peak modulus, equilibrium modulus, and relaxation time constants of the vitrified and control samples (tested one day after harvest) were similar and higher than the fresh (tested 21 days after harvest) and frozen samples. This demonstrated that vitrification does not adversely affect the mechanical properties of cartilage and can be used as an alternative to fresh allografts which are limited by storage time. The fresh samples also had inferior mechanical properties compared to the control samples suggesting that vitrified allografts could potentially improve clinical outcomes in addition to increasing donor tissue availability.
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Affiliation(s)
- Maha Ead
- Department of Mechanical Engineering, University of Alberta, Edmonton, Canada.
| | - Kezhou Wu
- Department of Surgery, University of Alberta, Edmonton, Canada
- Sports Medicine Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Chester Jar
- Department of Mechanical Engineering, University of Alberta, Edmonton, Canada
| | - Kajsa Duke
- Department of Mechanical Engineering, University of Alberta, Edmonton, Canada
| | - Nadr Jomha
- Department of Surgery, University of Alberta, Edmonton, Canada
| | - Lindsey Westover
- Department of Mechanical Engineering, University of Alberta, Edmonton, Canada
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17
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Raju V, Koorata PK. Computational assessment on the impact of collagen fiber orientation in cartilages on healthy and arthritic knee kinetics/kinematics. Med Eng Phys 2023; 117:103997. [PMID: 37331751 DOI: 10.1016/j.medengphy.2023.103997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 06/20/2023]
Abstract
BACKGROUND The inhomogeneous distribution of collagen fiber in cartilage can substantially influence the knee kinematics. This becomes vital for understanding the mechanical response of soft tissues, and cartilage deterioration including osteoarthritis (OA). Though the conventional computational models consider geometrical heterogeneity along with fiber reinforcements in the cartilage model as material heterogeneity, the influence of fiber orientation on knee kinetics and kinematics is not fully explored. This work examines how the collagen fiber orientation in the cartilage affects the healthy (intact knee) and arthritic knee response over multiple gait activities like running and walking. METHODS A 3D finite element knee joint model is used to compute the articular cartilage response during the gait cycle. A fiber-reinforced porous hyper elastic (FRPHE) material is used to model the soft tissue. A split-line pattern is used to implement the fiber orientation in femoral and tibial cartilage. Four distinct intact cartilage models and three OA models are simulated to assess the impact of the orientation of collagen fibers in a depth wise direction. The cartilage models with fibers oriented in parallel, perpendicular, and inclined to the articular surface are investigated for multiple knee kinematics and kinetics. FINDINGS The comparison of models with fiber orientation parallel to articulating surface for walking and running gait has the highest elastic stress and fluid pressure compared with inclined and perpendicular fiber-oriented models. Also, the maximum contact pressure is observed to be higher in the case of intact models during the walking cycle than for OA models. In contrast, the maximum contact pressure is higher during running in OA models than in intact models. Additionally, parallel-oriented models produce higher maximum stresses and fluid pressure for walking and running gait than proximal-distal-oriented models. Interestingly, during the walking cycle, the maximum contact pressure with intact models is approximately three times higher than on OA models. In contrast, the OA models exhibit higher contact pressure during the running cycle. INTERPRETATION Overall, the study indicates that collagen orientation is crucial for tissue responsiveness. This investigation provides insights into the development of tailored implants.
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Affiliation(s)
- Vaishakh Raju
- Applied Solid Mechanics Laboratory, Department of Mechanical Engineering, National Institute of Technology Karnataka, Surathkal, 575025, India
| | - Poornesh Kumar Koorata
- Applied Solid Mechanics Laboratory, Department of Mechanical Engineering, National Institute of Technology Karnataka, Surathkal, 575025, India.
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18
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Mononen ME, Paz A, Liukkonen MK, Turunen MJ. Atlas-based finite element analyses with simpler constitutive models predict personalized progression of knee osteoarthritis: data from the osteoarthritis initiative. Sci Rep 2023; 13:8888. [PMID: 37264050 DOI: 10.1038/s41598-023-35832-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 05/24/2023] [Indexed: 06/03/2023] Open
Abstract
New technologies are required to support a radical shift towards preventive healthcare. Here we focus on evaluating the possibility of finite element (FE) analysis-aided prevention of knee osteoarthritis (OA), a disease that affects 100 million citizens in the US and EU and this number is estimated to increase drastically. Current clinical methods to diagnose or predict joint health status relies on symptoms and tissue failures obtained from clinical imaging. In a joint with no detectable injuries, the diagnosis of the future health of the knee can be assumed to be very subjective. Quantitative approaches are therefore needed to assess the personalized risk for the onset and development of knee OA. FE analysis utilizing an atlas-based modeling approach has shown a preliminary capability for simulating subject-specific cartilage mechanical responses. However, it has been verified with a very limited subject number. Thus, the aim of this study is to verify the real capability of the atlas-based approach to simulate cartilage degeneration utilizing different material descriptions for cartilage. A fibril reinforced poroviscoelastic (FRPVE) material formulation was considered as state-of-the-art material behavior, since it has been preliminary validated against real clinical follow-up data. Simulated mechanical tissue responses and predicted cartilage degenerations within knee joint with FRPVE material were compared against simpler constitutive models for cartilage. The capability of the atlas-based modeling to offer a feasible approach with quantitative evaluation for the risk for the OA development (healthy vs osteoarthritic knee, p < 0.01, AUC ~ 0.7) was verified with 214 knees. Furthermore, the results suggest that accuracy for simulation of cartilage degeneration with simpler material models is similar to models using FPRVE materials if the material parameters are chosen properly.
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Affiliation(s)
- Mika E Mononen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland.
| | - Alexander Paz
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- Escuela de Ingeniería Civil y Geomática, Universidad del Valle, Cali, Colombia
| | - Mimmi K Liukkonen
- Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
| | - Mikael J Turunen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
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19
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Belluzzi E, Todros S, Pozzuoli A, Ruggieri P, Carniel EL, Berardo A. Human Cartilage Biomechanics: Experimental and Theoretical Approaches towards the Identification of Mechanical Properties in Healthy and Osteoarthritic Conditions. Processes (Basel) 2023. [DOI: 10.3390/pr11041014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
Articular cartilage is a complex connective tissue with the fundamental functions of load bearing, shock absorption and lubrication in joints. However, traumatic events, aging and degenerative pathologies may affect its structural integrity and function, causing pain and long-term disability. Osteoarthritis represents a health issue, which concerns an increasing number of people worldwide. Moreover, it has been observed that this pathology also affects the mechanical behavior of the articular cartilage. To better understand this correlation, the here proposed review analyzes the physiological aspects that influence cartilage microstructure and biomechanics, with a special focus on the pathological changes caused by osteoarthritis. Particularly, the experimental data on human articular cartilage are presented with reference to different techniques adopted for mechanical testing and the related theoretical mechanical models usually applied to articular cartilage are briefly discussed.
