1
|
Blom RP, Mol D, van Ruijven LJ, Kerkhoffs GMMJ, Smit TH. A Single Axial Impact Load Causes Articular Damage That Is Not Visible with Micro-Computed Tomography: An Ex Vivo Study on Caprine Tibiotalar Joints. Cartilage 2021; 13:1490S-1500S. [PMID: 31540553 PMCID: PMC8804841 DOI: 10.1177/1947603519876353] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Excessive articular loading, for example, an ankle sprain, may result in focal osteochondral damage, initiating a vicious degenerative process resulting in posttraumatic osteoarthritis (PTOA). Better understanding of this degenerative process would allow improving posttraumatic care with the aim to prevent PTOA. The primary objective of this study was to establish a drop-weight impact testing model with controllable, reproducible and quantitative axial impact loads to induce osteochondral damage in caprine tibiotalar joints. We aimed to induce osteochondral damage on microscale level of the tibiotalar joint without gross intra-articular fractures of the tibial plafond. DESIGN Fresh-frozen tibiotalar joints of mature goats were used as ex vivo articulating joint models. Specimens were axially impacted by a mass of 10.5 kg dropped from a height of 0.3 m, resulting in a speed of 2.4 m/s, an impact energy of 31.1 J and an impact impulse of 25.6 N·s. Potential osteochondral damage of the caprine tibiotalar joints was assessed using contrast-enhanced high-resolution micro-computed tomography (micro-CT). Subsequently, we performed quasi-static loading experiments to determine postimpact mechanical behavior of the tibiotalar joints. RESULTS Single axial impact loads with a mass of 15.5 kg dropped from 0.3 m, resulted in intra-articular fractures of the tibial plafond, where a mass of 10.55 kg dropped from 0.3 m did not result in any macroscopic damage. In addition, contrast-enhanced high-resolution micro-CT imaging neither reveal any acute microdamage (i.e., microcracks) of the subchondral bone nor any (micro)structural changes in articular cartilage. The Hexabrix content or voxel density (i.e., proteoglycan content of the articular cartilage) on micro-CT did not show any differences between intact and impacted specimens. However, quasi-static whole-tibiotalar-joint loading showed an altered biomechanical behavior after application of a single axial impact (i.e., increased hysteresis when compared with the intact or nonimpacted specimens). CONCLUSIONS Single axial impact loads did not induce osteochondral damage visible with high-resolution contrast-enhanced micro-CT. However, despite the lack of damage on macro- and even microscale, the single axial impact loads resulted in "invisible injuries" because of the observed changes in the whole-joint biomechanics of the caprine tibiotalar joints. Future research must focus on diagnostic tools for the detection of early changes in articular cartilage after a traumatic impact (i.e., ankle sprains or ankle fractures), as it is well known that this could result in PTOA.
Collapse
Affiliation(s)
- Robin P. Blom
- Department of Orthopaedic Surgery,
Amsterdam University Medical Center, Amsterdam Movement Sciences, Amsterdam, the
Netherlands
| | - Douwe Mol
- Department of Orthopaedic Surgery,
Amsterdam University Medical Center, Amsterdam Movement Sciences, Amsterdam, the
Netherlands
| | - Leo J. van Ruijven
- Department of Oral Cell Biology and
Functional Anatomy, ACTA–University of Amsterdam and VU University, Amsterdam
Movement Sciences, Amsterdam, the Netherlands
| | - Gino M. M. J. Kerkhoffs
- Department of Orthopaedic Surgery,
Amsterdam University Medical Center, Amsterdam Movement Sciences, Amsterdam, the
Netherlands,Academic Center for Evidence-Based
Sports medicine (ACES), Amsterdam Collaboration for Health and Safety in Sports
(ACHSS), IOC Research Center, Amsterdam, the Netherlands
| | - Theo H. Smit
- Department of Orthopaedic Surgery,
Amsterdam University Medical Center, Amsterdam Movement Sciences, Amsterdam, the
Netherlands,Department of Medical Biology, Amsterdam
University Medical Center, Amsterdam Movement Sciences, Amsterdam, the
Netherlands,Theo H. Smit, Department of Medical Biology,
Amsterdam University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, the
Netherlands.
