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Peters AE, Geraghty B, Bates KT, Akhtar R, Readioff R, Comerford E. Ligament mechanics of ageing and osteoarthritic human knees. Front Bioeng Biotechnol 2022; 10:954837. [PMID: 36082159 PMCID: PMC9446756 DOI: 10.3389/fbioe.2022.954837] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/25/2022] [Indexed: 11/18/2022] Open
Abstract
Knee joint ligaments provide stability to the joint by preventing excessive movement. There has been no systematic effort to study the effect of OA and ageing on the mechanical properties of the four major human knee ligaments. This study aims to collate data on the material properties of the anterior (ACL) and posterior (PCL) cruciate ligaments, medial (MCL) and lateral (LCL) collateral ligaments. Bone-ligament-bone specimens from twelve cadaveric human knee joints were extracted for this study. The cadaveric knee joints were previously collected to study ageing and OA on bone and cartilage material properties; therefore, combining our previous bone and cartilage data with the new ligament data from this study will facilitate subject-specific whole-joint modelling studies. The bone-ligament-bone specimens were tested under tensile loading to failure, determining material parameters including yield and ultimate (failure) stress and strain, secant modulus, tangent modulus, and stiffness. There were significant negative correlations between age and ACL yield stress (p = 0.03), ACL failure stress (p = 0.02), PCL secant (p = 0.02) and tangent (p = 0.02) modulus, and LCL stiffness (p = 0.046). Significant negative correlations were also found between OA grades and ACL yield stress (p = 0.02) and strain (p = 0.03), and LCL failure stress (p = 0.048). However, changes in age or OA grade did not show a statistically significant correlation with the MCL tensile parameters. Due to the small sample size, the combined effect of age and the presence of OA could not be statistically derived. This research is the first to report tensile properties of the four major human knee ligaments from a diverse demographic. When combined with our previous findings on bone and cartilage for the same twelve knee cadavers, the current ligament study supports the conceptualisation of OA as a whole-joint disease that impairs the integrity of many peri-articular tissues within the knee. The subject-specific data pool consisting of the material properties of the four major knee ligaments, subchondral and trabecular bones and articular cartilage will advance knee joint finite element models.
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Affiliation(s)
- Abby E Peters
- Department of Mechanical, Materials and Aerospace Engineering, School of Engineering, University of Liverpool, Liverpool, United Kingdom.,Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Brendan Geraghty
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Karl T Bates
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom.,Medical Research Council Versus Arthritis Centre for Integrated Research Into Musculoskeletal Ageing (CIMA), University of Liverpool, Liverpool, United Kingdom
| | - Riaz Akhtar
- Department of Mechanical, Materials and Aerospace Engineering, School of Engineering, University of Liverpool, Liverpool, United Kingdom
| | - Rosti Readioff
- Department of Mechanical, Materials and Aerospace Engineering, School of Engineering, University of Liverpool, Liverpool, United Kingdom.,Institute of Medical and Biological Engineering, School of Mechanical Engineering, Faculty of Engineering, University of Leeds, Leeds, United Kingdom.,School of Dentistry, University of Liverpool, Liverpool, United Kingdom
| | - Eithne Comerford
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom.,Medical Research Council Versus Arthritis Centre for Integrated Research Into Musculoskeletal Ageing (CIMA), University of Liverpool, Liverpool, United Kingdom.,School of Veterinary Science, University of Liverpool, Liverpool, United Kingdom
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McCarron L, Bindra R, Coombes BK, Bisset L. Wrist and forearm range of motion commencement time following primary triangular fibrocartilage complex foveal repair surgery: A scoping review. J Hand Ther 2021; 36:179-195. [PMID: 34972604 DOI: 10.1016/j.jht.2021.10.004] [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: 02/17/2021] [Revised: 08/08/2021] [Accepted: 10/02/2021] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Scoping review. BACKGROUND Rehabilitation guidelines following triangular fibrocartilage complex (TFCC) foveal repair surgery have been inconsistently reported in the published literature, with no consensus regarding wrist or forearm range of motion (ROM) commencement time. PURPOSE OF THE STUDY To scope the available literature to identify the extent and strength of the evidence supporting the clinical guidelines for wrist and forearm ROM commencement time following primary TFCC foveal repair surgery. METHODS A systematic search produced 26 studies (3 retrospective cohort studies, 1 prospective cohort study, 1 retrospective comparative study, and 21 retrospective case series) that described specific rehabilitation protocols following TFCC foveal repair surgery. RESULTS No supporting evidence was identified regarding rehabilitation protocol recommendations across all the included studies. Postsurgery wrist ROM commencement ranged from 2 to 8 weeks; forearm ROM commencement ranged from 2 to 12 weeks. ROM commencement times did not appear to systematically influence the rate of adverse events, although adverse events were poorly reported. CONCLUSIONS TFCC rehabilitation protocols were poorly reported and varied widely between the included studies. Additional research is recommended to comprehensively evaluate the association between wrist and/or forearm ROM and the rate of adverse events for this complex and multifaceted condition.
