1
|
Yammine KM, Mirda Abularach S, Kim SY, Bikovtseva AA, Lilianty J, Butty VL, Schiavoni RP, Bateman JF, Lamandé SR, Shoulders MD. ER procollagen storage defect without coupled unfolded protein response drives precocious arthritis. Life Sci Alliance 2024; 7:e202402842. [PMID: 38981683 PMCID: PMC11234256 DOI: 10.26508/lsa.202402842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 06/21/2024] [Accepted: 06/26/2024] [Indexed: 07/11/2024] Open
Abstract
Collagenopathies are a group of clinically diverse disorders caused by defects in collagen folding and secretion. For example, mutations in the gene encoding collagen type-II, the primary collagen in cartilage, can lead to diverse chondrodysplasias. One example is the Gly1170Ser substitution in procollagen-II, which causes precocious osteoarthritis. Here, we biochemically and mechanistically characterize an induced pluripotent stem cell-based cartilage model of this disease, including both hetero- and homozygous genotypes. We show that Gly1170Ser procollagen-II is notably slow to fold and secrete. Instead, procollagen-II accumulates intracellularly, consistent with an endoplasmic reticulum (ER) storage disorder. Likely owing to the unique features of the collagen triple helix, this accumulation is not recognized by the unfolded protein response. Gly1170Ser procollagen-II interacts to a greater extent than wild-type with specific ER proteostasis network components, consistent with its slow folding. These findings provide mechanistic elucidation into the etiology of this disease. Moreover, the easily expandable cartilage model will enable rapid testing of therapeutic strategies to restore proteostasis in the collagenopathies.
Collapse
Affiliation(s)
- Kathryn M Yammine
- https://ror.org/042nb2s44 Department of Chemistry, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Sophia Mirda Abularach
- https://ror.org/042nb2s44 Department of Chemistry, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Seo-Yeon Kim
- https://ror.org/042nb2s44 Department of Chemistry, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Agata A Bikovtseva
- https://ror.org/042nb2s44 Department of Chemistry, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Jinia Lilianty
- Murdoch Children's Research Institute, Parkville, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Vincent L Butty
- https://ror.org/042nb2s44 BioMicro Center, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Richard P Schiavoni
- https://ror.org/042nb2s44 Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - John F Bateman
- Murdoch Children's Research Institute, Parkville, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Shireen R Lamandé
- Murdoch Children's Research Institute, Parkville, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
- The Novo Nordisk Foundation Center for Stem Cell Medicine (reNEW), Murdoch Children's Research Institute, Parkville, Australia
| | - Matthew D Shoulders
- https://ror.org/042nb2s44 Department of Chemistry, Massachusetts Institute of Technology, Cambridge, MA, USA
- https://ror.org/042nb2s44 Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| |
Collapse
|
2
|
Lee JW, Lee B, Park CH, Heo JH, Lee TY, Lee D, Bae J, Sundharbaabu PR, Yeom WK, Chae S, Lim JH, Lee SW, Choi JS, Bae HB, Choi JY, Lee EH, Yoon DS, Yeom GY, Shin H, Lee JH. Monolithic DNApatite: An Elastic Apatite with Sub-Nanometer Scale Organo-Inorganic Structures. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2024:e2406179. [PMID: 39003621 DOI: 10.1002/adma.202406179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/20/2024] [Indexed: 07/15/2024]
Abstract
Hydroxyapatite (HA) exhibits outstanding biocompatibility, bioactivity, osteoconductivity, and natural anti-inflammatory properties. Pure HA, ion-doped HA, and HA-polymer composites are investigated, but critical limitations such as brittleness remain; numerous efforts are being made to address them. Herein, the novel self-crystallization of a polymeric single-stranded deoxyribonucleic acid (ssDNA) without additional phosphate ions for synthesizing deoxyribonucleic apatite (DNApatite) is presented. The synthesized DNApatite, DNA1Ca2.2(PO4)1.3OH2.1, has a repetitive dual phase of inorganic HA crystals and amorphous organic ssDNA at the sub-nm scale, forming nanorods. Its mechanical properties, including toughness and elasticity, are significantly enhanced compared with those of HA nanorod, with a Young's modulus similar to that of natural bone.
Collapse
Affiliation(s)
- Jin Woong Lee
- School of Advanced Materials Science & Engineering, Sungkyunkwan University (SKKU), Suwon, 16419, Republic of Korea
| | - Byoungsang Lee
- School of Advanced Materials Science & Engineering, Sungkyunkwan University (SKKU), Suwon, 16419, Republic of Korea
| | - Cheol Hyun Park
- School of Advanced Materials Science & Engineering, Sungkyunkwan University (SKKU), Suwon, 16419, Republic of Korea
| | - Jun Hyuk Heo
- School of Advanced Materials Science & Engineering, Sungkyunkwan University (SKKU), Suwon, 16419, Republic of Korea
- Research Center for Advanced Materials Technology, SKKU, Suwon, 16419, Republic of Korea
| | - Tae Yoon Lee
- School of Advanced Materials Science & Engineering, Sungkyunkwan University (SKKU), Suwon, 16419, Republic of Korea
| | - Dongtak Lee
- School of Biomedical Engineering, Korea University, Seoul, 02841, Republic of Korea
| | - Jina Bae
- School of Advanced Materials Science & Engineering, Sungkyunkwan University (SKKU), Suwon, 16419, Republic of Korea
| | | | - Won Kyun Yeom
- School of Advanced Materials Science & Engineering, Sungkyunkwan University (SKKU), Suwon, 16419, Republic of Korea
| | - Sudong Chae
- School of Advanced Materials Science & Engineering, Sungkyunkwan University (SKKU), Suwon, 16419, Republic of Korea
| | - Jae-Hyuk Lim
- School of Mechanical Engineering, SKKU, Suwon, 16419, Republic of Korea
| | - Seok-Won Lee
- School of Mechanical Engineering, SKKU, Suwon, 16419, Republic of Korea
| | - Jin-Seok Choi
- Analysis Center for Research Advancement, Korea Advanced Institute of Science and Technology, Daejeon, 34141, Republic of Korea
| | - Hyung-Bin Bae
- Analysis Center for Research Advancement, Korea Advanced Institute of Science and Technology, Daejeon, 34141, Republic of Korea
| | - Jae-Young Choi
- School of Advanced Materials Science & Engineering, Sungkyunkwan University (SKKU), Suwon, 16419, Republic of Korea
| | - Eun-Ho Lee
- School of Mechanical Engineering, SKKU, Suwon, 16419, Republic of Korea
| | - Dae Sung Yoon
- School of Biomedical Engineering, Korea University, Seoul, 02841, Republic of Korea
| | - Geun Young Yeom
- School of Advanced Materials Science & Engineering, Sungkyunkwan University (SKKU), Suwon, 16419, Republic of Korea
| | - Hyunjung Shin
- Department of Energy Science, SKKU, Suwon, 16419, Republic of Korea
| | - Jung Heon Lee
- School of Advanced Materials Science & Engineering, Sungkyunkwan University (SKKU), Suwon, 16419, Republic of Korea
- Research Center for Advanced Materials Technology, SKKU, Suwon, 16419, Republic of Korea
- Department of MetaBioHealth, SKKU, Suwon, 16419, Republic of Korea
| |
Collapse
|
3
|
Rovedo P, Meine H, Hucker P, Taghizadeh E, Izadpanah K, Zaitsev M, Lange T. Time-Resolved Quantification of Patellofemoral Cartilage Deformation in Response to Loading and Unloading via Dynamic MRI With Prospective Motion Correction. J Magn Reson Imaging 2024; 60:175-183. [PMID: 37668040 DOI: 10.1002/jmri.28986] [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: 05/08/2023] [Revised: 08/16/2023] [Accepted: 08/16/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND In vivo cartilage deformation has been studied by static magnetic resonance imaging (MRI) with in situ loading, but knowledge about strain dynamics after load onset and release is scarce. PURPOSE To measure the dynamics of patellofemoral cartilage deformation and recovery in response to in situ loading and unloading by using MRI with prospective motion correction. STUDY TYPE Prospective. SUBJECTS Ten healthy male volunteers (age: [31.4 ± 3.2] years). FIELD STRENGTH/SEQUENCE T1-weighted RF-spoiled 2D gradient-echo sequence with a golden angle radial acquisition scheme, augmented with prospective motion correction, at 3 T. ASSESSMENT In situ knee loading was realized with a flexion angle of approximately 40° using an MR-compatible pneumatic loading device. The loading paradigm consisted of 2 minutes of unloaded baseline followed by a 5-minute loading bout with 50% body weight and an unloading period of 38 minutes. The cartilage strain was assessed as the mean distance between patellar and femoral bone-cartilage interfaces as a percentage of the initial (pre-load) distance. STATISTICAL TESTS Wilcoxon signed-rank tests (significance level: P < 0.05), Pearson correlation coefficient (r). RESULTS The cartilage compression and recovery behavior was characterized by a viscoelastic response. The elastic compression ([-12.5 ± 3.1]%) was significantly larger than the viscous compression ([-7.6 ± 1.5]%) and the elastic recovery ([10.5 ± 2.1]%) was significantly larger than the viscous recovery ([6.1 ± 1.8]%). There was a significant residual offset strain ([-3.6 ± 2.3]%) across the cohort. A significant negative correlation between elastic compression and elastic recovery was observed (r = -0.75). DATA CONCLUSION The in vivo cartilage compression and recovery time course in response to loading was successfully measured via dynamic MRI with prospective motion correction. The clinical relevance of the strain characteristics needs to be assessed in larger subject and patient cohorts. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY: Stage 1.
Collapse
Affiliation(s)
- Philipp Rovedo
- Division of Medical Physics, Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Hans Meine
- Medical Image Computing Group, Department of Informatics, University of Bremen, Bremen, Germany
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
| | - Patrick Hucker
- Division of Medical Physics, Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Elham Taghizadeh
- Medical Image Computing Group, Department of Informatics, University of Bremen, Bremen, Germany
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
| | - Kaywan Izadpanah
- Department of Orthopedic and Trauma Surgery, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Maxim Zaitsev
- Division of Medical Physics, Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Thomas Lange
- Division of Medical Physics, Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| |
Collapse
|
4
|
Wan C, Li Z, Zhou Y. Effect of type 2 diabetes mellitus on the microstructural, compositional and mechanical properties of cartilages. Ann Anat 2024; 254:152259. [PMID: 38492655 DOI: 10.1016/j.aanat.2024.152259] [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: 03/30/2023] [Revised: 02/20/2024] [Accepted: 03/11/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Osteoarthritis (OA) is a chronic and complicated degenerative disorder of joints, including several phenotypes. Type 2 diabetes mellitus (T2DM) is one of the major causes of OA. However, few studies on the mechanical behavior of diabetic cartilages have been conducted. METHODS This study evaluated the microstructural, compositional, and mechanical properties of healthy and diabetic rat cartilages using scanning electronic microscopy, X-ray energy spectroscopy, histology staining, and microindentation tests. RESULTS Our results indicated that the diabetic cartilages had a significantly higher elastic modulus and similar permeability (95%CI: 3.72-8.56 MPa and 3.16×10-6-1.83×10-5 mm4/N·s) compared to the healthy cartilages (95%CI: 0.741-3.58 MPa and 3.15×10-6-1.14×10-5 mm4/N·s). Their stress relaxation behaviors were similar regardless of the loading rate except for the stretching parameter under the fast loading. Furthermore, the stress relaxation behaviors of the diabetic cartilages were significantly affected by the loading rate, especially the equilibrium force ratio and time constant. These mechanical outcomes could be attributed to the increase of fibril diameters and calcium aggregation in the cartilage. CONCLUSIONS This study deepens our understanding of how T2DM might facilitate OA in cartilages, which could contribute to the development of more scientific diagnosis and therapies for patients with diabetes.