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20
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Weizel A, Distler T, Detsch R, Boccaccini AR, Seitz H, Budday S. Time-dependent hyper-viscoelastic parameter identification of human articular cartilage and substitute materials. J Mech Behav Biomed Mater 2023; 138:105618. [PMID: 36566662 DOI: 10.1016/j.jmbbm.2022.105618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/02/2022] [Accepted: 12/08/2022] [Indexed: 12/13/2022]
Abstract
Numerical simulations are a valuable tool to understand which processes during mechanical stimulations of hydrogels for cartilage replacement influence the behavior of chondrocytes and contribute to the success or failure of these materials as implants. Such simulations critically rely on the correct prediction of the material response through appropriate material models and corresponding parameters. In this study, we identify hyper-viscoelastic material parameters for numerical simulations in COMSOL Multiphysics® v. 5.6 for human articular cartilage and two replacement materials, the commercially available ChondroFillerliquid and oxidized alginate gelatin (ADA-GEL) hydrogels. We incorporate the realistic experimental boundary conditions into an inverse parameter identification scheme based on data from multiple loading modes simultaneously, including cyclic compression-tension and stress relaxation experiments. We provide individual parameter sets for the unconditioned and conditioned responses and discuss how viscoelastic effects are related to the materials' microstructure. ADA-GEL and ChondroFillerliquid exhibit faster stress relaxation than cartilage with lower relaxation time constants, while cartilage has the largest viscoelastic stress contribution. The elastic response predominates in ADA-GEL and ChondroFillerliquid, while the viscoelastic response predominates in cartilage. These results will help to simulate mechanical stimulations, support the development of suitable materials with distinct mechanical properties in the future and provide parameters and insight into the time-dependent material behavior of human articular cartilage.
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Affiliation(s)
- A Weizel
- Chair of Microfluidics, Faculty of Mechanical Engineering and Marine Technology, University of Rostock, Rostock, Germany.
| | - T Distler
- Institute of Biomaterials, Department of Materials Science and Engineering, Friedrich-Alexander-University Erlangen-Nürnberg, 91058, Erlangen, Germany
| | - R Detsch
- Institute of Biomaterials, Department of Materials Science and Engineering, Friedrich-Alexander-University Erlangen-Nürnberg, 91058, Erlangen, Germany
| | - A R Boccaccini
- Institute of Biomaterials, Department of Materials Science and Engineering, Friedrich-Alexander-University Erlangen-Nürnberg, 91058, Erlangen, Germany
| | - H Seitz
- Chair of Microfluidics, Faculty of Mechanical Engineering and Marine Technology, University of Rostock, Rostock, Germany
| | - S Budday
- Institute of Applied Mechanics, Department of Mechanical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
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21
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Elahi SA, Castro-Viñuelas R, Govaerts A, Lories R, Famaey N, Jonkers I. Unconfined Compression Experimental Protocol for Cartilage Explants and Hydrogel Constructs: From Sample Preparation to Mechanical Characterization. Methods Mol Biol 2023; 2598:271-287. [PMID: 36355298 DOI: 10.1007/978-1-0716-2839-3_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Mechanical characterization of articular cartilage and cell-seeded hydrogel constructs is a challenging task due to the complex biphasic behavior of these materials. Here we describe a step-by-step unconfined compression testing protocol for inverse mechanical characterization of these materials from sample preparation to parameter identification. Examples from our ongoing experiments on alginate hydrogel constructs and preserved and damaged cartilage explants obtained from human hip samples are presented.
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Affiliation(s)
- Seyed Ali Elahi
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium.
- Soft Tissue Biomechanics Group, Biomechanics Division, Mechanical Engineering Department, KU Leuven, Leuven, Belgium.
| | - Rocío Castro-Viñuelas
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
- Tissue homeostasis and Disease Group, Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Anke Govaerts
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
- Tissue homeostasis and Disease Group, Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Rik Lories
- Tissue homeostasis and Disease Group, Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Nele Famaey
- Soft Tissue Biomechanics Group, Biomechanics Division, Mechanical Engineering Department, KU Leuven, Leuven, Belgium
| | - Ilse Jonkers
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
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22
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Ebrahimi M, Turkiewicz A, Finnilä MAJ, Saarakkala S, Englund M, Korhonen RK, Tanska P. Associations of human femoral condyle cartilage structure and composition with viscoelastic and constituent-specific material properties at different stages of osteoarthritis. J Biomech 2022; 145:111390. [PMID: 36442429 DOI: 10.1016/j.jbiomech.2022.111390] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 11/02/2022] [Accepted: 11/11/2022] [Indexed: 11/18/2022]
Abstract
The relationships between structure and function in human knee femoral cartilage are not well-known at different stages of osteoarthritis. Thus, our aim was to characterize the depth-dependent composition and structure (proteoglycan content, collagen network organization and collagen content) of normal and osteoarthritic human femoral condyle cartilage (n = 47) and relate them to their viscoelastic and constituent-specific mechanical properties that are obtained through dynamic sinusoidal testing and fibril-reinforced poroelastic material modeling of stress-relaxation testing, respectively. We characterized the proteoglycan content using digital densitometry, collagen network organization (orientation angle and anisotropy) using polarized light microscopy and collagen content using Fourier transform infrared spectroscopy. In the superficial cartilage (0-10 % of thickness), the collagen network disorganization and proteoglycan loss were associated with the smaller initial fibril network modulus - a parameter representing the pretension of the collagen network. Furthermore, the proteoglycan loss was associated with the greater strain-dependent fibril network modulus - a measure of nonlinear mechanical behavior. The proteoglycan loss was also associated with greater cartilage viscosity at a low loading frequency (0.005 Hz), while the collagen network disorganization was associated with greater cartilage viscosity at a high loading frequency (1 Hz). Our results suggest that proteoglycan loss and collagen network disorganization reduce the pretension of the collagen network while proteoglycan degradation also increases the nonlinear mechanical behavior of the collagen network. Further, the results also highlight that proteoglycan loss and collagen disorganization increase the viscosity of femoral cartilage, but their contribution to increased viscosity occurs in completely different loading frequencies.
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Affiliation(s)
- Mohammadhossein Ebrahimi
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland; Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.
| | - Aleksandra Turkiewicz
- Faculty of Medicine, Department of Clinical Sciences Lund, Orthopaedics, Clinical Epidemiology Unit, Lund University, Lund, Sweden
| | - Mikko A J Finnilä
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Simo Saarakkala
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland; Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Martin Englund
- Faculty of Medicine, Department of Clinical Sciences Lund, Orthopaedics, Clinical Epidemiology Unit, Lund University, Lund, Sweden
| | - Rami K Korhonen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Petri Tanska
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland.