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Affiliation(s)
- Luke McCarron
- School of Medicine and Dentistry, Griffith University, Queensland, Australia; Occupational Therapy Department, Bond University, Queensland, Australia; Orthopaedic and Trauma Department, Gold Coast Hospital and Health Service, Queensland, Australia.
| | - Randy Bindra
- School of Medicine, Griffith University, Queensland, Australia; Orthopaedic and Trauma Department, Gold Coast Hospital and Health Service, Queensland, Australia
| | - Brooke K Coombes
- School of Medicine and Dentistry, Griffith University, Queensland, Australia
| | - Leanne Bisset
- School of Medicine and Dentistry, Griffith University, Queensland, Australia
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Gonçalves AI, Vinhas A, Rodrigues MT, Gomes ME. The impact of cryopreservation in signature markers and immunomodulatory profile of tendon and ligament derived cells. J Cell Physiol 2021; 237:675-686. [PMID: 34368976 DOI: 10.1002/jcp.30540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 06/09/2021] [Accepted: 07/10/2021] [Indexed: 11/07/2022]
Abstract
Tendon and ligament (T/L) engineering strategies towards clinical practice have been challenged by a paucity of understanding in the identification and still poorly described characterization of cellular niches. Prospecting how resident cell populations behave in vitro, and how cryopreservation may influence T/ L-promoting factors, can provide insights into T/ L-cellular profiles for novel regenerative solutions. Therefore, we studied human T/ L-derived cells isolated from patellar tendons and cruciate ligaments as suitable cellular models to anticipate tendon and ligament niches responses for advanced strategies with predictive tenogenic and ligamentogenic value. Our results show that the crude populations isolated from tendon and ligament tissues hold a stem cell subset and share a similar behavior in terms of tenogenic/ligamentogenic commitment. Both T/ L-derived cells successfully undergo cryopreservation/thawing maintaining the tenogenic/ligamentogenic profiles. The major differences between cryopreserved and fresh populations were observed at the gene expression of MKX, SCX, and TNMD as well as at the protein levels of collagen type I and III, in which cells from tendon origin (hTDCs) evidence increased values in comparison to the ones from ligament (hLDCs, p < 0.05). In addition, low-temperature storage was shown to potentiate an immunomodulatory profile of cells, especially in hTDCs leading to an increase in the gene expression of the anti-inflammatory factors IL-4 and IL-10 (p < 0.05), as well as in the protein secretion of IL-10 (p < 0.01) and IL-4 (p < 0.001). Overall, the outcomes highlight the relevance of the cryopreserved T/ L-derived cells and their promising immunomodulatory cues as in vitro models for investigating cell-mediated mechanisms driving tissue healing and regeneration.
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Affiliation(s)
- Ana I Gonçalves
- 3B's Research Group, I3Bs - Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Avepark - Zona Industrial da Gandra, Barco, Guimarães, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Adriana Vinhas
- 3B's Research Group, I3Bs - Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Avepark - Zona Industrial da Gandra, Barco, Guimarães, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Márcia T Rodrigues
- 3B's Research Group, I3Bs - Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Avepark - Zona Industrial da Gandra, Barco, Guimarães, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Manuela E Gomes
- 3B's Research Group, I3Bs - Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Avepark - Zona Industrial da Gandra, Barco, Guimarães, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
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Jiao Y, Li C, Liu L, Wang F, Liu X, Mao J, Wang L. Construction and application of textile-based tissue engineering scaffolds: a review. Biomater Sci 2020; 8:3574-3600. [PMID: 32555780 DOI: 10.1039/d0bm00157k] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Tissue engineering (TE) provides a practicable method for tissue and organ repair or substitution. As the most important component of TE, a scaffold plays a critical role in providing a growing environment for cell proliferation and functional differentiation as well as good mechanical support. And the restorative effects are greatly dependent upon the nature of the scaffold including the composition, morphology, structure, and mechanical performance. Medical textiles have been widely employed in the clinic for a long time and are being extensively investigated as TE scaffolds. However, unfortunately, the advantages of textile technology cannot be fully exploited in tissue regeneration due to the ignoring of the diversity of fabric structures. Therefore, this review focuses on textile-based scaffolds, emphasizing the significance of the fabric design and the resultant characteristics of cell behavior and extracellular matrix reconstruction. The structure and mechanical behavior of the fabrics constructed by various textile techniques for different tissue repairs are summarized. Furthermore, the prospect of structural design in the TE scaffold preparation was anticipated, including profiled fibers and some unique and complex textile structures. Hopefully, the readers of this review would appreciate the importance of structural design of the scaffold and the usefulness of textile-based TE scaffolds in tissue regeneration.