| |
Collapse
|
2
|
Workman J, McGlashan S, Thambyah A. Macroscopically healthy articular cartilage with fibrillar-scale early tissue degeneration subject to impact loading results in greater extent of cell-death. J Mech Behav Biomed Mater 2020; 112:104043. [PMID: 32861062 DOI: 10.1016/j.jmbbm.2020.104043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 07/26/2020] [Accepted: 08/16/2020] [Indexed: 12/01/2022]
Abstract
From previous investigations it has been shown that there exists healthy-appearing articular cartilage that contains collagen fibril network destructuring. It is hypothesised that such sub-micron scale destructuring not only presents an increased vulnerability to tissue scale damage following impact loading, but an increase in cell death as well. Cartilage-on-bone blocks from 12 patellae, six healthy (G0) and the other six with sub-micron fibrillar destructuring (G1), were obtained and subject to 2.3 J impact loading. Two sets of sub-samples were obtained for each block tested. One set was used to examine for the live/dead cell response using calcein-AM and propidium iodide staining, imaged with confocal microscopy. The tissue microstructural matrix was imaged from the other matched set, unstained and in its fully hydrated state, using differential interference contrast optical light microscopy. High speed imaging of the impact was used to calculate the velocity changes or coefficient of restitution (COR) and used as a proxy of energy that the tissue absorbed. A previously defined tissue matrix damage score was used to quantify the extent of fracturing and cracking in the matrix. The cell death (PCD) was counted and presented as a percentage against all cells live plus dead. The energy absorbed was 36.5% higher in G1 than in G0 (p = 0.034). However, the damage score and PCD of samples in the G1 group was much larger than the G0 group, ~300% and 161% respectively. Microscopy showed that cell death is associated to both matrix compaction and further fibrillar destructuring from the ECM to the territorial matrix regions of the chondron. Following impact loading, cartilage tissue that appears normal but contains sub-micron fibrillar matrix destructuring responds with significantly increased cell death.
Collapse
Affiliation(s)
- J Workman
- University of Auckland, Faculty of Engineering, 2-4 Park Ave, Grafton, Auckland, 1023, New Zealand.
| | - S McGlashan
- University of Auckland, Faculty of Medical and Health Sciences, 85 Park Road, Grafton, 1023, Auckland, New Zealand
| | - A Thambyah
- University of Auckland, Faculty of Engineering, 2-4 Park Ave, Grafton, Auckland, 1023, New Zealand
| |
Collapse
|
3
|
Experimental Study on Creep Characteristics of Microdefect Articular Cartilages in the Damaged Early Stage. JOURNAL OF HEALTHCARE ENGINEERING 2019; 2019:8526436. [PMID: 31827742 PMCID: PMC6885224 DOI: 10.1155/2019/8526436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 09/26/2019] [Accepted: 10/17/2019] [Indexed: 11/17/2022]
Abstract
Traumatic joint injury is known to cause cartilage deterioration and osteoarthritis. In order to study the mechanical mechanism of damage evolution on articular cartilage, taking the fresh porcine articular cartilage as the experimental samples, the creep experiments of the intact cartilages and the cartilages with different depth defect were carried out by using the noncontact digital image correlation technology. And then, the creep constitutive equations of cartilages were established. The results showed that the creep curves of different layers changed exponentially and were not coincident for the cartilage sample. The defect affected the strain values of the creep curves. The creep behavior of cartilage was dependent on defect depth. The deeper the defect was, the larger the strain value was. The built three-parameter viscoelastic constitutive equation had a good correlation with the experimental results and could predict the creep performance of the articular cartilage. The creep values of the microdefective cartilage in the damaged early stage were different from the diseased articular cartilage. These findings pointed out that defect could accelerate the damage of cartilage. It was helpful to study the mechanical mechanism of damage evolution.