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23
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Chawla D, Eriten M, Henak CR. Effect of osmolarity and displacement rate on cartilage microfracture clusters failure into two regimes. J Mech Behav Biomed Mater 2022; 136:105467. [PMID: 36198233 DOI: 10.1016/j.jmbbm.2022.105467] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 08/16/2022] [Accepted: 09/12/2022] [Indexed: 11/22/2022]
Abstract
Articular cartilage is a poroviscoelastic (PVE) material with remarkable resistance to fracture and fatigue failure. Cartilage failure mechanisms and material properties that govern failure are incompletely understood. Because cartilage is partially comprised of negatively charged glycosaminoglycans, altering solvent osmolarity can influence PVE relaxations. Therefore, this study aims to use osmolarity as a tool to provide additional data to interpret the role of PVE relaxations and identify cartilage failure regimes. Cartilage fracture was induced using a 100 μm radius spheroconical indenter at controlled displacement rates under three different osmolarity solvents. Secondarily, contact pressure (CP) and strain energy density (SED) were estimated to cluster data into two failure regimes with an expectation maximization algorithm. Critical displacement, critical load, critical time, and critical work to fracture increased with increasing osmolarity at a slow displacement rate whereas no significant effect was observed at a fast displacement rate. Clustering provided two distinct failure regimes, with regime (I) at lower normalized thickness (contact radius divided by sample thickness), and regime (II) at higher normalized thickness. Varied CP and SED in regime (I) suggest that failure in the regime is strain-governed. Constant CP and SED in regime (II) suggests that failure in the regime is dominantly governed by stress. These regimes can be interpreted as ductile versus brittle, or using a pressurized fragmentation interpretation. These findings demonstrated fundamental failure properties and postulate failure regimes for articular cartilage.
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Affiliation(s)
- Dipul Chawla
- Department of Mechanical Engineering, University of Wisconsin-Madison, 1513 University Ave., Madison, WI, 53706, USA
| | - Melih Eriten
- Department of Mechanical Engineering, University of Wisconsin-Madison, 1513 University Ave., Madison, WI, 53706, USA
| | - Corinne R Henak
- Department of Mechanical Engineering, University of Wisconsin-Madison, 1513 University Ave., Madison, WI, 53706, USA; Department of Biomedical Engineering, University of Wisconsin-Madison, 1550 University Ave., Madison, WI, 53706, USA; Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, 1111 Highland Ave., Madison, WI, 53705, USA.
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24
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Berni M, Erani P, Lopomo NF, Baleani M. Optimization of In Situ Indentation Protocol to Map the Mechanical Properties of Articular Cartilage. MATERIALS (BASEL, SWITZERLAND) 2022; 15:6425. [PMID: 36143736 PMCID: PMC9505484 DOI: 10.3390/ma15186425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/29/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
Tissue engineering aims at developing complex composite scaffolds for articular cartilage repair. These scaffolds must exhibit a mechanical behavior similar to the whole osteochondral unit. In situ spherical indentation allows us to map the mechanical behavior of articular cartilage, avoiding removal of the underlying bone tissue. Little is known about the impact of grid spacing, indenter diameter, and induced deformation on the cartilage response to indentation. We investigated the impact of grid spacing (range: a to 3a, where a is the radius of the contact area between cartilage and indenter), indenter diameter (range: 1 to 8 mm), and deformation induced by indentation (constant indentation depth versus constant nominal deformation) on cartilage response. The bias induced by indentations performed in adjacent grid points was minimized with a 3a grid spacing. The cartilage response was indenter-dependent for diameters ranging between 1 and 6 mm with a nominal deformation of 15%. No significant differences were found using 6 mm and 8 mm indenters. Six mm and 8 mm indenters were used to map human articular cartilage with a grid spacing equal to 3a. Instantaneous elastic modulus E0 was calculated for constant indentation depth and constant nominal deformation. E0 value distribution did not change significantly by switching the two indenters, while dispersion decreased by 5-6% when a constant nominal deformation was applied. Such an approach was able to discriminate changes in tissue response due to doubling the indentation rate. The proposed procedure seems to reduce data dispersion and properly determine cartilage mechanical properties to be compared with those of complex composite scaffolds.
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Affiliation(s)
- Matteo Berni
- Laboratorio di Tecnologia Medica, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Paolo Erani
- Laboratorio di Tecnologia Medica, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | | | - Massimiliano Baleani
- Laboratorio di Tecnologia Medica, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
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25
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Moo EK, Ebrahimi M, Sibole SC, Tanska P, Korhonen RK. The intrinsic quality of proteoglycans, but not collagen fibres, degrades in osteoarthritic cartilage. Acta Biomater 2022; 153:178-189. [PMID: 36113721 DOI: 10.1016/j.actbio.2022.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 08/31/2022] [Accepted: 09/02/2022] [Indexed: 11/01/2022]
Abstract
The function of articular cartilage as a load-bearing connective tissue is derived primarily from a balanced interaction between the swelling proteoglycan (PG) matrix and tension-resistant collagen fibrous network. Such balance is compromised during joint disease such as osteoarthritis (OA) due to degradation to PGs and/or collagens. While the PG degradation is generally thought to be related to a loss of protein abundance, the collagenous degradation is more complex as it can be caused independently by a decrease of collagen content, disorganisation of fibrous structure and softening of individual collagen fibrils. A comprehensive understanding of the initial trajectories of degradation of PGs and collagen network can improve our chance of finding potential therapeutic solutions for OA. Here, we developed geometrically, structurally, and compositionally realistic and sample-specific Finite Element (FE) models under the framework of multiphasic mixture theory, from which the elastic moduli of collagen fibres and the PG load-bearing quality in healthy and diseased cartilages were estimated by numerical optimisation of the multi-step indentation stress relaxation force-time curves. We found the intrinsic quality of collagen fibres, measured by their elastic moduli, to stay constant for healthy and diseased cartilages. Combining with previous findings which show unaltered collagen content during early stages of OA, our results suggest the disorganisation of collagen fibrous network as the first form of collagenous degradation in osteoarthritic cartilage. We also found that PG degradation involves not only a loss of protein abundance, but also the quality of the remaining PGs in generating sufficient osmotic pressure for load bearing. This study sheds light on the mechanism of OA pathogenesis and highlights the restoration of collageneous organisation in cartilage as key medical intervention for OA. STATEMENT OF SIGNIFICANCE: Collagen network in articular cartilage consists of individual fibres that are organised into depth-dependent structure specialised for joint load-bearing and lubrication. During osteoarthritis, the collagen network undergoes mechanical degradation, but it is unclear if a loss of content, disorganisation of fibrous structure, or softening of individual fibres causes this degeneration. Using mechanical indentation, Finite Element modelling, and numerical optimisation methods, we determined that individual fibres did not soften in early disease stage. Together with previous findings showing unaltered collagen content, our results pinpoint the disorganisation of collagen structure as the main culprit for early collagenous degradation in osteoarthritic cartilage. Thus, early restoration in cartilage of collagen organisation, instead of individual fibre quality, may be key to slow osteoarthritis development.
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Affiliation(s)
- Eng Kuan Moo
- Department of Applied Physics, University of Eastern Finland, POB 1627, Kuopio 70211, Finland; Human Performance Laboratory, University of Calgary, 2500, University Drive NW, Calgary, Alberta 2N1N4, Canada.
| | | | - Scott C Sibole
- Human Performance Laboratory, University of Calgary, 2500, University Drive NW, Calgary, Alberta 2N1N4, Canada
| | - Petri Tanska
- Department of Applied Physics, University of Eastern Finland, POB 1627, Kuopio 70211, Finland
| | - Rami K Korhonen
- Department of Applied Physics, University of Eastern Finland, POB 1627, Kuopio 70211, Finland.