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Affiliation(s)
- Yongjie Jiao
- Key Laboratory of Textile Science and Technology of Ministry of Education and College of Textiles, Donghua University, Shanghai 201620, China.
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Abstract
Introduction. Tendons are specialised, heterogeneous connective tissues, which represent a significant healthcare challenge after injury. Primary surgical repair is the gold standard modality of care; however, it is highly dependent on the extent of injuries. Tissue engineering represents an alternative solution for good tissue integration and regeneration. In this review, we look at the advanced biomaterial composites employed to improve cellular growth while providing appropriate mechanical properties for tendon and ligament repair. Methodology. Comprehensive literature searches focused on advanced composite biomaterials for tendon and ligament tissue engineering. Studies were categorised depending on the application. Results. In the literature, a range of natural and/or synthetic materials have been combined to produce composite scaffolds tendon and ligament tissue engineering. In vitro and in vivo assessment demonstrate promising cellular integration with sufficient mechanical strength. The biological properties were improved with the addition of growth factors within the composite materials. Most in vivo studies were completed in small-scale animal models. Conclusions. Advanced composite materials represent a promising solution to the challenges associated with tendon and ligament tissue engineering. Nevertheless, these approaches still demonstrate limitations, including the necessity of larger-scale animal models to ease future clinical translation and comprehensive assessment of tissue response after implantation.
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A mathematical model of the process of ligament repair: effect of cold therapy and mechanical stress. J Theor Biol 2012; 302:53-61. [PMID: 22381538 DOI: 10.1016/j.jtbi.2012.01.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Revised: 01/18/2012] [Accepted: 01/24/2012] [Indexed: 01/15/2023]
Abstract
This article proposes a mathematical model that predicts the wound healing process of the ligament after a sprain, grade II. The model describes the swelling, expression of the platelet-derived growth factor (PDGF), formation and migration of fibroblasts into the injury area and the expression of collagen fibers. Additionally, the model can predict the effect of ice treatment in reducing inflammation and the action of mechanical stress in the process of remodeling of collagen fibers. The results obtained from computer simulation show a high concordance with the clinical data previously reported by other authors.
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Rodrigues MT, Reis RL, Gomes ME. Engineering tendon and ligament tissues: present developments towards successful clinical products. J Tissue Eng Regen Med 2012; 7:673-86. [DOI: 10.1002/term.1459] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Accepted: 11/24/2011] [Indexed: 12/18/2022]
Affiliation(s)
- Márcia T. Rodrigues
- 3Bs Research Group - Biomaterials, Biodegradables and Biomimetics; University of Minho; Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine; AvePark; 4806-909; Taipas; Guimarães; Portugal
| | - Rui L. Reis
- 3Bs Research Group - Biomaterials, Biodegradables and Biomimetics; University of Minho; Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine; AvePark; 4806-909; Taipas; Guimarães; Portugal
| | - Manuela E. Gomes
- 3Bs Research Group - Biomaterials, Biodegradables and Biomimetics; University of Minho; Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine; AvePark; 4806-909; Taipas; Guimarães; Portugal
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Garzón-Alvarado DA, Cárdenas Sandoval RP, Vanegas Acosta JC. A mathematical model of medial collateral ligament repair: migration, fibroblast proliferation and collagen formation. Comput Methods Biomech Biomed Engin 2011; 15:571-83. [PMID: 21491258 DOI: 10.1080/10255842.2010.550887] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
The partial rupture of ligament fibres leads to an injury known as grade 2 sprain. Wound healing after injury consists of four general stages: swelling, release of platelet-derived growth factor (PDGF), fibroblast migration and proliferation and collagen production. The aim of this paper is to present a mathematical model based on reaction-diffusion equations for describing the repair of the medial collateral ligament when it has suffered a grade 2 sprain. We have used the finite element method to solve the equations of this. The results have simulated the tissue swelling at the time of injury, predicted PDGF influence, the concentration of fibroblasts migrating towards the place of injury and reproduced the random orientation of immature collagen fibres. These results agree with experimental data reported by other authors. The model describes wound healing during the 9 days following such injury.
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Affiliation(s)
- D A Garzón-Alvarado
- Group of Mathematical Modeling and Numerical Methods, GNUM-UN, National University of Colombia, Bogotá, Colombia
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