Collapse
Affiliation(s)
- Chao Wan
- Department of Mechanics, School of Aerospace Engineering, Beijing Institute of Technology, China; Tangshan Research Institute, Beijing Institute of Technology, China.
| | - Zhongjie Li
- Department of Mechanics, School of Aerospace Engineering, Beijing Institute of Technology, China
| | - Yizun Zhou
- Department of Mechanics, School of Aerospace Engineering, Beijing Institute of Technology, China
| |
Collapse
|
5
|
Lee YT, Mohd Yunus MH, Yazid MD, Ugusman A. Unraveling the path to osteoarthritis management: targeting chondrocyte apoptosis for therapeutic intervention. Front Cell Dev Biol 2024; 12:1347126. [PMID: 38827524 PMCID: PMC11140145 DOI: 10.3389/fcell.2024.1347126] [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: 11/30/2023] [Accepted: 05/06/2024] [Indexed: 06/04/2024] Open
Abstract
Osteoarthritis (OA) is a chronic disease affecting joints and further causing disabilities. This disease affects around 240 million people worldwide. It is a multifactorial disease, and its etiology is difficult to determine. Although numerous therapeutic strategies are available, the therapies are aimed at reducing pain and improving patients' quality of life. Hence, there is an urgent need to develop disease-modifying drugs (DMOAD) that can reverse or halt OA progression. Apoptosis is a cell removal process that is important in maintaining homeostatic mechanisms in the development and sustaining cell population. The apoptosis of chondrocytes is believed to play an important role in OA progression due to poor chondrocytes self-repair abilities to maintain the extracellular matrix (ECM). Hence, targeting chondrocyte apoptosis can be one of the potential therapeutic strategies in OA management. There are various mediators and targets available to inhibit apoptosis such as autophagy, endoplasmic reticulum (ER) stress, oxidative stress, and inflammation. As such, this review highlights the importance and potential targets that can be aimed to reduce chondrocyte apoptosis.
Collapse
Affiliation(s)
- Yi Ting Lee
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
| | - Mohd Heikal Mohd Yunus
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
| | - Muhammad Dain Yazid
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
| | - Azizah Ugusman
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
| |
Collapse
|
6
|
Lv H, Liu P, Hu H, Li X, Li P. MiR-98-5p plays suppressive effects on IL-1β-induced chondrocyte injury associated with osteoarthritis by targeting CASP3. J Orthop Surg Res 2024; 19:239. [PMID: 38615043 PMCID: PMC11015643 DOI: 10.1186/s13018-024-04628-9] [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: 08/23/2023] [Accepted: 02/14/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND This study aims to explore how miR-98-5p affects osteoarthritis, focusing on its role in chondrocyte inflammation, apoptosis, and extracellular matrix (ECM) degradation. METHODS Quantitative real-time PCR was used to measure miR-98-5p and CASP3 mRNA levels in OA cartilage tissues and IL-1β-treated CHON-001 cells. We predicted miR-98-5p and CASP3 binding sites using TargetScan and confirmed them via luciferase reporter assays. Chondrocyte viability was analyzed using CCK-8 assays, while pro-inflammatory cytokines (IL-1β, IL-6, TNF-α) were quantified via ELISA. Caspase-3 activity was examined to assess apoptosis, and Western blotting was conducted for protein marker quantification. RESULTS Our results showed lower miR-98-5p levels in both OA cartilage and IL-1β-stimulated cells. Increasing miR-98-5p resulted in reduced pro-inflammatory cytokines, decreased caspase-3 activity, and improved cell viability. Furthermore, miR-98-5p overexpression hindered IL-1β-induced ECM degradation, evident from the decline in MMP-13 and β-catenin levels, and an increase in COL2A1 expression. MiR-98-5p's impact on CASP3 mRNA directly influenced its expression. Mimicking miR-98-5p's effects, CASP3 knockdown also inhibited IL-1β-induced inflammation, apoptosis, and ECM degradation. In contrast, CASP3 overexpression negated the suppressive effects of miR-98-5p. CONCLUSIONS In conclusion, our data collectively suggest that miR-98-5p plays a protective role against IL-1β-induced damage in chondrocytes by targeting CASP3, highlighting its potential as a therapeutic target for OA.
Collapse
Affiliation(s)
- Hang Lv
- Department of Orthopedics, Hanan Branch, The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, No. 411, Guogeli Street, Nangang District, Harbin City, 150060, Heilongjiang Province, China
| | - Peiran Liu
- Department of Orthopedics, Hanan Branch, The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, No. 411, Guogeli Street, Nangang District, Harbin City, 150060, Heilongjiang Province, China
| | - Hai Hu
- Department of Orthopedics, Hanan Branch, The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, No. 411, Guogeli Street, Nangang District, Harbin City, 150060, Heilongjiang Province, China
| | - Xiaodong Li
- Orthopedic ward, The Third Affiliated Hospital of Heilongjiang University of Chinese Medicine, No. 2 Xiangjiang Road, Xiangfang District, Harbin City, 150000, Heilongjiang Province, China
| | - Pengfei Li
- Department of Orthopedics, Hanan Branch, The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, No. 411, Guogeli Street, Nangang District, Harbin City, 150060, Heilongjiang Province, China.
| |
Collapse
|
7
|
Welhaven HD, Viles E, Starke J, Wallace C, Bothner B, June RK, Hahn AK. Metabolomic profiles of cartilage and bone reflect tissue type, radiography-confirmed osteoarthritis, and spatial location within the joint. Biochem Biophys Res Commun 2024; 703:149683. [PMID: 38373382 DOI: 10.1016/j.bbrc.2024.149683] [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: 11/16/2023] [Revised: 02/09/2024] [Accepted: 02/12/2024] [Indexed: 02/21/2024]
Abstract
Osteoarthritis is the most common chronic joint disease, characterized by the abnormal remodeling of joint tissues including articular cartilage and subchondral bone. However, there are currently no therapeutic drug targets to slow the progression of disease because disease pathogenesis is largely unknown. Thus, the goals of this study were to identify metabolic differences between articular cartilage and subchondral bone, compare the metabolic shifts in osteoarthritic grade III and IV tissues, and spatially map metabolic shifts across regions of osteoarthritic hip joints. Articular cartilage and subchondral bone from 9 human femoral heads were obtained after total joint arthroplasty, homogenized and metabolites were extracted for liquid chromatography-mass spectrometry analysis. Metabolomic profiling revealed that distinct metabolic endotypes exist between osteoarthritic tissues, late-stage grades, and regions of the diseased joint. The pathways that contributed the most to these differences between tissues were associated with lipid and amino acid metabolism. Differences between grades were associated with nucleotide, lipid, and sugar metabolism. Specific metabolic pathways such as glycosaminoglycan degradation and amino acid metabolism, were spatially constrained to more superior regions of the femoral head. These results suggest that radiography-confirmed grades III and IV osteoarthritis are associated with distinct global metabolic and that metabolic shifts are not uniform across the joint. The results of this study enhance our understanding of osteoarthritis pathogenesis and may lead to potential drug targets to slow, halt, or reverse tissue damage in late stages of osteoarthritis.
Collapse
Affiliation(s)
- Hope D Welhaven
- Department of Chemistry & Biochemistry, Montana State University, Bozeman, MT, 59717, United States.
| | - Ethan Viles
- Department of Mechanical & Industrial Engineering, Montana State University, Bozeman, MT, 59717, United States.
| | - Jenna Starke
- Montana WWAMI, University of Washington School of Medicine, Seattle, WA, 98195, United States.
| | - Cameron Wallace
- Department of Orthopaedic Surgery, University of Utah Health, Salt Lake City, UT, 84103, United States.
| | - Brian Bothner
- Department of Chemistry & Biochemistry, Montana State University, Bozeman, MT, 59717, United States.
| | - Ronald K June
- Department of Mechanical & Industrial Engineering, Montana State University, Bozeman, MT, 59717, United States.
| | - Alyssa K Hahn
- Department of Biological and Environmental Sciences, Carroll College, Helena, MT, 59625, United States.
| |
Collapse
|
8
|
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.
Collapse
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;
| | | |
Collapse
|
9
|
Yammine KM, Abularach SM, Kim SY, Bikovtseva AA, Lilianty J, Butty VL, Schiavoni RP, Bateman JF, Lamandé SR, Shoulders MD. ER procollagen storage defect without coupled unfolded protein response drives precocious arthritis. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.10.19.562780. [PMID: 37905055 PMCID: PMC10614947 DOI: 10.1101/2023.10.19.562780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Collagenopathies are a group of clinically diverse disorders caused by defects in collagen folding and secretion. For example, mutations in the gene encoding collagen type-II, the primary collagen in cartilage, can lead to diverse chondrodysplasias. One example is the Gly1170Ser substitution in procollagen-II, which causes precocious osteoarthritis. Here, we biochemically and mechanistically characterize an induced pluripotent stem cell-based cartilage model of this disease, including both hetero- and homozygous genotypes. We show that Gly1170Ser procollagen-II is notably slow to fold and secrete. Instead, procollagen-II accumulates intracellularly, consistent with an endoplasmic reticulum (ER) storage disorder. Owing to unique features of the collagen triple helix, this accumulation is not recognized by the unfolded protein response. Gly1170Ser procollagen-II interacts to a greater extent than wild-type with specific proteostasis network components, consistent with its slow folding. These findings provide mechanistic elucidation into the etiology of this disease. Moreover, the cartilage model will enable rapid testing of therapeutic strategies to restore proteostasis in the collagenopathies.
Collapse
|
10
|
Cognetti DJ, Defoor MT, Yuan TT, Sheean AJ. Knee Joint Preservation in Tactical Athletes: A Comprehensive Approach Based upon Lesion Location and Restoration of the Osteochondral Unit. Bioengineering (Basel) 2024; 11:246. [PMID: 38534520 DOI: 10.3390/bioengineering11030246] [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: 12/15/2023] [Revised: 02/18/2024] [Accepted: 02/28/2024] [Indexed: 03/28/2024] Open
Abstract
The unique physical demands of tactical athletes put immense stress on the knee joint, making these individuals susceptible to injury. In order to ensure operational readiness, management options must restore and preserve the native architecture and minimize downtime, while optimizing functionality. Osteochondral lesions (OCL) of the knee have long been acknowledged as significant sources of knee pain and functional deficits. The management of OCL is predicated on certain injury characteristics, including lesion location and the extent of subchondral disease. Techniques such as marrow stimulation, allograft and autologous chondrocyte implantation are examined in detail, with a focus on their application and suitability in tactical athlete populations. Moreover, the restoration of the osteochondral unit (OCU) is highlighted as a central aspect of knee joint preservation. The discussion encompasses the biomechanical considerations and outcomes associated with various cartilage restoration techniques. Factors influencing procedure selection, including lesion size, location, and patient-specific variables, are thoroughly examined. Additionally, the review underscores the critical role of post-operative rehabilitation and conditioning programs in optimizing outcomes. Strengthening the surrounding musculature, enhancing joint stability, and refining movement patterns are paramount in facilitating the successful integration of preservation procedures. This narrative review aims to provide a comprehensive resource for surgeons, engineers, and sports medicine practitioners engaged in the care of tactical athletes and the field of cartilage restoration. The integration of advanced preservation techniques and tailored rehabilitation protocols offers a promising avenue for sustaining knee joint health and function in this demanding population.