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26
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A musculoskeletal finite element model of rat knee joint for evaluating cartilage biomechanics during gait. PLoS Comput Biol 2022; 18:e1009398. [PMID: 35657996 PMCID: PMC9166403 DOI: 10.1371/journal.pcbi.1009398] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 04/26/2022] [Indexed: 12/02/2022] Open
Abstract
Abnormal loading of the knee due to injuries or obesity is thought to contribute to the development of osteoarthritis (OA). Small animal models have been used for studying OA progression mechanisms. However, numerical models to study cartilage responses under dynamic loading in preclinical animal models have not been developed. Here we present a musculoskeletal finite element model of a rat knee joint to evaluate cartilage biomechanical responses during a gait cycle. The rat knee joint geometries were obtained from a 3-D MRI dataset and the boundary conditions regarding loading in the joint were extracted from a musculoskeletal model of the rat hindlimb. The fibril-reinforced poroelastic (FRPE) properties of the rat cartilage were derived from data of mechanical indentation tests. Our numerical results showed the relevance of simulating anatomical and locomotion characteristics in the rat knee joint for estimating tissue responses such as contact pressures, stresses, strains, and fluid pressures. We found that the contact pressure and maximum principal strain were virtually constant in the medial compartment whereas they showed the highest values at the beginning of the gait cycle in the lateral compartment. Furthermore, we found that the maximum principal stress increased during the stance phase of gait, with the greatest values at midstance. We anticipate that our approach serves as a first step towards investigating the effects of gait abnormalities on the adaptation and degeneration of rat knee joint tissues and could be used to evaluate biomechanically-driven mechanisms of the progression of OA as a consequence of joint injury or obesity. Osteoarthritis is a disease of the musculoskeletal system which is characterized by the degradation of articular cartilage. Changes in the knee loading after injuries or obesity contribute to the development of cartilage degeneration. Since injured cartilage cannot be reversed back to intact conditions, small animal models have been widely used for investigating osteoarthritis progression mechanisms. Moreover, experimental studies have been complemented with numerical models to overcome inherent limitations such as cost, difficulties to obtain accurate measures and replicate degenerative situations in the knee joint. However, computational models to study articular cartilage responses under dynamic loading in small animal models have not been developed. Thus, here we present a musculoskeletal finite element model (MSFE) of a rat knee joint to evaluate cartilage biomechanical responses during gait. Our computational model considers both the anatomical and locomotion characteristics of the rat knee joint for estimating mechanical responses in the articular cartilage. We suggest that our approach can be used to investigate tissue adaptations based on the mechanobiological responses of the cartilage to prevent the progression of osteoarthritis.
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27
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Rapid X-Ray-Based 3-D Finite Element Modeling of Medial Knee Joint Cartilage Biomechanics During Walking. Ann Biomed Eng 2022; 50:666-679. [PMID: 35262835 PMCID: PMC9079039 DOI: 10.1007/s10439-022-02941-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 02/23/2022] [Indexed: 11/30/2022]
Abstract
Finite element (FE) modeling is becoming an increasingly popular method for analyzing knee joint mechanics and biomechanical mechanisms leading to osteoarthritis (OA). The most common and widely available imaging method for knee OA diagnostics is planar X-ray imaging, while more sophisticated imaging methods, e.g., magnetic resonance imaging (MRI) and computed tomography (CT), are seldom used. Hence, the capability to produce accurate biomechanical knee joint models directly from X-ray imaging would bring FE modeling closer to clinical use. Here, we extend our atlas-based framework by generating FE knee models from X-ray images (N = 28). Based on measured anatomical landmarks from X-ray and MRI, knee joint templates were selected from the atlas library. The cartilage stresses and strains of the X-ray-based model were then compared with the MRI-based model during the stance phase of the gait. The biomechanical responses were statistically not different between MRI- vs. X-ray-based models when the template obtained from X-ray imaging was the same as the MRI template. However, if this was not the case, the peak values of biomechanical responses were statistically different between X-ray and MRI models. The developed X-ray-based framework may pave the way for a clinically feasible approach for knee joint FE modeling.
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28
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Esrafilian A, Stenroth L, Mononen ME, Vartiainen P, Tanska P, Karjalainen PA, Suomalainen JS, Arokoski J, Saxby DJ, Lloyd DG, Korhonen RK. An EMG-assisted muscle-force driven finite element analysis pipeline to investigate joint- and tissue-level mechanical responses in functional activities: towards a rapid assessment toolbox. IEEE Trans Biomed Eng 2022; 69:2860-2871. [PMID: 35239473 DOI: 10.1109/tbme.2022.3156018] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Joint tissue mechanics (e.g., stress and strain) are believed to have a major involvement in the onset and progression of musculoskeletal disorders, e.g., knee osteoarthritis (KOA). Accordingly, considerable efforts have been made to develop musculoskeletal finite element (MS-FE) models to estimate highly detailed tissue mechanics that predict cartilage degeneration. However, creating such models is time-consuming and requires advanced expertise. This limits these complex, yet promising MS-FE models to research applications with few participants and makes the models impractical for clinical assessments. Also, these previously developed MS-FE models have not been used to assess activities other than gait. This study introduces and verifies a semi-automated rapid state-of-the-art MS-FE modeling and simulation toolbox incorporating an electromyography- (EMG) assisted MS model and a muscle-force driven FE model of the knee with fibril-reinforced poro(visco)elastic cartilages and menisci. To showcase the usability of the pipeline, we estimated joint- and tissue-level knee mechanics in 15 KOA individuals performing different daily activities. The pipeline was verified by comparing the estimated muscle activations and joint mechanics to existing experimental data. To determine the importance of EMG-assisted MS approach, results were compared to those from the same FE models but driven by static-optimization-based MS models. The EMG-assisted MS-FE pipeline bore a closer resemblance to experiments compared to the static-optimization-based MS-FE pipeline. Importantly, the developed pipeline showed great potential as a rapid MS-FE analysis toolbox to investigate multiscale knee mechanics during different activities of individuals with KOA. The template FE model of the study is freely available here.