Collapse
|
4
|
Henak CR, Bartell LR, Cohen I, Bonassar LJ. Multiscale Strain as a Predictor of Impact-Induced Fissuring in Articular Cartilage. J Biomech Eng 2017; 139:2571657. [PMID: 27760253 DOI: 10.1115/1.4034994] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Indexed: 11/08/2022]
Abstract
Mechanical damage is central to both initiation and progression of osteoarthritis (OA). However, specific causal links between mechanics and cartilage damage are incompletely understood, which results in an inability to predict failure. The lack of understanding is primarily due to the difficulty in simultaneously resolving the high rates and small length scales relevant to the problem and in correlating such measurements to the resulting fissures. This study leveraged microscopy and high-speed imaging to resolve mechanics on the previously unexamined time and length scales of interest in cartilage damage, and used those mechanics to develop predictive models. The specific objectives of this study were to: first, quantify bulk and local mechanics during impact-induced fissuring; second, develop predictive models of fissuring based on bulk mechanics and local strain; and third, evaluate the accuracy of these models in predicting fissures. To achieve these three objectives, bovine tibial cartilage was impacted using a custom spring-loaded device mounted on an inverted microscope. The occurrence of fissures was modulated by varying impact energy. For the first objective, during impact, deformation was captured at 10,000 frames per second and bulk and local mechanics were analyzed. For the second objective, data from samples impacted with a 1.2 mm diameter rod were fit to logistic regression functions, creating models of fissure probability based on bulk and local mechanics. Finally, for the third objective, data from samples impacted with a 0.8 mm diameter rod were used to test the accuracy of model predictions. This study provides a direct comparison between bulk and local mechanical thresholds for the prediction of fissures in cartilage samples, and demonstrates that local mechanics provide more accurate predictions of local failure than bulk mechanics provide. Bulk mechanics were accurate predictors of fissure for the entire sample cohort, but poor predictors of fissure for individual samples. Local strain fields were highly heterogeneous and significant differences were determined between fissured and intact samples, indicating the presence of damage thresholds. In particular, first principal strain rate and maximum shear strain were the best predictors of local failure, as determined by concordance statistics. These data provide an important step in establishing causal links between local mechanics and cartilage damage; ultimately, data such as these can be used to link macro- and micro-scale mechanics and thereby predict mechanically mediated disease on a subject-specific basis.
Collapse
Affiliation(s)
- Corinne R Henak
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY 14853
| | - Lena R Bartell
- Department of Applied and Engineering Physics, Cornell University, Ithaca, NY 14853
| | - Itai Cohen
- Department of Physics, Cornell University, Ithaca, NY 14853
| | - Lawrence J Bonassar
- Meinig School of Biomedical Engineering, 149 Weill Hall, Cornell University, Ithaca, NY 14853; Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY 14853 e-mail:
| |
Collapse
|
5
|
Kaleem B, Maier F, Drissi H, Pierce DM. Low-energy impact of human cartilage: predictors for microcracking the network of collagen. Osteoarthritis Cartilage 2017; 25:544-553. [PMID: 27903450 DOI: 10.1016/j.joca.2016.11.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 11/08/2016] [Accepted: 11/21/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE We aimed to determine the minimum mechanical impact to cause microstructural damage in the network of collagen (microcracking) within human cartilage and hypothesized that energies below 0.1 J or 1 mJ/mm3 would suffice. DESIGN We completed 108 low-energy impact tests (0.05, 0.07, or 0.09 J; 0.75 or 1.0 m/s2) using healthy cartilage specimens from six male donors (30.2 ± 8.8 yrs old). Before and after impact we acquired, imaging the second harmonic generation (SHG), ten images from each specimen (50 μm depth, 5 μm step size), resulting in 2160 images. We quantified both the presence and morphology of microcracks. We then correlated test parameters (predictors) impact energy/energy dissipation density, nominal stress/stress rate, and strain/strain rate to microcracking and tested for significance. Where predictors significantly correlated with microstructural outcomes we fitted binary logistic regression plots with 95% confidence intervals (CIs). RESULTS No specimens presented visible damage following impact. We found that impact energy/energy dissipation density and nominal stress/stress rate were significant (P < 0.05) predictors of microcracking while both strain and strain rate were not. In our test configuration, an impact energy density of 2.93 mJ/mm3, an energy dissipation density of 1.68 mJ/mm3, a nominal stress of 4.18 MPa, and a nominal stress rate of 689 MPa/s all corresponded to a 50% probability of microcracking in the network of collagen. CONCLUSIONS An impact energy density of 1.0 mJ/mm3 corresponded to a ∼20% probability of microcracking. Such changes may initiate a degenerative cascade leading to post-traumatic osteoarthritis.