Collapse
Affiliation(s)
- Daniel J Cognetti
- Department of Orthopedic Surgery, Brooke Army Medical Center, 3551 Roger Brooke Drive, San Antonio, TX 78234, USA
| | - Mikalyn T Defoor
- Department of Orthopedic Surgery, Brooke Army Medical Center, 3551 Roger Brooke Drive, San Antonio, TX 78234, USA
| | - Tony T Yuan
- Advanced Exposures Diagnostics, Interventions and Biosecurity Group, 59 Medical Wing, Lackland Air Force Base, San Antonio, TX 78236, USA
- Center for Biotechnology (4D Bio3), Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Andrew J Sheean
- Department of Orthopedic Surgery, Brooke Army Medical Center, 3551 Roger Brooke Drive, San Antonio, TX 78234, USA
| |
Collapse
|
11
|
Song J, Zeng X, Li C, Yin H, Mao S, Ren D. Alteration in cartilage matrix stiffness as an indicator and modulator of osteoarthritis. Biosci Rep 2024; 44:BSR20231730. [PMID: 38014522 PMCID: PMC10794814 DOI: 10.1042/bsr20231730] [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: 10/11/2023] [Revised: 11/22/2023] [Accepted: 11/24/2023] [Indexed: 11/29/2023] Open
Abstract
Osteoarthritis (OA) is characterized by cartilage degeneration and destruction, leading to joint ankylosis and disability. The major challenge in diagnosing OA at early stage is not only lack of clinical symptoms but also the insufficient histological and immunohistochemical signs. Alteration in cartilage stiffness during OA progression, especially at OA initiation, has been confirmed by growing evidences. Moreover, the stiffness of cartilage extracellular matrix (ECM), pericellular matrix (PCM) and chondrocytes during OA development are dynamically changed in unique and distinct fashions, revealing possibly inconsistent conclusions when detecting cartilage matrix stiffness at different locations and scales. In addition, it will be discussed regarding the mechanisms through which OA-related cartilage degenerations exhibit stiffened or softened matrix, highlighting some critical events that generally incurred to cartilage stiffness alteration, as well as some typical molecules that participated in constituting the mechanical properties of cartilage. Finally, in vitro culturing chondrocytes in various stiffness-tunable scaffolds provided a reliable method to explore the matrix stiffness-dependent modulation of chondrocyte metabolism, which offers valuable information on optimizing implant scaffolds to maximally promote cartilage repair and regeneration during OA. Overall, this review systematically and comprehensively elucidated the current progresses in the relationship between cartilage stiffness alteration and OA progression. We hope that deeper attention and understanding in this researching field will not only develop more innovative methods in OA early detection and diagnose but also provide promising ideas in OA therapy and prognosis.
Collapse
Affiliation(s)
- Jing Song
- Qingdao University Affiliated Qingdao Women and Children’s Hospital, Department of Stomatology Medical Center, Qingdao University, Qingdao, Shandong, CN, China
| | - Xuemin Zeng
- The Affiliated Hospital of Qingdao University, Department of Stomatology Medical Center, Qingdao University, Qingdao, Shandong, CN, China
| | - Chenzhi Li
- The Affiliated Hospital of Qingdao University, Department of Stomatology Medical Center, Qingdao University, Qingdao, Shandong, CN, China
| | - Hongyan Yin
- Institute of Hybrid Materials, College of Materials Science and Engineering, Qingdao University, Qingdao, Shandong, CN, China
| | - Sui Mao
- Institute of Hybrid Materials, College of Materials Science and Engineering, Qingdao University, Qingdao, Shandong, CN, China
| | - Dapeng Ren
- The Affiliated Hospital of Qingdao University, Department of Stomatology Medical Center, Qingdao University, Qingdao, Shandong, CN, China
| |
Collapse
|
12
|
Wang G, Zhang XA, Kapilevich L, Hu M. Recent advances in polymeric microparticle-based drug delivery systems for knee osteoarthritis treatment. Front Bioeng Biotechnol 2023; 11:1290870. [PMID: 38130826 PMCID: PMC10733461 DOI: 10.3389/fbioe.2023.1290870] [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: 09/08/2023] [Accepted: 11/28/2023] [Indexed: 12/23/2023] Open
Abstract
Due to the poor bioavailability and high joint clearance of drugs, sustained delivery of therapeutic agents has proven difficult in the treatment of osteoarthritis (OA). Intra-articular (IA) drug delivery strategy is an attractive option for enhancing OA patients' prognosis, for which various polymer materials have been used as drug carriers due to their attractive delivery properties, to slow or even reverse the progress of OA by prolonging the duration of therapeutic agent residence in the joint. This article focuses on the recent developments in natural and synthetic polymer-based microsphere drug delivery systems for treating knee osteoarthritis. It evaluates the translational potential of some novel formulations for clinical application.
Collapse
Affiliation(s)
- Guangxin Wang
- Department of Orthopedics, The Fourth People’s Hospital of Shenyang, Shenyang, China
| | - Xin-an Zhang
- College of Exercise and Health, Shenyang Sport University, Shenyang, China
| | - Leonid Kapilevich
- Faculty of Physical Education, Nаtionаl Reseаrch Tomsk Stаte University, Tomsk, Russiа
| | - Mingjie Hu
- College of Exercise and Health, Shenyang Sport University, Shenyang, China
| |
Collapse
|
13
|
Bukhari SI, Allana AR, Najjad KR, Noor SS, Chinoy A. Epidemiology of hip & knee replacement across Pakistan: Multicenter cross-sectional study. Pak J Med Sci 2023; 39:1557-1561. [PMID: 37936780 PMCID: PMC10626118 DOI: 10.12669/pjms.39.6.7006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 12/20/2022] [Accepted: 09/03/2023] [Indexed: 11/09/2023] Open
Abstract
Objective To know about the predictive prevalence of hip and knee arthroplasty across Pakistan. Methods It is retrospective cross-sectional study with data collection from Pakistan National Joint Registry (PNJR) of number of hip and knee arthroplasty cases in seven years (2014-2021). Fourteen high volume centers across Pakistan who consented for data publication were included. Stata version 16 was used for data analysis. Mean & standard deviation was reported for quantitative variable & frequency and proportion were reported for qualitative variables. Results Our results showed a total of 9572 people had total knee replacement in last seven years from 2014-2021 with the rate of 9.57/100,000 population. Mean age of the patient was 61.7±8.95 with 69.5% patients being female and 30.5% being male. Our results showed a total of 2265 people had total hip replacement in last seven years from 2014-2021with the rate of 2.26/100,000 population. Mean age of the patient was 50.7±15.4 with 62% patients being male and 38% being female. Conclusion This is the first epidemiological study in Pakistan on the rates of hip and knee arthroplasty cases in Pakistan based on registry data, showing that more knee arthroplasty cases are being performed as compared to hip arthroplasty.
Collapse
Affiliation(s)
- Syed Imran Bukhari
- Syed Imran Bukhari, FCPS. Department of Trauma & Orthopedics, Lady Reading Hospital, Peshawar, Pakistan
| | - Asad Rehman Allana
- Asad Rehman Allana, BDS, DRS. Department of Community Health Sciences, Aga Khan University Hospital, Karachi, Pakistan
| | - Kazim Rahim Najjad
- Kazim Rahim Najjad, FCPS. Department of Trauma & Orthopedics, Liaqat National Hospital, Karachi, Pakistan
| | - Syed Shahid Noor
- Syed Shahid Noor, FRCS. Department of Trauma & Orthopedics, Liaqat National Hospital, Karachi, Pakistan
| | - Amin Chinoy
- Amin Chinoy, FRCS. Department of Trauma & Orthopedics, Indus Hospital, Karachi, Pakistan
| |
Collapse
|
14
|
Lee W, Miller EY, Zhu H, Schneider SE, Reiter DA, Neu CP. Multi-frame biomechanical and relaxometry analysis during in vivo loading of the human knee by spiral dualMRI and compressed sensing. Magn Reson Med 2023; 90:995-1009. [PMID: 37213087 PMCID: PMC10330244 DOI: 10.1002/mrm.29690] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/27/2023] [Accepted: 04/14/2023] [Indexed: 05/23/2023]
Abstract
PURPOSE Knee cartilage experiences repetitive loading during physical activities, which is altered during the pathogenesis of diseases like osteoarthritis. Analyzing the biomechanics during motion provides a clear understanding of the dynamics of cartilage deformation and may establish essential imaging biomarkers of early-stage disease. However, in vivo biomechanical analysis of cartilage during rapid motion is not well established. METHODS We used spiral displacement encoding with stimulated echoes (DENSE) MRI on in vivo human tibiofemoral cartilage during cyclic varus loading (0.5 Hz) and used compressed sensing on the k-space data. The applied compressive load was set for each participant at 0.5 times body weight on the medial condyle. Relaxometry methods were measured on the cartilage before (T1ρ , T2 ) and after (T1ρ ) varus load. RESULTS Displacement and strain maps showed a gradual shift of displacement and strain in time. Compressive strain was observed in the medial condyle cartilage and shear strain was roughly half of the compressive strain. Male participants had more displacement in the loading direction compared to females, and T1ρ values did not change after cyclic varus load. Compressed sensing reduced the scanning time up to 25% to 40% when comparing the displacement maps and substantially lowered the noise levels. CONCLUSION These results demonstrated the ease of which spiral DENSE MRI could be applied to clinical studies because of the shortened imaging time, while quantifying realistic cartilage deformations that occur through daily activities and that could serve as biomarkers of early osteoarthritis.
Collapse
Affiliation(s)
- Woowon Lee
- Paul M. Rady Department of Mechanical Engineering, University of Colorado Boulder, Boulder, CO, USA
| | - Emily Y. Miller
- Biomedical Engineering Program, University of Colorado Boulder, Boulder, CO, USA
| | - Hongtian Zhu
- Paul M. Rady Department of Mechanical Engineering, University of Colorado Boulder, Boulder, CO, USA
| | - Stephanie E. Schneider
- Paul M. Rady Department of Mechanical Engineering, University of Colorado Boulder, Boulder, CO, USA
| | - David A. Reiter
- Department of Radiology & Imaging Sciences, Emory University, Atlanta, GA, USA
| | - Corey P. Neu
- Paul M. Rady Department of Mechanical Engineering, University of Colorado Boulder, Boulder, CO, USA
- Biomedical Engineering Program, University of Colorado Boulder, Boulder, CO, USA
- BioFrontiers Institute, University of Colorado Boulder, Boulder, CO, USA
| |
Collapse
|
15
|
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.
Collapse
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
| |
Collapse
|
16
|
Davis S, Zekonyte J, Karali A, Roldo M, Blunn G. Early Degenerative Changes in a Spontaneous Osteoarthritis Model Assessed by Nanoindentation. Bioengineering (Basel) 2023; 10:995. [PMID: 37760097 PMCID: PMC10525236 DOI: 10.3390/bioengineering10090995] [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: 07/26/2023] [Revised: 08/15/2023] [Accepted: 08/18/2023] [Indexed: 09/29/2023] Open
Abstract
Understanding early mechanical changes in articular cartilage (AC) and subchondral bone (SB) is crucial for improved treatment of osteoarthritis (OA). The aim of this study was to develop a method for nanoindentation of fresh, unfixed osteochondral tissue to assess the early changes in the mechanical properties of AC and SB. Nanoindentation was performed throughout the depth of AC and SB in the proximal tibia of Dunkin Hartley guinea pigs at 2 months, 3 months, and 2 years of age. The contralateral tibias were either histologically graded for OA or analyzed using immunohistochemistry. The results showed an increase in the reduced modulus (Er) in the deep zone of AC during early-stage OA (6.0 ± 1.75 MPa) compared to values at 2 months (4.04 ± 1.25 MPa) (*** p < 0.001). In severe OA (2-year) specimens, there was a significant reduction in Er throughout the superficial and middle AC zones, which correlated to increased ADAMTS 4 and 5 staining, and proteoglycan loss in these regions. In the subchondral bone, a 35.0% reduction in stiffness was observed between 2-month and 3-month specimens (*** p < 0.001). The severe OA age group had significantly increased SB stiffness of 36.2% and 109.6% compared to 2-month and 3-month-old specimens respectively (*** p < 0.001). In conclusion, this study provides useful information about the changes in the mechanical properties of both AC and SB during both early- and late-stage OA and indicates that an initial reduction in stiffness of the SB and an increase in stiffness in the deep zone of AC may precede early-stage cartilage degeneration.