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29
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Verma DK, Kumari P, Kanagaraj S. Engineering Aspects of Incidence, Prevalence, and Management of Osteoarthritis: A Review. Ann Biomed Eng 2022; 50:237-252. [DOI: 10.1007/s10439-022-02913-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 01/01/2022] [Indexed: 12/14/2022]
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30
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Mohammadi A, te Moller NCR, Ebrahimi M, Plomp S, Brommer H, van Weeren PR, Mäkelä JTA, Töyräs J, Korhonen RK. Site- and Zone-Dependent Changes in Proteoglycan Content and Biomechanical Properties of Bluntly and Sharply Grooved Equine Articular Cartilage. Ann Biomed Eng 2022; 50:1787-1797. [PMID: 35754073 PMCID: PMC9794534 DOI: 10.1007/s10439-022-02991-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 06/09/2022] [Indexed: 12/31/2022]
Abstract
In this study, we mapped and quantified changes of proteoglycan (PG) content and biomechanical properties in articular cartilage in which either blunt or sharp grooves had been made, both close to the groove and more remote of it, and at the opposing joint surface (kissing site) in equine carpal joints. In nine adult Shetland ponies, standardized blunt and sharp grooves were surgically made in the radiocarpal and middle carpal joints of a randomly chosen front limb. The contralateral control limb was sham-operated. At 39 weeks after surgery, ponies were euthanized. In 10 regions of interest (ROIs) (six remote from the grooves and four directly around the grooves), PG content as a function of tissue-depth and distance-to-groove was estimated using digital densitometry. Biomechanical properties of the cartilage were evaluated in the six ROIs remote from the grooves. Compared to control joints, whole tissue depth PG loss was found in sites adjacent to sharp and, to a larger extent, blunt grooves. Also, superficial PG loss of the surgically untouched kissing cartilage layers was observed. Significant PG loss was observed up to 300 µm (sharp) and at 500 µm (blunt) from the groove into the surrounding tissue. Equilibrium modulus was lower in grooved cartilage than in controls. Grooves, in particular blunt grooves, gave rise to severe PG loss close to the grooved sites and to mild degeneration more remote from the grooves in both sharply and bluntly grooved cartilage and at the kissing sites, resulting in loss of mechanical strength over the 9-month period.
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Affiliation(s)
- Ali Mohammadi
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Nikae C. R. te Moller
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Mohammadhossein Ebrahimi
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland ,Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Saskia Plomp
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Harold Brommer
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - P. René van Weeren
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Janne T. A. Mäkelä
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Juha Töyräs
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland ,School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Australia ,Science Service Center, Kuopio University Hospital, Kuopio, Finland
| | - Rami K. Korhonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
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31
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te Moller NCR, Mohammadi A, Plomp S, Serra Bragança FM, Beukers M, Pouran B, Afara IO, Nippolainen E, Mäkelä JTA, Korhonen RK, Töyräs J, Brommer H, van Weeren PR. Structural, compositional, and functional effects of blunt and sharp cartilage damage on the joint: A 9-month equine groove model study. J Orthop Res 2021; 39:2363-2375. [PMID: 33368588 PMCID: PMC8597083 DOI: 10.1002/jor.24971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 12/09/2020] [Accepted: 12/21/2020] [Indexed: 02/04/2023]
Abstract
This study aimed to quantify the long-term progression of blunt and sharp cartilage defects and their effect on joint homeostasis and function of the equine carpus. In nine adult Shetland ponies, the cartilage in the radiocarpal and middle carpal joint of one front limb was grooved (blunt or sharp randomized). The ponies were subjected to an 8-week exercise protocol and euthanized at 39 weeks. Structural and compositional alterations in joint tissues were evaluated in vivo using serial radiographs, synovial biopsies, and synovial fluid samples. Joint function was monitored by quantitative gait analysis. Macroscopic, microscopic, and biomechanical evaluation of the cartilage and assessment of subchondral bone parameters were performed ex vivo. Grooved cartilage showed higher OARSI microscopy scores than the contra-lateral sham-operated controls (p < 0.0001). Blunt-grooved cartilage scored higher than sharp-grooved cartilage (p = 0.007) and fixed charge density around these grooves was lower (p = 0.006). Equilibrium and instantaneous moduli trended lower in grooved cartilage than their controls (significant for radiocarpal joints). Changes in other tissues included a threefold to sevenfold change in interleukin-6 expression in synovium from grooved joints at week 23 (p = 0.042) and an increased CPII/C2C ratio in synovial fluid extracted from blunt-grooved joints at week 35 (p = 0.010). Gait analysis outcome revealed mild, gradually increasing lameness. In conclusion, blunt and, to a lesser extent, sharp grooves in combination with a period of moderate exercise, lead to mild degeneration in equine carpal cartilage over a 9-month period, but the effect on overall joint health remains limited.
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Affiliation(s)
- Nikae C. R. te Moller
- Department of Clinical Sciences, Faculty of Veterinary MedicineUtrecht UniversityUtrechtthe Netherlands
| | - Ali Mohammadi
- Department of Applied PhysicsUniversity of Eastern FinlandKuopioFinland
| | - Saskia Plomp
- Department of Clinical Sciences, Faculty of Veterinary MedicineUtrecht UniversityUtrechtthe Netherlands
| | - Filipe M. Serra Bragança
- Department of Clinical Sciences, Faculty of Veterinary MedicineUtrecht UniversityUtrechtthe Netherlands
| | - Martijn Beukers
- Department of Clinical Sciences, Faculty of Veterinary MedicineUtrecht UniversityUtrechtthe Netherlands
| | - Behdad Pouran
- Department of OrthopaedicsUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Isaac O. Afara
- Department of Applied PhysicsUniversity of Eastern FinlandKuopioFinland
| | - Ervin Nippolainen
- Department of Applied PhysicsUniversity of Eastern FinlandKuopioFinland
| | | | - Rami K. Korhonen
- Department of Applied PhysicsUniversity of Eastern FinlandKuopioFinland
| | - Juha Töyräs
- Department of Applied PhysicsUniversity of Eastern FinlandKuopioFinland
- Diagnostic Imaging CenterKuopio University HospitalKuopioFinland
- School of Information Technology and Electrical EngineeringThe University of QueenslandBrisbaneQueenslandAustralia
| | - Harold Brommer
- Department of Clinical Sciences, Faculty of Veterinary MedicineUtrecht UniversityUtrechtthe Netherlands
| | - P. René van Weeren
- Department of Clinical Sciences, Faculty of Veterinary MedicineUtrecht UniversityUtrechtthe Netherlands
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32
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Linus A, Ebrahimi M, Turunen MJ, Saarakkala S, Joukainen A, Kröger H, Koistinen A, Finnilä MA, Afara IO, Mononen ME, Tanska P, Korhonen RK. High-resolution infrared microspectroscopic characterization of cartilage cell microenvironment. Acta Biomater 2021; 134:252-260. [PMID: 34365039 DOI: 10.1016/j.actbio.2021.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 07/15/2021] [Accepted: 08/02/2021] [Indexed: 01/06/2023]
Abstract
The lateral resolution of infrared spectroscopy has been inadequate for accurate biochemical characterization of the cell microenvironment, a region regulating biochemical and biomechanical signals to cells. In this study, we demonstrate the capacity of a high-resolution Fourier transform infrared microspectroscopy (HR-FTIR-MS) to characterize the collagen content of this region. Specifically, we focus on the collagen content in the cartilage cell (chondrocyte) microenvironment of healthy and osteoarthritic (OA) cartilage. Human tibial cartilage samples (N = 28) were harvested from 7 cadaveric donors and graded for OA severity (healthy, early OA, advanced OA). HR-FTIR-MS was used to analyze the collagen content of the chondrocyte microenvironment of five distinct zones across the tissue depth. HR-FTIR-MS successfully showed collagen content distribution across chondrocytes and their environment. In zones 2 and 3 (10 - 50% of the tissue thickness), we observed that collagen content was smaller (P < 0.05) in early OA compared to the healthy tissue in the vicinity of cells (pericellular region). The collagen content loss was extended to the extracellular matrix in advanced OA tissue. No significant differences in the collagen content of the chondrocyte microenvironment were observed between the groups in the most superficial (0-10%) and deep zones (50-100%). HR-FTIR-MS revealed collagen loss in the early OA cartilage pericellular region before detectable changes in the extracellular matrix in advanced OA. HR-FTIR-MS-based compositional assessment enables a better understanding of OA-related changes in tissues. This technique can be used to identify new disease mechanisms enabling better intervention strategies. STATEMENT OF SIGNIFICANCE: Osteoarthritis (OA) is the most common degenerative joint disease causing pain and disability. While significant progress has been made in OA research, OA pathogenesis is still poorly understood and current OA treatments are mainly palliative. This study demonstrates that high-resolution FTIR microspectroscopy (HR-FTIR-MS) can characterize OA-induced compositional changes in the cell microenvironment (pericellular matrix) during the early disease stages before tissue changes in the extracellular matrix become apparent. This technique may further enable the identification of new OA mechanisms and improve our current understanding of OA pathogenesis, thus, enabling the development of better treatment methods.