Collapse
Affiliation(s)
- B Kaleem
- University of Connecticut, Department of Biomedical Engineering, Storrs, CT, USA
| | - F Maier
- Department of Mechanical Engineering, University of Connecticut, Storrs, CT, USA
| | - H Drissi
- University of Connecticut Health Center, Orthopedic Surgery, Farmington, CT, USA
| | - D M Pierce
- University of Connecticut, Department of Biomedical Engineering, Storrs, CT, USA; Department of Mechanical Engineering, University of Connecticut, Storrs, CT, USA.
| |
Collapse
|
6
|
Workman J, Thambyah A, Broom N. The influence of early degenerative changes on the vulnerability of articular cartilage to impact-induced injury. Clin Biomech (Bristol, Avon) 2017; 43:40-49. [PMID: 28199881 DOI: 10.1016/j.clinbiomech.2017.01.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 11/01/2016] [Accepted: 01/03/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Recently, the structural changes in a bovine model of early degeneration were validated by our research group to be analogous to that in early human osteoarthritis. The hypothesis of this study was that the structural changes associated with increasing levels of degeneration would lead to higher levels of tissue damage in response to impact induced injury. METHODS A total of forty bovine patellae were obtained for this study. Cartilage-on-bone samples were extracted from the distal lateral quarter, a region known to be affected by varying levels of degeneration. A single impact drop test was applied to these samples delivering 2.3J of energy. A dynamic load cell and image capture at 2000fps allowed for the calculation of the reaction stress and coefficient of restitution. The extent of tissue damage was examined from the micro to ultrastructural levels using differential interference contrast optical microscopy and scanning electron microscopy respectively. FINDINGS The impact mechanical properties of mildly degenerate articular cartilage were not significantly different but showed a significantly larger amount of structural damage. From comparing the mechanical and structural response of intact and mildly degenerate cartilage, to tissue showing increased macro-scale tissue degeneration, the significance of the surface layer and fibrillar scale transverse interconnectivity in effectively attenuating impact loads is demonstrated in this study. INTERPRETATION This study shows that even though articular cartilage can appear visibly normal under macroscopic observation, the micro-scale structural changes associated with very early stage osteoarthritis can have a significant effect on its vulnerability to impact damage.
Collapse
Affiliation(s)
- Joshua Workman
- University of Auckland, 2-6 Park Ave, Grafton, Auckland 1023, New Zealand
| | - Ashvin Thambyah
- University of Auckland, 2-6 Park Ave, Grafton, Auckland 1023, New Zealand.