Collapse
Affiliation(s)
- Sarah Davis
- School of Pharmacy and Biomedical Science, University of Portsmouth, Portsmouth PO1 2DT, UK; (M.R.); (G.B.)
- School of Mechanical and Design Engineering, University of Portsmouth, Portsmouth PO1 3DJ, UK; (J.Z.); (A.K.)
| | - Jurgita Zekonyte
- School of Mechanical and Design Engineering, University of Portsmouth, Portsmouth PO1 3DJ, UK; (J.Z.); (A.K.)
| | - Aikaterina Karali
- School of Mechanical and Design Engineering, University of Portsmouth, Portsmouth PO1 3DJ, UK; (J.Z.); (A.K.)
| | - Marta Roldo
- School of Pharmacy and Biomedical Science, University of Portsmouth, Portsmouth PO1 2DT, UK; (M.R.); (G.B.)
| | - Gordon Blunn
- School of Pharmacy and Biomedical Science, University of Portsmouth, Portsmouth PO1 2DT, UK; (M.R.); (G.B.)
| |
Collapse
|
17
|
Fackler NP, Yareli-Salinas E, Callan KT, Athanasiou KA, Wang D. In Vitro Effects of Triamcinolone and Methylprednisolone on the Viability and Mechanics of Native Articular Cartilage. Am J Sports Med 2023; 51:2465-2471. [PMID: 37183987 PMCID: PMC10353030 DOI: 10.1177/03635465231162644] [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: 08/19/2022] [Accepted: 02/01/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND The chondrotoxic effects of methylprednisolone acetate (MP) and triamcinolone acetonide (TA) have been well described. However, the mechanical effects of these commonly used steroids on native cartilage are largely unknown. PURPOSE To investigate the in vitro effects of a single 1-hour MP or TA exposure on the viability, mechanics, and biochemical content of native articular cartilage explants. STUDY DESIGN Controlled laboratory study. METHODS Articular cartilage explants (n = 6 per group) were harvested from the femoral condyles of bovine stifles. Explants were exposed to chondrogenic medium containing a clinical dose of MP or TA for 1 hour, followed by fresh medium wash and exchange. Explants in the control group underwent the same treatment with chondrogenic medium alone. At 24 hours after treatment, samples were assessed for viability (live/dead), mechanical properties (creep indentation and Instron tensile testing), biochemical (collagen and glycosaminoglycan) content, and pyridinoline crosslinking via mass spectrometry. RESULTS Mean cell viability was significantly decreased in native explants exposed to MP (35.5%) compared with the control (49.8%; P < .001) and TA (45.7%; P = .01) specimens. Significant decreases were seen in the mechanical properties of steroid-treated native explants when compared with controls, with decreases in aggregate modulus (646.3 vs 312.8 kPa [MP] and 257.0 kPa [TA]; P < .001), shear modulus (370.1 vs 191.2 kPa [MP] and 157.4 kPa [TA]; P < .001), and ultimate tensile strength (9.650 vs 5.648 MPa [MP; P = .021] and 6.065 MPa [TA; P = .0403]). No significant differences in collagen and glycosaminoglycan content were found in the steroid-treated groups. Pyridinoline crosslinking was significantly decreased in explants exposed to TA compared with controls (P = .027). CONCLUSION Exposure of MP to articular cartilage explants was chondrotoxic, and exposure of articular cartilage explants to MP or TA resulted in significant decreases in mechanical properties of articular cartilage explants compared with controls. Clinicians should be judicious regarding use of intra-articular steroids, particularly in patients with intact healthy articular cartilage.
Collapse
Affiliation(s)
- Nathan P. Fackler
- Department of Orthopaedic Surgery, University of California, Irvine, Orange, California, USA
| | - Evelia Yareli-Salinas
- Department of Biomedical Engineering, University of California, Irvine, Irvine, California, USA
| | - Kylie T. Callan
- Department of Orthopaedic Surgery, University of California, Irvine, Orange, California, USA
| | - Kyriacos A. Athanasiou
- Department of Biomedical Engineering, University of California, Irvine, Irvine, California, USA
| | - Dean Wang
- Department of Orthopaedic Surgery, University of California, Irvine, Orange, California, USA
- Department of Biomedical Engineering, University of California, Irvine, Irvine, California, USA
| |
Collapse
|
18
|
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.
Collapse
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.
| |
Collapse
|
19
|
Taheri M, Behnaz F, Ghasemi M. Efficacy of Intramuscular Injection of Calcitonin on Pain Functional Status of Patients with Knee Osteoarthritis. Anesth Pain Med 2023; 13:e133992. [PMID: 37601958 PMCID: PMC10439726 DOI: 10.5812/aapm-133992] [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: 01/25/2023] [Revised: 02/06/2023] [Accepted: 02/13/2023] [Indexed: 08/22/2023] Open
Abstract
Background Recently, increased attention has been paid to calcitonin for the management of osteoarthritis (OA) regarding its metabolic properties for bone turnover and cartilage. Objectives This study was designed to assess the efficacy of intramuscular calcitonin injection in the functional status of individuals suffering from knee OA. Methods A total of 40 eligible cases with OA were randomly assigned into intervention and control groups. At baseline, pain intensity and functional ability were evaluated based on the Numeric Rating scale (NRS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaires. Both groups were prescribed with AcetaGel (500 mg) and piroxicam (0.5% topical gel) every 8 hours as needed, and the patients were instructed about conservative treatments and lifestyle modifications. In the case group, the patients received calcitonin (50 IU/mL solution for injection; Aburaihan Pharmaceutical Co., Iran) intramuscularly (gluteal muscle) once a week for 4 consecutive weeks. One month after the last dose, the patients were evaluated based on NRS and WOMAC questionnaires. Results Demographic data did not show any statistically significant difference. A total of 40 cases (male and female) with mean age values of 53.10 ± 5.28 and 54.55 ± 5.26 years were included in the case and control groups, respectively. The mean body mass index values of the case and control groups were 27.45 ± 1.57 and 27.15 ± 1.53 kg/m2, respectively. After 1 month of treatment with calcitonin, significant improvements were observed in NRS outcomes (P < 0.001). The total WOMAC score was also statistically improved (P < 0.001). Conclusions The findings of the present study revealed that the weekly administration of 50 IU calcitonin for 28 days could significantly improve physical ability and pain intensity in OA patients.
Collapse
Affiliation(s)
- Mehrdad Taheri
- Department of Anesthesiology, Imam Hossein Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Faranak Behnaz
- Department of Anesthesiology, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahshid Ghasemi
- Department of Anesthesiology, Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
20
|
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.
Collapse
|
21
|
Szapary HJ, Flaman L, Frank E, Chubinskaya S, Dwivedi G, Grodzinsky AJ. Effects of dexamethasone and dynamic loading on cartilage of human osteochondral explants challenged with inflammatory cytokines. J Biomech 2023; 149:111480. [PMID: 36791513 DOI: 10.1016/j.jbiomech.2023.111480] [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: 11/05/2022] [Revised: 01/23/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
Post-traumatic osteoarthritis (PTOA), characterized by articular cartilage degradation initiated in an inflammatory environment after traumatic joint injury, can lead to alterations in cartilage biomechanical properties. Low dose dexamethasone (Dex) shows chondroprotection in cartilage challenged with inflammatory cytokines, but little is known about the structural biomechanical response of human cartilage to Dex in such a diseased state. This study examined changes in the biomechanical properties and biochemical composition of the cartilage within human osteochondral explants in response to treatment with exogenous cytokines, Dex, and a regimen of cyclic loading at the start and end of culture. Osteochondral explants were harvested from five pairs of human ankle talocrural joints (Collins grade 0-1) and cultured for 10 days with/without exogenous cytokines (100 ng/mL TNFα, 50 ng/mL IL-6, 250 ng/mL sIL-6R) ± Dex (100 nM). Biomechanical testing on day-0 and day-10 enabled estimation of the unconfined compression equilibrium modulus (Ey), dynamic stiffness (Ed) and hydraulic permeability (kp) of cartilage excised from bone, accompanied by biochemical assessment of media and cartilage tissue. Dex preserved chondrocyte cell viability and decreased sulfated glycosaminoglycan (sGAG) loss and nitric oxide release, but did not alter Ey, Ed and kp (before or after loading) on day-10. In the cytokine/cytokine+Dex treated groups, sGAG content exhibited a weaker correlation with Ey and Ed than at baseline, suggesting an important role for structural rather than biochemical changes in producing biomechanical alterations in response to cytokines and Dex. These findings aid in forming a more complete profile of potential clinical effects of Dex for use in OA/PTOA treatment regimens.
Collapse
Affiliation(s)
- Hannah J Szapary
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Health Sciences and Technology, Harvard Medical School, Boston, MA 02115, USA.
| | - Lisa Flaman
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Eliot Frank
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
| | - Susan Chubinskaya
- Departments of Pediatrics, Orthopedic Surgery and Medicine (Section of Rheumatology), Rush University Medical Center, Chicago, IL 60612, USA.
| | - Garima Dwivedi
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Alan J Grodzinsky
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
| |
Collapse
|
22
|
van Loon J, Sierevelt IN, Spekenbrink-Spooren A, Opdam KTM, Poolman RW, Kerkhoffs GMMJ, Haverkamp D. Higher risk of 2-year cup revision of ceramic-on-ceramic versus ceramic-on-polyethylene bearing: analysis of 33,454 primary press-fit total hip arthroplasties registered in the Dutch Arthroplasty Register (LROI). Hip Int 2023; 33:280-287. [PMID: 34974763 PMCID: PMC9978866 DOI: 10.1177/11207000211064975] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND PURPOSE The influence of bearing on short-term revision in press-fit total hip arthroplasty (THA) remains under-reported. The aim of this study was to describe 2-year cup revision rates of ceramic-on-ceramic (CoC) and ceramic-on-polyethylene (CoPE). PATIENTS AND METHODS Primary press-fit THAs with one of the three most used cups available with both CoC or CoPE bearing recorded in the Dutch Arthroplasty Register (LROI) were included (2007-2019). Primary outcome was 2-year cup revision for all reasons. Secondary outcomes were: reasons for revision, incidence of different revision procedures and use of both bearings over time. RESULTS 2-year Kaplan-Meier cup revision rate in 33,454 THAs (12,535 CoC; 20,919 CoPE) showed a higher rate in CoC (0.67% [95% CI, 0.54-0.81]) compared to CoPE (0.44% [95% CI, 0.34-0.54]) (p = 0.004). Correction for confounders (age, gender, cup type, head size) resulted in a hazard ratio (HR) of 0.64 [95%CI, 0.48-0.87] (p = 0.019). Reasons for cup revision differed only by more cup revision due to loosening in CoC (26.2% vs.1 3.2%) (p = 0.030). For aseptic loosening a revision rate of 0.153% [95% CI, 0.075-0.231] was seen in CoC and 0.058% [95%CI 0.019-0.097] in CoPE (p = 0.007). Correction for head size resulted in a HR of 0.475 [95% CI, 0.197-1.141] (p = 0.096). Incidence of different revision procedures did not differ between bearings. Over time the use of CoPE has increased and CoC decreased. CONCLUSIONS A higher 2-year cup revision rate in press-fit THA was observed in CoC compared to CoPE. Cup loosening was the only significantly different reason for revision and seen more often in CoC and mostly aseptic. Future randomised controlled trials need to confirm causality, since the early cup revision data provided has the potential to be useful when choosing the bearing in press-fit THA, when combined with other factors like bone quality and patient and implant characteristics.