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Nissinen MT, Hänninen N, Prakash M, Mäkelä JTA, Nissi MJ, Töyräs J, Nieminen MT, Korhonen RK, Tanska P. Functional and structural properties of human patellar articular cartilage in osteoarthritis. J Biomech 2021; 126:110634. [PMID: 34454206 DOI: 10.1016/j.jbiomech.2021.110634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 06/18/2021] [Accepted: 07/05/2021] [Indexed: 10/20/2022]
Abstract
Changes in the fibril-reinforced poroelastic (FRPE) mechanical material parameters of human patellar cartilage at different stages of osteoarthritis (OA) are not known. Further, the patellofemoral joint loading is thought to include more sliding and shear compared to other knee joint locations, thus, the relations between structural and functional changes may differ in OA. Thus, our aim was to determine the patellar cartilage FRPE properties followed by associating them with the structure and composition. Osteochondral plugs (n = 14) were harvested from the patellae of six cadavers. Then, the FRPE material properties were determined, and those properties were associated with proteoglycan content, collagen fibril orientation angle, optical retardation (fibril parallelism), and the state of OA of the samples. The initial fibril network modulus and permeability strain-dependency factor were 72% and 63% smaller in advanced OA samples when compared to early OA samples. Further, we observed a negative association between the initial fibril network modulus and optical retardation (r = -0.537, p < 0.05). We also observed positive associations between 1) the initial permeability and optical retardation (r = 0.547, p < 0.05), and 2) the initial fibril network modulus and optical density (r = 0.670, p < 0.01).These results suggest that the reduced pretension of the collagen fibrils, as shown by the reduced initial fibril network modulus, is linked with the loss of proteoglycans and cartilage swelling in human patellofemoral OA. The characterization of these changes is important to improve the representativeness of knee joint models in tissue and cell scale.
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Affiliation(s)
- Mikko T Nissinen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland; Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.
| | - Nina Hänninen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland; Research Unit of Medical Imaging, Physics, and Technology, University of Oulu, Oulu, Finland
| | - Mithilesh Prakash
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Janne T A Mäkelä
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Mikko J Nissi
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland; Research Unit of Medical Imaging, Physics, and Technology, University of Oulu, Oulu, Finland
| | - Juha Töyräs
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland; Science Service Center, Kuopio University Hospital, Kuopio, Finland; School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Australia
| | - Miika T Nieminen
- Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland; Research Unit of Medical Imaging, Physics, and Technology, University of Oulu, Oulu, Finland; Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Rami K Korhonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Petri Tanska
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
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Elahi SA, Tanska P, Mukherjee S, Korhonen RK, Geris L, Jonkers I, Famaey N. Guide to mechanical characterization of articular cartilage and hydrogel constructs based on a systematic in silico parameter sensitivity analysis. J Mech Behav Biomed Mater 2021; 124:104795. [PMID: 34488174 DOI: 10.1016/j.jmbbm.2021.104795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 08/07/2021] [Accepted: 08/21/2021] [Indexed: 10/20/2022]
Abstract
Osteoarthritis is a whole joint disease with cartilage degeneration being an important manifestation. Tissue engineering treatment is a solution for repairing cartilage defects by implantation of chondrocyte-laden hydrogel constructs within the defect. In silico models have recently been introduced to simulate and optimize the design of these constructs. These models require accurate knowledge on the mechanical properties of the hydrogel constructs and cartilage explants, which are challenging to obtain due to their anisotropic structure and time-dependent behaviour. We performed a systematic in silico parameter sensitivity analysis to find the most efficient unconfined compression testing protocols for mechanical characterization of hydrogel constructs and cartilage explants, with a minimum number of tests but maximum identifiability of the material parameters. The construct and explant were thereby modelled as porohyperelastic and fibril-reinforced poroelastic materials, respectively. Three commonly used loading regimes were simulated in Abaqus (ramp, relaxation and dynamic loading) with varying compressive strain magnitudes and rates. From these virtual experiments, the resulting material parameters were obtained for each combination using a numerical inverse identification scheme. For hydrogels, maximum sensitivity to the different material parameters was found when using a single step ramp loading (20% compression with 10%/s rate) followed by 15 min relaxation. For cartilage explants, a two-stepped ramp loading (10% compression with 10%/s rate and 10% compression with 1%/s rate), each step followed by 15 min relaxation, yielded the maximum sensitivity to the different material parameters. With these protocols, the material parameters could be retrieved with the lowest amount of uncertainty (hydrogel: < 2% and cartilage: < 6%). These specific results and the overall methodology can be used to optimize mechanical testing protocols to yield reliable material parameters for in silico models of cartilage and hydrogel constructs.
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Affiliation(s)
- Seyed Ali Elahi
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium; Soft Tissue Biomechanics Group, Biomechanics Division, Mechanical Engineering Department, KU Leuven, Leuven, Belgium.
| | - Petri Tanska
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Satanik Mukherjee
- Prometheus, Division of Skeletal Tissue Engineering, KU Leuven, Leuven, Belgium; Biomechanics Section, KU Leuven, Leuven, Belgium
| | - Rami K Korhonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Liesbet Geris
- Prometheus, Division of Skeletal Tissue Engineering, KU Leuven, Leuven, Belgium; Biomechanics Section, KU Leuven, Leuven, Belgium; GIGA in Silico Medicine, University of Liège, Liège, Belgium
| | - Ilse Jonkers
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Nele Famaey
- Soft Tissue Biomechanics Group, Biomechanics Division, Mechanical Engineering Department, KU Leuven, Leuven, Belgium
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Pekedis M, Ozan F, Yildiz H. Biomechanics of the Femoral Head Cartilage and Subchondral Trabecular Bone in Osteoporotic and Osteopenic Fractures. Ann Biomed Eng 2021; 49:3388-3400. [PMID: 34472001 DOI: 10.1007/s10439-021-02861-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 08/23/2021] [Indexed: 11/28/2022]
Abstract
This study aimed to investigate the relationship between the micro structural properties of the subchondral trabecular bone (STB) and the macro mechanical properties of the articular cartilage (AC) in patients with osteoporotic (OP) and osteopenic (OPE) fractures. Sixteen femoral head samples (OP;OPE, n = 8 each) were obtained from female patients who underwent hip hemiarthroplasty. STB and AC specimens were harvested from those heads. Bone specimens were scanned using µ-CT to determine the micro structural properties. In-situ nondestructive compressive tests were performed for the cartilages to obtain elastic properties. The finite element technique was implemented on STB models created from µ-CT data to compute apparent elastic modulus. In addition, dynamic cyclic destructive tests were performed on STB and AC specimens to assess failure cycles. The results demonstrated that STB specimens in OPE group have more interconnected structure and higher cyclic dynamic strength than those in OP group. Furthermore, bone mineral density, failure cycle, and trabecular number of STB were positively correlated with the cartilage failure cycle, which indicates that STB alteration may affect the macroscopic mechanical properties of AC. The findings suggest that STB loss correlates with a decrease in cartilage strength and that improving of bone quality may prevent cartilage weakness.