| | - Neil Broom
- University of Auckland, 2-6 Park Ave, Grafton, Auckland 1023, New Zealand
| |
Collapse
|
7
|
Bourne DA, Moo EK, Herzog W. Cartilage and chondrocyte response to extreme muscular loading and impact loading: Can in vivo pre-load decrease impact-induced cell death? Clin Biomech (Bristol, Avon) 2015; 30:537-45. [PMID: 25957254 DOI: 10.1016/j.clinbiomech.2015.04.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 04/14/2015] [Accepted: 04/16/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Impact loading causes cartilage damage and cell death. Pre-loading prior to impact loading may protect cartilage and chondrocytes. However, there is no systematic evidence and understanding of the effects of pre-load strategies on cartilage damage and chondrocyte death. This study aimed at determining the effects of the pre-load history on impact-induced chondrocyte death in an intact joint. METHODS Patellofemoral joints from 42 rabbits were loaded by controlled quadriceps muscle contractions and an external impacter. Two extreme muscular loading conditions were used: (i) a short-duration, high intensity, static muscle contraction, and (ii) a long-duration, low-intensity, cyclic muscle loading protocol. A 5-Joule centrally-oriented, gravity-accelerated impact load was applied to the joints. Chondrocyte viability was quantified following the muscular loading protocols, following application of the isolated impact loads, and following application of the impact loads that were preceded by the muscular pre-loads. Joint contact pressures were measured for all loading conditions by a pressure-sensitive film. FINDINGS Comparing to cartilage injured by impact loading alone, cartilage pre-loaded by static, maximal intensity, short-term muscle loads had lower cell death, while cartilage pre-loaded by repetitive, low-intensity, long-term muscular loads has higher cell death. The locations of peak joint contact pressures were not strongly correlated with the locations of greatest cell death occurrence. INTERPRETATION Static, high intensity, short muscular pre-load protected cells from impact injury, whereas repetitive, low intensity, prolonged muscular pre-loading to the point of muscular fatigue left the chondrocytes vulnerable to injury. However, cell death seems to be unrelated to the peak joint pressures.
Collapse
Affiliation(s)
- Douglas A Bourne
- Human Performance Laboratory, Faculty of Kinesiology, The University of Calgary, Calgary, Alberta, Canada
| | - Eng Kuan Moo
- Human Performance Laboratory, Faculty of Kinesiology, The University of Calgary, Calgary, Alberta, Canada
| | - Walter Herzog
- Human Performance Laboratory, Faculty of Kinesiology, The University of Calgary, Calgary, Alberta, Canada.
| |
Collapse
|
8
|
Hosseini SM, Veldink MB, Ito K, van Donkelaar CC. Is collagen fiber damage the cause of early softening in articular cartilage? Osteoarthritis Cartilage 2013; 21:136-43. [PMID: 23010079 DOI: 10.1016/j.joca.2012.09.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Revised: 08/03/2012] [Accepted: 09/11/2012] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Because collagen damage and cartilage softening have not yet been determined simultaneously in one study for the very early onset of osteoarthritis (OA), it remains questionable whether they are associated. The aim of the present study is therefore to evaluate whether indeed, initial collagen damage can be found when tissue softening occurs as a result of excessive mechanical loading. METHODS To investigate this aim, a series of specific indentation loading protocols were designed to induce and monitor cartilage softening in osteochondral explants of bovine carpometacarpal joints. The experiment contained one control group (n = 6) in which no damage was induced and four experimental groups in which samples received either a constant load of 3 (n = 5), 6 (n = 5) or 15 N (n = 6), or an increasing load (n = 7) from 2 to 13 N in 11 steps. Moreover, to determine mechanically induced collagen damage, Col2-3/4M (cumulative collagen damage) and Col2-3/4C(short) (only enzymatic damage) staining were compared. RESULTS The normalized peak and equilibrium reaction forces decreased in the groups that received increasing and 15 N peak loading. However, Col2-3/4M staining was negative in all samples, while enzymatic damage (Col2-3/4C(short)) appeared similar in experiments and in unloaded control groups. CONCLUSION It was shown that a loading magnitude threshold exists above which softening occurs in cartilage. However, in samples that did show softening, we were unable to detect collagen damage. Thus, our results demonstrate that cartilage softening most likely precedes collagen damage.
Collapse
Affiliation(s)
- S M Hosseini
- Orthopaedic Biomechanics Group, Department of Biomedical Engineering, Eindhoven University of Technology (TU/e), Eindhoven, The Netherlands.
| | | | | | | |
Collapse
|
9
|
Thambyah A, Zhang G, Kim W, Broom ND. Impact induced failure of cartilage-on-bone following creep loading: A microstructural and fracture mechanics study. J Mech Behav Biomed Mater 2012; 14:239-47. [DOI: 10.1016/j.jmbbm.2012.06.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Revised: 06/09/2012] [Accepted: 06/12/2012] [Indexed: 11/25/2022]
|