Collapse
Affiliation(s)
- Justin van Loon
- Xpert Clinics Orthopedie Amsterdam, The
Netherlands,Department of Orthopaedic Surgery,
Amsterdam Movement Sciences, Amsterdam UMC, Academic Medical Centre, University of
Amsterdam, Amsterdam, The Netherlands,Department of Orthopaedic Surgery,
Tergooi, Hilversum, The Netherlands
| | - Inger N Sierevelt
- Xpert Clinics Orthopedie Amsterdam, The
Netherlands,Department of Orthopaedic Surgery,
Spaarne Gasthuis Academy, TM Hoofddorp, The Netherlands
| | | | - Kim TM Opdam
- Department of Orthopaedic Surgery,
Amsterdam Movement Sciences, Amsterdam UMC, Academic Medical Centre, University of
Amsterdam, Amsterdam, The Netherlands
| | - Rudolf W Poolman
- Department of Orthopaedic Surgery,
Leiden University Medical Centre, Leiden, The Netherlands,Department of Orthopaedic Surgery,
OLVG, Amsterdam, The Netherlands
| | - Gino MMJ Kerkhoffs
- Department of Orthopaedic Surgery,
Amsterdam Movement Sciences, Amsterdam UMC, Academic Medical Centre, University of
Amsterdam, Amsterdam, The Netherlands
| | - Daniël Haverkamp
- Xpert Clinics Orthopedie Amsterdam, The
Netherlands,Daniël Haverkamp, Xpert Clinics Orthopedie
Amsterdam, Laarderhoogtweg 12, Amsterdam, North-Holland, 1101EA, The
Netherlands.
| |
Collapse
|
23
|
Massey PA, Kushner R, Miller C, Lowery M, Barton RS, Solitro GF. Compressibility of Osteochondral Autograft Transfer Donor Grafts: A Comparison of Different Donor Regions and How Much Shortening Occurs of Plugs After Impaction. Orthop J Sports Med 2023; 11:23259671221147329. [PMID: 36743726 PMCID: PMC9893359 DOI: 10.1177/23259671221147329] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 10/11/2022] [Indexed: 02/04/2023] Open
Abstract
Background Osteochondral autograft transfer (OAT) is a useful technique for full-thickness cartilage lesions of the distal femur. Various techniques recommend harvesting a plug 2 mm longer than the recipient hole to allow for graft impaction. Grafts with limited compressibility may not sit flush when impacted. Purpose To compare the compressibility/shortening of OAT donor plug regions from the distal femur of human cadaveric knees after impaction. Study Design Controlled laboratory study. Methods A total of 20 cadaveric knees (mean age, 70.3 ± 8.4 years) were divided into 4 donor regions: medial intercondylar (IC) notch, lateral IC notch, medial trochlea, and lateral trochlea. Each region was subdivided into 4 zones: far superior (FSZ), middle superior (MSZ), middle inferior (MIZ), and far inferior (FIZ). A total of 320 grafts (6-mm diameter, 15-mm depth) were extracted, and a custom-built machine was used to strike the graft 5 times using a predetermined energy of 0.11 J. The graft length was measured initially and after each impact. Statistical analysis of the compressibility for each of the 4 regions and all 16 zones was performed utilizing analysis of variance, with post hoc testing using the Fisher's least significant difference. Results Compression in the lateral IC notch, medial IC notch, medial trochlea, and lateral trochlea was 2.4 ± 1.5, 2.1 ± 0.7, 3.1 ± 2.2, and 2.1 ± 0.6 mm, respectively, with significant differences between the 4 regions (P < .01) and the most compression in the medial trochlea (P < .01). Subgroup analysis showed that the lateral trochlea had higher compressibility for FIZ versus MIZ (P = .02) and the lateral IC notch had higher compressibility for FSZ versus FIZ and MIZ (P < .05 for both). Conclusion Compressibility varied between OAT donor sites in the distal femur. OAT donor grafts showed the highest compressibility in the medial trochlea (3.1 mm) and lateral IC notch FSZ (3.0 mm). Clinical Relevance The lateral trochlea, medial IC notch, and the lower zones of the lateral IC notch grafts should not be oversized more than 2 mm in length, as these grafts may not compress adequately.
Collapse
Affiliation(s)
- Patrick A. Massey
- Department of Orthopaedic Surgery, Louisiana State University,
Shreveport, Louisiana, USA.,Patrick A. Massey, MD, MBA, Department of Orthopaedic Surgery,
Louisiana State University, 1501 Kings Highway, Shreveport, LA 71103, USA
()
| | - Rachel Kushner
- Department of Orthopaedic Surgery, Louisiana State University,
Shreveport, Louisiana, USA
| | - Cole Miller
- School of Medicine, Louisiana State University, Shreveport,
Louisiana, USA
| | - Michael Lowery
- Department of Orthopaedic Surgery, Louisiana State University,
Shreveport, Louisiana, USA
| | - Richard S. Barton
- Department of Orthopaedic Surgery, Louisiana State University,
Shreveport, Louisiana, USA
| | - Giovanni F. Solitro
- Department of Orthopaedic Surgery, Louisiana State University,
Shreveport, Louisiana, USA
| |
Collapse
|
24
|
Gao J, Ren P, Gong H. Morphological and mechanical alterations in articular cartilage and subchondral bone during spontaneous hip osteoarthritis in guinea pigs. Front Bioeng Biotechnol 2023; 11:1080241. [PMID: 36756384 PMCID: PMC9900117 DOI: 10.3389/fbioe.2023.1080241] [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: 10/26/2022] [Accepted: 01/09/2023] [Indexed: 01/24/2023] Open
Abstract
Objectives: This study aimed to investigate the morphological and mechanical changes in articular cartilage and subchondral bone during spontaneous hip osteoarthritis in guinea pigs. Materials and methods: Hip joints of guinea pigs were investigated at 1, 3, 6, and 9 months of age (hereafter denoted as 1 M, 3 M, 6 M, and 9 M, respectively; n = 7 in each group). Morphological and mechanical alterations during spontaneous hip osteoarthritis in guinea pigs were investigated. The alterations included the micromechanical properties of articular cartilage (stiffness and creep deformation), microstructure of the subchondral bone (bone mineral density, bone volume fraction, trabecular thickness, trabecular number, and trabecular separation), micromorphology of the articular cartilage, and surface nanostructure (grain size and roughness) of the articular cartilage and subchondral bone. Results: Micromechanical properties of articular cartilage in 1 M showed the lowest stiffness and highest creep deformation with no significant differences in stiffness or creep deformation amongst 3 M, 6 M, and 9 M. Articular cartilage thickness decreased with age. The earliest degeneration of articular cartilage occurred at 6 months of age, characterised by surface unevenness and evident chondrocytes reduction in micromorphology, as well as increased grain size and decreased roughness in nanostructure. No degeneration at micro- or nanostructure of subchondral bone was observed before 9 months. Conclusion: Morphological degeneration of cartilage occurred before degeneration of mechanical properties. Meanwhile, degeneration of cartilage occurred before degeneration of subchondral bone during hip osteoarthritis. The current study provided novel insights into the structural and micromechanical interaction of hip osteoarthritis, which can serve as a theoretical basis for understanding the formation and progression of osteoarthritis.
Collapse
Affiliation(s)
- Jiazi Gao
- Department of Engineering Mechanics, Nanling Campus, Jilin University, Changchun, China
| | - Pengling Ren
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - He Gong
- Department of Engineering Mechanics, Nanling Campus, Jilin University, Changchun, China,*Correspondence: He Gong,
| |
Collapse
|
25
|
Pietryga K, Reczyńska-Kolman K, Reseland JE, Haugen H, Larreta-Garde V, Pamuła E. Biphasic monolithic osteochondral scaffolds obtained by diffusion-limited enzymatic mineralization of gellan gum hydrogel. Biocybern Biomed Eng 2023. [DOI: 10.1016/j.bbe.2022.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
|
26
|
Pastrama M, van Hees R, Stavenuiter I, Petterson NJ, Ito K, Lopata R, van Donkelaar CC. Characterization of intra-tissue strain fields in articular cartilage explants during post-loading recovery using high frequency ultrasound. J Biomech 2022; 145:111370. [PMID: 36375264 DOI: 10.1016/j.jbiomech.2022.111370] [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: 06/02/2022] [Revised: 10/02/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022]
Abstract
This study aims to demonstrate the potential of ultrasound elastography as a research tool for non-destructive imaging of intra-tissue strain fields and tissue quality assessment in cartilage explants. Osteochondral plugs from bovine patellae were loaded up to 10, 40, or 70 N using a hemi-spherical indenter. The load was kept constant for 15 min, after which samples were unloaded and ultrasound imaging of strain recovery over time was performed in the indented area for 1 h. Tissue strains were determined using speckle tracking and accumulated to LaGrangian strains in the indentation direction. For all samples, strain maps showed a heterogeneous strain field, with the highest values in the superficial cartilage under the indenter tip at the bottom of the indent and decreasing values in the deeper cartilage. Strains were higher at higher load levels and tissue recovery over time was faster after indentation at 10 N than at 40 N and 70 N. At lower compression levels most displacement occurred near the surface with little deformation in the deep layers, while at higher levels strains increased more evenly in all cartilage zones. Ultrasound elastography is a promising method for high resolution imaging of intra-tissue strain fields and evaluation of cartilage quality in tissue explants in a laboratory setting. In the future, it may become a clinical diagnostic tool used to identify the extent of cartilage damage around visible defects.
Collapse
Affiliation(s)
- Maria Pastrama
- Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, The Netherlands
| | - Roy van Hees
- Cardiovascular Biomechanics, Photoacoustics & Ultrasound Laboratory Eindhoven (PULS/e), Department of Biomedical Engineering, Eindhoven University of Technology, The Netherlands
| | - Isabel Stavenuiter
- Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, The Netherlands
| | - Niels J Petterson
- Cardiovascular Biomechanics, Photoacoustics & Ultrasound Laboratory Eindhoven (PULS/e), Department of Biomedical Engineering, Eindhoven University of Technology, The Netherlands
| | - Keita Ito
- Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, The Netherlands
| | - Richard Lopata
- Cardiovascular Biomechanics, Photoacoustics & Ultrasound Laboratory Eindhoven (PULS/e), Department of Biomedical Engineering, Eindhoven University of Technology, The Netherlands
| | - Corrinus C van Donkelaar
- Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, The Netherlands.
| |
Collapse
|
27
|
Pei S, Zhou Y, Li Y, Azar T, Wang W, Kim DG, Liu XS. Instrumented nanoindentation in musculoskeletal research. PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2022; 176:38-51. [PMID: 35660010 DOI: 10.1016/j.pbiomolbio.2022.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/24/2022] [Accepted: 05/31/2022] [Indexed: 06/15/2023]
Abstract
Musculoskeletal tissues, such as bone, cartilage, and muscle, are natural composite materials that are constructed with a hierarchical structure ranging from the cell to tissue level. The component differences and structural complexity, together, require comprehensive multiscale mechanical characterization. In this review, we focus on nanoindentation testing, which is used for nanometer to sub-micrometer length scale mechanical characterization. In the following context, we will summarize studies of nanoindentation in musculoskeletal research, examine the critical factors that affect nanoindentation testing results, and briefly summarize other commonly used techniques that can be conjoined with nanoindentation for synchronized imaging and colocalized characterization.