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Affiliation(s)
- Mahmut Pekedis
- Department of Mechanical Engineering, Faculty of Engineering, Ege University, Bornova, 35100, Izmir, Turkey.
| | - Firat Ozan
- Department of Orthopedics and Traumatology, Kayseri City Hospital, 38080, Kayseri, Turkey
| | - Hasan Yildiz
- Department of Mechanical Engineering, Faculty of Engineering, Ege University, Bornova, 35100, Izmir, Turkey
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36
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Elastic, Dynamic Viscoelastic and Model-Derived Fibril-Reinforced Poroelastic Mechanical Properties of Normal and Osteoarthritic Human Femoral Condyle Cartilage. Ann Biomed Eng 2021; 49:2622-2634. [PMID: 34341898 PMCID: PMC8455392 DOI: 10.1007/s10439-021-02838-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 07/15/2021] [Indexed: 12/27/2022]
Abstract
Osteoarthritis (OA) degrades articular cartilage and weakens its function. Modern fibril-reinforced poroelastic (FRPE) computational models can distinguish the mechanical properties of main cartilage constituents, namely collagen, proteoglycans, and fluid, thus, they can precisely characterize the complex mechanical behavior of the tissue. However, these properties are not known for human femoral condyle cartilage. Therefore, we aimed to characterize them from human subjects undergoing knee replacement and from deceased donors without known OA. Multi-step stress-relaxation measurements coupled with sample-specific finite element analyses were conducted to obtain the FRPE material properties. Samples were graded using OARSI scoring to determine the severity of histopathological cartilage degradation. The results suggest that alterations in the FRPE properties are not evident in the moderate stages of cartilage degradation (OARSI 2-3) as compared with normal tissue (OARSI 0-1). Drastic deterioration of the FRPE properties was observed in severely degraded cartilage (OARSI 4). We also found that the FRPE properties of femoral condyle cartilage related to the collagen network (initial fibril-network modulus) and proteoglycan matrix (non-fibrillar matrix modulus) were greater compared to tibial and patellar cartilage in OA. These findings may inform cartilage tissue-engineering efforts and help to improve the accuracy of cartilage representations in computational knee joint models.
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37
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Guilak F, Hayes AJ, Melrose J. Perlecan in Pericellular Mechanosensory Cell-Matrix Communication, Extracellular Matrix Stabilisation and Mechanoregulation of Load-Bearing Connective Tissues. Int J Mol Sci 2021; 22:2716. [PMID: 33800241 PMCID: PMC7962540 DOI: 10.3390/ijms22052716] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/04/2021] [Accepted: 03/05/2021] [Indexed: 12/14/2022] Open
Abstract
In this study, we review mechanoregulatory roles for perlecan in load-bearing connective tissues. Perlecan facilitates the co-acervation of tropoelastin and assembly of elastic microfibrils in translamellar cross-bridges which, together with fibrillin and elastin stabilise the extracellular matrix of the intervertebral disc annulus fibrosus. Pericellular perlecan interacts with collagen VI and XI to define and stabilize this matrix compartment which has a strategic position facilitating two-way cell-matrix communication between the cell and its wider extracellular matrix. Cues from the extracellular matrix are fed through this pericellular matrix back to the chondrocyte, allowing it to perceive and respond to subtle microenvironmental changes to regulate tissue homeostasis. Thus perlecan plays a key regulatory role in chondrocyte metabolism, and in chondrocyte differentiation. Perlecan acts as a transport proteoglycan carrying poorly soluble, lipid-modified proteins such as the Wnt or Hedgehog families facilitating the establishment of morphogen gradients that drive tissue morphogenesis. Cell surface perlecan on endothelial cells or osteocytes acts as a flow sensor in blood and the lacunar canalicular fluid providing feedback cues to smooth muscle cells regulating vascular tone and blood pressure, and the regulation of bone metabolism by osteocytes highlighting perlecan's multifaceted roles in load-bearing connective tissues.
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Affiliation(s)
- Farshid Guilak
- Department of Orthopaedic Surgery, Washington University, St. Louis, MO 63110, USA;
- Shriners Hospitals for Children—St. Louis, St. Louis, MO 63110, USA
| | - Anthony J. Hayes
- Bioimaging Research Hub, Cardiff School of Biosciences, Cardiff University, Cardiff, Wales CF10 3AX, UK;
| | - James Melrose
- Graduate School of Biomedical Engineering, University of New South Wales, Sydney, NSW 2052, Australia
- Raymond Purves Laboratory, Institute of Bone and Joint Research, Kolling Institute, Northern Sydney Local Health District, Royal North Shore Hospital, St. Leonards, NSW 2065, Australia
- Sydney Medical School, Northern, University of Sydney at Royal North Shore Hospital, St. Leonards, NSW 2065, Australia
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38
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Ristaniemi A, Regmi D, Mondal D, Torniainen J, Tanska P, Stenroth L, Finnilä MAJ, Töyräs J, Korhonen RK. Structure, composition and fibril-reinforced poroviscoelastic properties of bovine knee ligaments and patellar tendon. J R Soc Interface 2021; 18:20200737. [PMID: 33499766 DOI: 10.1098/rsif.2020.0737] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Tissue-level stress-relaxation of ligaments and tendons in the toe region is characterized by fast and long-term relaxations and an increase in relaxation magnitude with strain. Characterizing the compositional and structural origins of these phenomena helps in the understanding of mechanisms of ligament and tendon function and adaptation in health and disease. A three-step tensile stress-relaxation test was conducted on dumbbell-shaped pieces of bovine knee ligaments and patellar tendon (PT) (n = 10 knees). Their mechanical behaviour was characterized by a fibril-reinforced poroviscoelastic material model, able to describe characteristic times and magnitudes of fast and long-term relaxations. The crimp angle and length of tissues were measured with polarized light microscopy, while biochemical contents were determined by colorimetric biochemical methods. The long-term relaxation time was longer in the anterior cruciate ligament (ACL) and PT compared with collateral ligaments (p < 0.05). High hydroxyproline content predicted greater magnitude and shorter time of both fast and long-term relaxation. High uronic acid content predicted longer time of long-term relaxation, whereas high crimp angle predicted higher magnitude of long-term relaxation. ACL and PT are better long-term stabilizers than collateral ligaments. The long-term relaxation behaviour is affected or implied by proteoglycans and crimp angle, possibly relating to slow structural reorganization of the tissue.