Collapse
Affiliation(s)
- Shaopeng Pei
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, United States
| | - Yilu Zhou
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, United States
| | - Yihan Li
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, United States
| | - Tala Azar
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, United States
| | - Wenzheng Wang
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, United States; Department of Orthopaedic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Do-Gyoon Kim
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH, 43210, USA
| | - X Sherry Liu
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, United States.
| |
Collapse
|
28
|
Kivijärvi T, Øyvind Goksøyr, Yassin MA, Jain S, Yamada S, Morales-López A, Mustafa K, Finne-Wistrand A. Hybrid material based on hyaluronan hydrogels and poly(l-lactide-co-1,3-trimethylene carbonate) scaffolds toward a cell-instructive microenvironment with long-term in vivo degradability. Mater Today Bio 2022; 17:100483. [DOI: 10.1016/j.mtbio.2022.100483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/14/2022] [Accepted: 10/29/2022] [Indexed: 11/16/2022] Open
|
29
|
Warren MR, Bajpayee AG. Modeling Electrostatic Charge Shielding Induced by Cationic Drug Carriers in Articular Cartilage Using Donnan Osmotic Theory. Bioelectricity 2022; 4:248-258. [PMID: 36644714 PMCID: PMC9811830 DOI: 10.1089/bioe.2021.0026] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Background Positively charged drug carriers are rapidly emerging as a viable solution for long-standing challenges in delivery to dense, avascular, negatively charged tissues. These cationic carriers have demonstrated especially strong promise in targeting drugs to articular cartilage for osteoarthritis (OA) treatment. It is critical to evaluate the dose-dependent effects of their high intratissue uptake levels on charge-shielding of anionic matrix constituents, and the resulting changes in tissue osmotic swelling and mechanical integrity. Materials and Methods We use the ideal Donnan osmotic theory to derive a model for predicting intracartilage swelling pressures as a function of net charge (z) and equilibrium uptake of short-length, arginine-rich, multivalent, cationic peptide carriers (cationic peptide carriers [CPCs], z varied from +8 to +20) in cartilage samples with varying arthritic severities and fixed charge density (FCD). We use this model to determine the dose-dependent influence of CPCs on both physiological osmotic swelling pressures and compressive electrostatic moduli of cartilage in healthy and arthritic states. Results Under physiological conditions, the Donnan model predicted carrier-induced reductions in free swelling pressure between 8 and 29 kPa, and diminished compressive modulus by 20-68 kPa, both dependent on the net charge and uptake of CPCs. The magnitudes of deswelling and stiffness reduction increased monotonically with carrier uptake and net charge. Furthermore, predicted levels of deswelling by CPC charge shielding were amplified in tissues with reduced FCD (which model OA). Finally, the Donnan model predicted markedly higher reductions in tissue compressive modulus in hypotonic bathing salinity compared with physiological and hypertonic conditions. Conclusion This analysis demonstrates the importance of considering charge shielding as a likely adverse effect associated with uptake of cationic drug carriers into negatively charged tissues, especially in the case of damaged tissue. The simple modeling approach and principles described herein can inform the design of cationic drug delivery carriers and their clinical treatment regimens.
Collapse
Affiliation(s)
- Matthew R. Warren
- Department of Bioengineering and Northeastern University, Boston, Massachusetts, USA
| | - Ambika G. Bajpayee
- Department of Bioengineering and Northeastern University, Boston, Massachusetts, USA
- Department of Mechanical Engineering, Northeastern University, Boston, Massachusetts, USA
| |
Collapse
|
30
|
Jung M, Ghamrawi S, Du EY, Gooding JJ, Kavallaris M. Advances in 3D Bioprinting for Cancer Biology and Precision Medicine: From Matrix Design to Application. Adv Healthc Mater 2022; 11:e2200690. [PMID: 35866252 DOI: 10.1002/adhm.202200690] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/08/2022] [Indexed: 01/28/2023]
Abstract
The tumor microenvironment is highly complex owing to its heterogeneous composition and dynamic nature. This makes tumors difficult to replicate using traditional 2D cell culture models that are frequently used for studying tumor biology and drug screening. This often leads to poor translation of results between in vitro and in vivo and is reflected in the extremely low success rates of new candidate drugs delivered to the clinic. Therefore, there has been intense interest in developing 3D tumor models in the laboratory that are representative of the in vivo tumor microenvironment and patient samples. 3D bioprinting is an emerging technology that enables the biofabrication of structures with the virtue of providing accurate control over distribution of cells, biological molecules, and matrix scaffolding. This technology has the potential to bridge the gap between in vitro and in vivo by closely recapitulating the tumor microenvironment. Here, a brief overview of the tumor microenvironment is provided and key considerations in biofabrication of tumor models are discussed. Bioprinting techniques and choice of bioinks for both natural and synthetic polymers are also outlined. Lastly, current bioprinted tumor models are reviewed and the perspectives of how clinical applications can greatly benefit from 3D bioprinting technologies are offered.
Collapse
Affiliation(s)
- MoonSun Jung
- Children's Cancer Institute, Lowy Cancer Research Center, UNSW Sydney, Sydney, NSW, 2052, Australia.,Australian Centre for NanoMedicine, UNSW Sydney, Sydney, NSW, 2052, Australia.,School of Clinical Medicine, UNSW Medicine & Health, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - Sarah Ghamrawi
- Children's Cancer Institute, Lowy Cancer Research Center, UNSW Sydney, Sydney, NSW, 2052, Australia.,Australian Centre for NanoMedicine, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - Eric Y Du
- Australian Centre for NanoMedicine, UNSW Sydney, Sydney, NSW, 2052, Australia.,School of Chemistry, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - J Justin Gooding
- Australian Centre for NanoMedicine, UNSW Sydney, Sydney, NSW, 2052, Australia.,School of Chemistry, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - Maria Kavallaris
- Children's Cancer Institute, Lowy Cancer Research Center, UNSW Sydney, Sydney, NSW, 2052, Australia.,Australian Centre for NanoMedicine, UNSW Sydney, Sydney, NSW, 2052, Australia.,School of Clinical Medicine, UNSW Medicine & Health, UNSW Sydney, Sydney, NSW, 2052, Australia
| |
Collapse
|
31
|
Fan M, Wang C, Kwok B, Kahle ER, He L, Lucas Lu X, Mauck RL, Han L. Impacts of aging on murine cartilage biomechanics and chondrocyte in situ calcium signaling. J Biomech 2022; 144:111336. [PMID: 36240656 PMCID: PMC9641638 DOI: 10.1016/j.jbiomech.2022.111336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/19/2022] [Accepted: 09/26/2022] [Indexed: 11/17/2022]
Abstract
Aging is the most prominent risk factor for osteoarthritis onset, but the etiology of aging-associated cartilage degeneration is not fully understood. Recent studies by Guilak and colleagues have highlighted the crucial roles of cell-matrix interactions in cartilage homeostasis and disease. This study thus quantified aging-associated changes in cartilage biomechanics and chondrocyte intracellular calcium signaling, [Ca2+]i, activities in wild-type mice at 3, 12 and 22 months of age. In aged mice, articular cartilage exhibits reduced staining of sulfated glycosaminoglycans (sGAGs), indicating decreased aggrecan content. On cartilage surface, collagen fibrils undergo significant thickening while retaining their transverse isotropic architecture, and exhibit signs of fibril crimping in the 22-month group. These compositional and structural changes contribute to a significant decrease in cartilage modulus at 22 months of age (0.55 ± 0.25 MPa, mean ± 95 % CI, n = 8) relative to those at 3 and 12 months (1.82 ± 0.48 MPa and 1.45 ± 0.46 MPa, respectively, n ≥ 8). Despite the decreases in sGAG content and tissue modulus, chondrocytes do not exhibit significantly demoted [Ca2+]i activities in situ, in both physiological (isotonic) and osmotically instigated (hypo- and hypertonic) conditions. At 12 months of age, there exists a sub-population of chondrocytes with hyper-active [Ca2+]i responses under hypotonic stimuli, possibly indicating a phenotypic shift of chondrocytes during aging. Together, these results yield new insights into aging-associated biomechanical and mechanobiological changes of murine cartilage, providing a benchmark for elucidating the molecular mechanisms of age-related changes in cell-matrix interactions.
Collapse
Affiliation(s)
- Mingyue Fan
- School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA 19104, United States
| | - Chao Wang
- School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA 19104, United States
| | - Bryan Kwok
- School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA 19104, United States
| | - Elizabeth R Kahle
- School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA 19104, United States
| | - Lan He
- School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA 19104, United States
| | - X Lucas Lu
- Department of Mechanical Engineering, University of Delaware, Newark, DE 19716, United States
| | - Robert L Mauck
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States; Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz Veterans Administration Medical Center, Philadelphia, PA 19104, United States
| | - Lin Han
- School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA 19104, United States.
| |
Collapse
|
32
|
Pan RL, Martyniak K, Karimzadeh M, Gelikman DG, DeVries J, Sutter K, Coathup M, Razavi M, Sawh-Martinez R, Kean TJ. Systematic review on the application of 3D-bioprinting technology in orthoregeneration: current achievements and open challenges. J Exp Orthop 2022; 9:95. [PMID: 36121526 PMCID: PMC9485345 DOI: 10.1186/s40634-022-00518-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 08/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Joint degeneration and large or complex bone defects are a significant source of morbidity and diminished quality of life worldwide. There is an unmet need for a functional implant with near-native biomechanical properties. The potential for their generation using 3D bioprinting (3DBP)-based tissue engineering methods was assessed. We systematically reviewed the current state of 3DBP in orthoregeneration. METHODS This review was performed using PubMed and Web of Science. Primary research articles reporting 3DBP of cartilage, bone, vasculature, and their osteochondral and vascular bone composites were considered. Full text English articles were analyzed. RESULTS Over 1300 studies were retrieved, after removing duplicates, 1046 studies remained. After inclusion and exclusion criteria were applied, 114 articles were analyzed fully. Bioink material types and combinations were tallied. Cell types and testing methods were also analyzed. Nearly all papers determined the effect of 3DBP on cell survival. Bioink material physical characterization using gelation and rheology, and construct biomechanics were performed. In vitro testing methods assessed biochemistry, markers of extracellular matrix production and/or cell differentiation into respective lineages. In vivo proof-of-concept studies included full-thickness bone and joint defects as well as subcutaneous implantation in rodents followed by histological and µCT analyses to demonstrate implant growth and integration into surrounding native tissues. CONCLUSIONS Despite its relative infancy, 3DBP is making an impact in joint and bone engineering. Several groups have demonstrated preclinical efficacy of mechanically robust constructs which integrate into articular joint defects in small animals. However, notable obstacles remain. Notably, researchers encountered pitfalls in scaling up constructs and establishing implant function and viability in long term animal models. Further, to translate from the laboratory to the clinic, standardized quality control metrics such as construct stiffness and graft integration metrics should be established with investigator consensus. While there is much work to be done, 3DBP implants have great potential to treat degenerative joint diseases and provide benefit to patients globally.
Collapse
Affiliation(s)
- Rachel L Pan
- College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Kari Martyniak
- Biionix Cluster, College of Medicine, University of Central Florida, 6900 Lake Nona Blvd, Orlando, FL, 32827, USA
| | - Makan Karimzadeh
- Biionix Cluster, College of Medicine, University of Central Florida, 6900 Lake Nona Blvd, Orlando, FL, 32827, USA
| | - David G Gelikman
- College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Jonathan DeVries
- College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Kelly Sutter
- College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Melanie Coathup
- Biionix Cluster, College of Medicine, University of Central Florida, 6900 Lake Nona Blvd, Orlando, FL, 32827, USA
| | - Mehdi Razavi
- Biionix Cluster, College of Medicine, University of Central Florida, 6900 Lake Nona Blvd, Orlando, FL, 32827, USA
| | - Rajendra Sawh-Martinez
- College of Medicine, University of Central Florida, Orlando, FL, USA.,Plastic and Reconstructive Surgery, AdventHealth, Orlando, FL, USA
| | - Thomas J Kean
- Biionix Cluster, College of Medicine, University of Central Florida, 6900 Lake Nona Blvd, Orlando, FL, 32827, USA.
| |
Collapse
|
33
|
Wang F, Metzner F, Zheng L, Osterhoff G, Schleifenbaum S. Selected mechanical properties of human cancellous bone subjected to different treatments: short-term immersion in physiological saline and acetone treatment with subsequent immersion in physiological saline. J Orthop Surg Res 2022; 17:376. [PMID: 35933396 PMCID: PMC9357305 DOI: 10.1186/s13018-022-03265-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 07/22/2022] [Indexed: 11/10/2022] Open
Abstract
Background Physiological saline (0.9% NaCl) and acetone are extensively used for storage (as well as hydration) and removal of bone marrow, respectively, of cancellous bone during preparation and mechanical testing. Our study aimed to investigate the mechanical properties of cancellous bone subjected to short-term immersion in saline and acetone treatment with subsequent immersion in saline. Methods Cylindrical samples (Ø6 × 12 mm) were harvested from three positions (left, middle, and right) of 1 thoracic vertebral body, 19 lumbar vertebral bodies, and 5 sacral bones, as well as from 9 femoral heads. All samples were divided into two groups according to the different treatments, (i) samples from the left and middle sides were immersed in saline at 4℃ for 43 h (saline-immersed group, n = 48); (ii) samples from the respective right side were treated with a combination of acetone and ultrasonic bath (4 h), air-dried at room temperature (21℃, 15 h), and then immersed in saline at room temperature (21℃, 24 h) (acetone and saline-treated group, n = 38). All samples were subjected, both before and after treatment, to a non-destructive compression test with a strain of 0.45%, and finally destructive tests with a strain of 50%. Actual density (ρact), initial modulus (E0), maximum stress (σmax), energy absorption (W), and plateau stress (σp) were calculated as evaluation indicators. Results Based on visual observation, a combination of acetone and ultrasonic bath for 4 h failed to completely remove bone marrow from cancellous bone samples. The mean values of ρact, σmax, W, and σp were significantly higher in the femoral head than in the spine. There was no significant difference in E0 between non-treated and saline-immersed samples (non-treated 63.98 ± 20.23 vs. saline-immersed 66.29 ± 20.61, p = 0.132). The average E0 of acetone and saline-treated samples was significantly higher than that of non-treated ones (non-treated 62.17 ± 21.08 vs. acetone and saline-treated 74.97 ± 23.98, p = 0.043). Conclusion Short-term storage in physiological saline is an appropriate choice and has no effect on the E0 of cancellous bone. Treatment of cancellous bone with acetone resulted in changes in mechanical properties that could not be reversed by subsequent immersion in physiological saline. Supplementary Information The online version contains supplementary material available at 10.1186/s13018-022-03265-4.
Collapse
Affiliation(s)
- Fangxing Wang
- ZESBO - Center for Research on Musculoskeletal Systems, Department of Orthopedic Surgery, Traumatology and Plastic Surgery, Leipzig University, Semmelweisstraße 14, 04103, Leipzig, Germany. .,Department of Orthopedic Surgery, Traumatology and Plastic Surgery, Leipzig University, Liebigstraße. 20 Haus 4, 04103, Leipzig, Germany.
| | - Florian Metzner
- ZESBO - Center for Research on Musculoskeletal Systems, Department of Orthopedic Surgery, Traumatology and Plastic Surgery, Leipzig University, Semmelweisstraße 14, 04103, Leipzig, Germany.,Department of Orthopedic Surgery, Traumatology and Plastic Surgery, Leipzig University, Liebigstraße. 20 Haus 4, 04103, Leipzig, Germany
| | - Leyu Zheng
- Department of Orthopedic Surgery, Traumatology and Plastic Surgery, Leipzig University, Liebigstraße. 20 Haus 4, 04103, Leipzig, Germany
| | - Georg Osterhoff
- Department of Orthopedic Surgery, Traumatology and Plastic Surgery, Leipzig University, Liebigstraße. 20 Haus 4, 04103, Leipzig, Germany
| | - Stefan Schleifenbaum
- ZESBO - Center for Research on Musculoskeletal Systems, Department of Orthopedic Surgery, Traumatology and Plastic Surgery, Leipzig University, Semmelweisstraße 14, 04103, Leipzig, Germany.,Department of Orthopedic Surgery, Traumatology and Plastic Surgery, Leipzig University, Liebigstraße. 20 Haus 4, 04103, Leipzig, Germany
| |
Collapse
|
34
|
Bao Z, Chen M, Li C, Shan Q, Wang Y, Yang W. Monosodium iodoacetate-induced subchondral bone microstructure and inflammatory changes in an animal model of osteoarthritis. Open Life Sci 2022; 17:781-793. [PMID: 35903181 PMCID: PMC9287849 DOI: 10.1515/biol-2022-0079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 04/02/2022] [Accepted: 04/21/2022] [Indexed: 11/15/2022] Open
Abstract
The monosodium iodoacetate (MIA)-induced osteoarthritis (OA) may lead to cartilage degeneration and histopathological lesions. However, the correlation between inflammatory reaction and subchondral bone remodeling in a rodent osteoarthritic model is ambiguous. In this study, intra-articular injection of MIA was performed in 36 four-week-old specific pathogen-free male Wistar rats to induce OA. After 4 weeks of intervention, changes in intrinsic structural properties of the subchondral bones were measured, and the histological evaluation, as well as biochemical analysis, was conducted. We found that intra-articular injection of MIA increased chondrocyte apoptosis and promoted cartilage matrix degradation, such as cartilage surface defects and shallow or disappearing staining. MIA also induced inflammation, improved the expression of IL-1β, TNF-α, and matrix metalloproteinase, and decreased the expression of cartilage-specific proteins with the extension of modeling time. Meanwhile, the MIA also significantly accelerated the subchondral bone remodeling, as shown by the decreased subchondral bone density, thinning of trabeculae, disordered cartilage structure, and morphology. In conclusion, we have shown that MIA-induced rodent osteoarthritic model would cause decreased subchondral bone density, sparse trabecular bone, and other manifestations of osteoporosis accompanied by an inflammatory response, which would worsen with the progression of modeling time. Our results suggest that different phases of MIA-induced OA are associated with the changes in subchondral bone microstructure and the progression of local inflammation.
Collapse
Affiliation(s)
- Zheming Bao
- Department of Pharmacy, Medical Supplies Centre of PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, China
- Orthopedics Department, 960th Hospital of PLA Joint Service Support Force, Jinan, China
| | - Mengli Chen
- Department of Pharmacy, Medical Supplies Centre of PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, China
| | - Chen Li
- Department of Pharmacy, Medical Supplies Centre of PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, China
| | - Qing Shan
- Department of Pharmacy, Medical Supplies Centre of PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, China
| | - Yichen Wang
- Department of Pharmacy, Medical Supplies Centre of PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, China
| | - Wenshan Yang
- Department of Pharmacy, Medical Supplies Centre of PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, China
| |
Collapse
|
35
|
Karim A, Bajbouj K, Qaisar R, Hall AC, Hamad M. The role of disrupted iron homeostasis in the development and progression of arthropathy. J Orthop Res 2022; 40:1243-1250. [PMID: 35289955 DOI: 10.1002/jor.25323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 03/13/2022] [Indexed: 02/04/2023]
Abstract
Arthropathy or joint disease leads to significant pain and disability irrespective of etiology. Clinical and experimental evidence point to the presence of considerable links between arthropathy and iron overload. Previous work has suggested that iron accumulation in the joints is often associated with increased oxidative stress, disrupted matrix metabolism, and cartilage degeneration. However, key issues regarding the role of iron overload in the pathogenesis of arthropathy remain ambiguous. For example, significant gaps in our knowledge of the primary cellular targets of iron overload-induced damage and the exact molecular mechanism through which disrupted iron homeostasis leads to joint damage still exist. The exact signaling pathway that links iron metabolism and cellular damage in arthropathy also remains largely unmapped. In this review, we focus on the relationship between iron overload and arthropathy with special emphasis on the adversarial relationship between iron that accumulates in the joints over time and cartilage homeostasis. A better understanding of the mechanisms and pathways underlying iron-induced cartilage degeneration may help in defining new prognostic markers and therapeutic targets in arthropathy.
Collapse
Affiliation(s)
- Asima Karim
- Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Khuloud Bajbouj
- Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Rizwan Qaisar
- Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Andrew C Hall
- Centre for Discovery Brain Sciences, Edinburgh Medical School: Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, Scotland, UK
| | - Mawieh Hamad
- Department of Medical Laboratory Sciences, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| |
Collapse
|
36
|
Bielajew BJ, Donahue RP, Lamkin EK, Hu JC, Hascall VC, Athanasiou KA. Proteomic, mechanical, and biochemical characterization of cartilage development. Acta Biomater 2022; 143:52-62. [PMID: 35235865 DOI: 10.1016/j.actbio.2022.02.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/04/2022] [Accepted: 02/23/2022] [Indexed: 01/06/2023]
Abstract
The objective of this work is to examine the development of porcine cartilage by analyzing its mechanical properties, biochemical content, and proteomics at different developmental stages. Cartilage from the knees of fetal, neonatal, juvenile, and mature pigs was analyzed using histology, mechanical testing, biochemical assays, fluorophore-assisted carbohydrate electrophoresis, and bottom-up proteomics. Mature cartilage has 2.2-times the collagen per dry weight of fetal cartilage, and fetal cartilage has 2.1-times and 17.9-times the glycosaminoglycan and DNA per dry weight of mature cartilage, respectively. Tensile and compressive properties peak in the juvenile stage, with a tensile modulus 4.7-times that of neonatal. Proteomics analysis reveals increases in collagen types II and III, while collagen types IX, XI, and XIV, and aggrecan decrease with age. For example, collagen types IX and XI decrease 9.4-times and 5.1-times, respectively from fetal to mature. Mechanical and biochemical measurements have their greatest developmental changes between the neonatal and juvenile stages, where mechanotransduction plays a major role. Bottom-up proteomics serves as a powerful tool for tissue characterization, showing results beyond those of routine biochemical analysis. For example, proteomic analysis shows significant drops in collagen types IX, XI, and XIV throughout development, which shows insight into the permanence of cartilage's matrix. Changes in overall glycosaminoglycan content compared to aggrecan and link protein indicate non-enzymatic degradation of aggrecan structures or hyaluronan in mature cartilage. In addition to tissue characterization, bottom-up proteomics techniques are critical in tissue engineering efforts toward repair or regeneration of cartilage in animal models. STATEMENT OF SIGNIFICANCE: In this study, the development of porcine articular cartilage is interrogated through biomechanical, biochemical, and proteomic techniques, to determine how mechanics and extracellular matrix composition change from fetal to mature cartilage. For the first time, a bottom-up proteomics approach is used to reveal a wide variety of protein changes through aging; for example, the collagen subtype composition of the cartilage increases in collagen types II and III, and decreases in collagen types IX, XI, and XIV. This analysis shows that bottom-up proteomics is a critical tool in tissue characterization, especially toward developing a deeper understanding of matrix composition and development in tissue engineering studies.