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Affiliation(s)
- Aapo Ristaniemi
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Dristi Regmi
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Diponkor Mondal
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - Jari Torniainen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Petri Tanska
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Lauri Stenroth
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Mikko A J Finnilä
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - Juha Töyräs
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland.,School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Australia
| | - Rami K Korhonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
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39
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Ristaniemi A, Tanska P, Stenroth L, Finnilä MAJ, Korhonen RK. Comparison of material models for anterior cruciate ligament in tension: from poroelastic to a novel fibril-reinforced nonlinear composite model. J Biomech 2020; 114:110141. [PMID: 33302181 DOI: 10.1016/j.jbiomech.2020.110141] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 11/05/2020] [Accepted: 11/12/2020] [Indexed: 12/15/2022]
Abstract
Computational models of the knee joint are useful for evaluating stresses and strains within the joint tissues. However, the outcome of those models is sensitive to the material model and material properties chosen for ligaments, the collagen reinforced tissues connecting bone to bone. The purpose of this study was to investigate different compositionally motivated material models and further to develop a model that can accurately reproduce experimentally measured stress-relaxation data of bovine anterior cruciate ligament (ACL). Tensile testing samples were extracted from ACLs of bovine knee joints (N = 10) and subjected to a three-step stress-relaxation test at the toe region. Data from the experiments was averaged and one average finite element model was generated to replicate the experiment. Poroelastic and different fibril-reinforced poro(visco)elastic material models were applied, and their material parameters were optimized to reproduce the experimental force-time response. Material models with only fluid flow mediated relaxation were not able to capture the stress-relaxation behavior (R2 = 0.806, 0.803 and 0.938). The inclusion of the viscoelasticity of the fibrillar network improved the model prediction (R2 = 0.978 and 0.976), but the complex stress-relaxation behavior was best captured by a poroelastic model with a nonlinear two-relaxation-time strain-recruited viscoelastic fibrillar network (R2 = 0.997). The results suggest that in order to replicate the multi-step stress-relaxation behavior of ACL in tension, the fibrillar network formulation should include the complex nonlinear viscoelastic phenomena.
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Affiliation(s)
- A Ristaniemi
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.
| | - P Tanska
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - L Stenroth
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - M A J Finnilä
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - R K Korhonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
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40
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Kafian-Attari I, Nippolainen E, Semenov D, Hauta-Kasari M, Töyräs J, Afara IO. Tissue optical properties combined with machine learning enables estimation of articular cartilage composition and functional integrity. BIOMEDICAL OPTICS EXPRESS 2020; 11:6480-6494. [PMID: 33282503 PMCID: PMC7687936 DOI: 10.1364/boe.402929] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/21/2020] [Accepted: 09/25/2020] [Indexed: 05/06/2023]
Abstract
Absorption and reduced scattering coefficients ( μ a , μ s ' ) of biological tissues have shown significant potential in biomedical applications. Thus, they are effective parameters for the characterization of tissue integrity and provide vital information on the health of biological tissues. This study investigates the potential of optical properties ( μ a , μ s ' ) for estimating articular cartilage composition and biomechanical properties using multivariate and machine learning techniques. The results suggest that μa could optimally estimate cartilage proteoglycan content in the superficial zone, in addition to its equilibrium modulus. While μ s ' could effectively estimate the proteoglycan content of the middle and deep zones in addition to the instantaneous and dynamic moduli of articular cartilage.
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Affiliation(s)
- Iman Kafian-Attari
- University of Eastern Finland, Department of Applied Physics, Yliopistonranta 1, Kuopio 70120, Finland
| | - Ervin Nippolainen
- University of Eastern Finland, Department of Applied Physics, Yliopistonranta 1, Kuopio 70120, Finland
| | - Dmitry Semenov
- University of Eastern Finland, School of Computing, Lämsikatu 15, Joensuu 80110, Finland
| | - Markku Hauta-Kasari
- University of Eastern Finland, School of Computing, Lämsikatu 15, Joensuu 80110, Finland
| | - Juha Töyräs
- University of Eastern Finland, Department of Applied Physics, Yliopistonranta 1, Kuopio 70120, Finland
- The University of Queensland, School of Information Technology, and Electrical Engineering, Brisbane, QLD 4067, Australia
| | - Isaac O. Afara
- University of Eastern Finland, Department of Applied Physics, Yliopistonranta 1, Kuopio 70120, Finland
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41
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Ebrahimi M, Turunen MJ, Finnilä MA, Joukainen A, Kröger H, Saarakkala S, Korhonen RK, Tanska P. Structure-Function Relationships of Healthy and Osteoarthritic Human Tibial Cartilage: Experimental and Numerical Investigation. Ann Biomed Eng 2020; 48:2887-2900. [PMID: 32648191 PMCID: PMC7723942 DOI: 10.1007/s10439-020-02559-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 06/26/2020] [Indexed: 02/07/2023]
Abstract
Relationships between composition, structure and constituent-specific functional properties of human articular cartilage at different stages of osteoarthritis (OA) are poorly known. We established these relationships by comparison of elastic, viscoelastic and fibril-reinforced poroelastic mechanical properties with microscopic and spectroscopic analysis of structure and composition of healthy and osteoarthritic human tibial cartilage (n = 27). At a low frequency (0.005 Hz), proteoglycan content correlated negatively and collagen content correlated positively with the phase difference (i.e. tissue viscosity). At a high-frequency regime (> 0.05 Hz), proteoglycan content correlated negatively and collagen orientation angle correlated positively with the phase difference. Proteoglycans were lost in the early and advanced OA groups compared to the healthy group, while the superficial collagen orientation angle was greater only in the advanced OA group compared to the healthy group. Simultaneously, the initial fibril network modulus (fibril pretension) was smaller in the early and advanced OA groups compared to the healthy group. These findings suggest different mechanisms contribute to cartilage viscosity in low and high frequencies, and that the loss of superficial collagen pretension during early OA is due to lower tissue swelling (PG loss), while in advanced OA, both collagen disorganization and lower swelling modulate the collagen fibril pretension.
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Affiliation(s)
- Mohammadhossein Ebrahimi
- Department of Applied Physics, University of Eastern Finland, POB 1627, 70211, Kuopio, Finland.
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.
| | - Mikael J Turunen
- Department of Applied Physics, University of Eastern Finland, POB 1627, 70211, Kuopio, Finland
- SIBlabs, University of Eastern Finland, Kuopio, Finland
| | - Mikko A Finnilä
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | | | | | - Simo Saarakkala
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Rami K Korhonen
- Department of Applied Physics, University of Eastern Finland, POB 1627, 70211, Kuopio, Finland
| | - Petri Tanska
- Department of Applied Physics, University of Eastern Finland, POB 1627, 70211, Kuopio, Finland
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