Collapse
|
37
|
Boon-In S, Theerasilp M, Crespy D. Marrying the incompatible for better: Incorporation of hydrophobic payloads in superhydrophilic hydrogels. J Colloid Interface Sci 2022; 622:75-86. [PMID: 35489103 DOI: 10.1016/j.jcis.2022.04.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 04/04/2022] [Accepted: 04/05/2022] [Indexed: 01/31/2023]
Abstract
HYPOTHESIS The entrapment of lyophobic in superhydrophilic hydrogels is challenging because of the intrinsic incompatibility between hydrophobic and hydrophilic molecules. To achieve such entrapment without affecting the hydrogel's formation, the electrospinning of nanodroplets or nanoparticles with a water-soluble polymer could reduce the incompatibility through the reduction of interfacial tension and the formation of a barrier film preventing coalescence or aggregation. EXPERIMENTS Nanodroplets or nanoparticles dispersion are electrospun in the presence of a hydrophilic polymer in hydrogel precursors. The dissolution of the hydrophilic nanofibers during electrospinning allows a redispersion of emulsion droplets and nanoparticles in the hydrogel's matrix. FINDINGS Superhydrophilic hydrogels with well-distributed hydrophobic nanodroplets or nanoparticles are obtained without detrimentally imparting the viscosity of hydrogel's precursors and the mechanical properties of the hydrogels. Compared with the incorporation of droplets without electrospinning, higher loadings of hydrophobic payload are achieved without premature leakage. This concept can be used to entrap hydrophobic agrochemicals, drugs, or antibacterial agents in simple hydrogels formulation.
Collapse
Affiliation(s)
- Supissra Boon-In
- Department of Materials Science and Engineering, School of Molecular Science and Engineering, Vidyasirimedhi Institute of Science and Technology (VISTEC), Rayong 21210, Thailand.
| | - Man Theerasilp
- Department of Materials Science and Engineering, School of Molecular Science and Engineering, Vidyasirimedhi Institute of Science and Technology (VISTEC), Rayong 21210, Thailand.
| | - Daniel Crespy
- Department of Materials Science and Engineering, School of Molecular Science and Engineering, Vidyasirimedhi Institute of Science and Technology (VISTEC), Rayong 21210, Thailand.
| |
Collapse
|
38
|
Klimek K, Benko A, Vandrovcova M, Travnickova M, Douglas TEL, Tarczynska M, Broz A, Gaweda K, Ginalska G, Bacakova L. Biomimetic biphasic curdlan-based scaffold for osteochondral tissue engineering applications - Characterization and preliminary evaluation of mesenchymal stem cell response in vitro. BIOMATERIALS ADVANCES 2022; 135:212724. [PMID: 35929204 DOI: 10.1016/j.bioadv.2022.212724] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 02/15/2022] [Accepted: 02/18/2022] [Indexed: 06/15/2023]
Abstract
Osteochondral defects remain a huge problem in medicine today. Biomimetic bi- or multi-phasic scaffolds constitute a very promising alternative to osteochondral autografts and allografts. In this study, a new curdlan-based scaffold was designed for osteochondral tissue engineering applications. To achieve biomimetic properties, it was enriched with a protein component - whey protein isolate as well as a ceramic ingredient - hydroxyapatite granules. The scaffold was fabricated via a simple and cost-efficient method, which represents a significant advantage. Importantly, this technique allowed generation of a scaffold with two distinct, but integrated phases. Scanning electron microcopy and optical profilometry observations demonstrated that phases of biomaterial possessed different structural properties. The top layer of the biomaterial (mimicking the cartilage) was smoother than the bottom one (mimicking the subchondral bone), which is beneficial from a biological point of view because unlike bone, cartilage is a smooth tissue. Moreover, mechanical testing showed that the top layer of the biomaterial had mechanical properties close to those of natural cartilage. Although the mechanical properties of the bottom layer of scaffold were lower than those of the subchondral bone, it was still higher than in many analogous systems. Most importantly, cell culture experiments indicated that the biomaterial possessed high cytocompatibility towards adipose tissue-derived mesenchymal stem cells and bone marrow-derived mesenchymal stem cells in vitro. Both phases of the scaffold enhanced cell adhesion, proliferation, and chondrogenic differentiation of stem cells (revealing its chondroinductive properties in vitro) as well as osteogenic differentiation of these cells (revealing its osteoinductive properties in vitro). Given all features of the novel curdlan-based scaffold, it is worth noting that it may be considered as promising candidate for osteochondral tissue engineering applications.
Collapse
Affiliation(s)
- Katarzyna Klimek
- Medical University of Lublin, Chair and Department of Biochemistry and Biotechnology, Chodzki 1 Street, 20-093 Lublin, Poland.
| | - Aleksandra Benko
- AGH University of Science and Technology, Faculty of Materials Science and Ceramics, 30 A. Mickiewicza Av., 30-059 Krakow, Poland
| | - Marta Vandrovcova
- Institute of Physiology of the Czech Academy of Sciences, Laboratory of Biomaterials and Tissue Engineering, Videnska 1083 Street, 14220 Prague, Czech Republic
| | - Martina Travnickova
- Institute of Physiology of the Czech Academy of Sciences, Laboratory of Biomaterials and Tissue Engineering, Videnska 1083 Street, 14220 Prague, Czech Republic
| | - Timothy E L Douglas
- Engineering Department, Lancaster University, Gillow Avenue, LA1 4YW Lancaster, United Kingdom; Materials Science Institute (MSI), Lancaster University, Lancaster, United Kingdom
| | - Marta Tarczynska
- Medical University of Lublin, Department and Clinic of Orthopaedics and Traumatology, Jaczewskiego 8 Street, 20-090 Lublin, Poland
| | - Antonin Broz
- Institute of Physiology of the Czech Academy of Sciences, Laboratory of Biomaterials and Tissue Engineering, Videnska 1083 Street, 14220 Prague, Czech Republic
| | - Krzysztof Gaweda
- Medical University of Lublin, Department and Clinic of Orthopaedics and Traumatology, Jaczewskiego 8 Street, 20-090 Lublin, Poland
| | - Grazyna Ginalska
- Medical University of Lublin, Chair and Department of Biochemistry and Biotechnology, Chodzki 1 Street, 20-093 Lublin, Poland
| | - Lucie Bacakova
- Institute of Physiology of the Czech Academy of Sciences, Laboratory of Biomaterials and Tissue Engineering, Videnska 1083 Street, 14220 Prague, Czech Republic
| |
Collapse
|
39
|
Batool S, Hammami M, Mantebea H, Badar F, Xia Y. Location-Specific Study of Young Rabbit Femoral Cartilage by Quantitative µMRI and Polarized Light Microscopy. Cartilage 2022; 13:19476035221085143. [PMID: 35306861 PMCID: PMC9137317 DOI: 10.1177/19476035221085143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Microscopic magnetic resonance imaging (µMRI) and polarized light microscopy (PLM) are used to characterize the structural variations at different anatomical locations of femoral cartilage in young rabbits (12-14 weeks old). DESIGN Four intact knees were imaged by µMRI at 86 µm resolution. Three small cartilage-bone specimens were harvested from each of 2 femoral medial condyles and imaged by quantitative µMRI (T2 anisotropy) at 9.75 µm resolution (N = 6). These specimens, as well as the other 2 intact femoral condyles, were used for histology and imaged by quantitative PLM (retardation and angle) at 0.25 µm to 4 µm resolutions. RESULTS Quantitative MRI relaxation data and PLM fibril data revealed collaboratively distinct topographical variations in both cartilage thickness and its collagen organization in the juvenile joint. Cartilage characteristics from the central location have a 3-zone arcade-like fibril structure and a distinct magic angle effect, commonly seen in mature articular cartilage, while cartilage at the anterior location lacks these characteristics. Overall, the lowest retardation values and isotropic T2 values have been found in the distal femur (trochlear ridge), with predominant parallel fibers with respect to the articular surface. Central cartilage is the thickest (~550 µm), approximately twice as thick as the anterior and posterior locations. CONCLUSION Distinctly different characteristics of tissue properties were found in cartilage at different topographical locations on femoral condyle in rabbits. Knowledge of location-specific structural differences in the collagen network over the joint surface can improve the understanding of local mechanobiology and provide insights to tissue engineering and degradation repairs.
Collapse
Affiliation(s)
- Syeda Batool
- Department of Physics, Center for Biomedical Research, Oakland University, Rochester, MI, USA
| | - Mouhamad Hammami
- Department of Physics, Center for Biomedical Research, Oakland University, Rochester, MI, USA
| | - Hannah Mantebea
- Department of Physics, Center for Biomedical Research, Oakland University, Rochester, MI, USA
| | - Farid Badar
- Department of Physics, Center for Biomedical Research, Oakland University, Rochester, MI, USA
| | - Yang Xia
- Department of Physics, Center for Biomedical Research, Oakland University, Rochester, MI, USA,Yang Xia, Department of Physics, Center for Biomedical Research, Oakland University, 244 Meadow Brook Road, Rochester, MI 48309, USA.
| |
Collapse
|
40
|
Piezoelectric Electrospun Fibrous Scaffolds for Bone, Articular Cartilage and Osteochondral Tissue Engineering. Int J Mol Sci 2022; 23:ijms23062907. [PMID: 35328328 PMCID: PMC8952277 DOI: 10.3390/ijms23062907] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/26/2022] [Accepted: 03/02/2022] [Indexed: 01/15/2023] Open
Abstract
Osteochondral tissue (OCT) related diseases, particularly osteoarthritis, number among the most prevalent in the adult population worldwide. However, no satisfactory clinical treatments have been developed to date to resolve this unmet medical issue. Osteochondral tissue engineering (OCTE) strategies involving the fabrication of OCT-mimicking scaffold structures capable of replacing damaged tissue and promoting its regeneration are currently under development. While the piezoelectric properties of the OCT have been extensively reported in different studies, they keep being neglected in the design of novel OCT scaffolds, which focus primarily on the tissue’s structural and mechanical properties. Given the promising potential of piezoelectric electrospun scaffolds capable of both recapitulating the piezoelectric nature of the tissue’s fibrous ECM and of providing a platform for electrical and mechanical stimulation to promote the regeneration of damaged OCT, the present review aims to examine the current state of the art of these electroactive smart scaffolds in OCTE strategies. A summary of the piezoelectric properties of the different regions of the OCT and an overview of the main piezoelectric biomaterials applied in OCTE applications are presented. Some recent examples of piezoelectric electrospun scaffolds developed for potentially replacing damaged OCT as well as for the bone or articular cartilage segments of this interfacial tissue are summarized. Finally, the current challenges and future perspectives concerning the use of piezoelectric electrospun scaffolds in OCT regeneration are discussed.
Collapse
|
41
|
The synthetic artificial stem cell (SASC): Shifting the paradigm of cell therapy in regenerative engineering. Proc Natl Acad Sci U S A 2022; 119:2116865118. [PMID: 34987101 PMCID: PMC8764679 DOI: 10.1073/pnas.2116865118] [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] [Accepted: 11/22/2021] [Indexed: 12/14/2022] Open
Abstract
This paper presents the synthetic artificial stem cell (SASC) system: a versatile therapy which provides the ability to tailor paracrine responses of different cells and provide a more potent regenerative effect for targeted tissues. Upon challenging the SASC system against an osteoarthritis model, we demonstrate that the factors combined tailored for chondrogenesis have a potent antiinflammatory and chondroprotective effect. This paper also demonstrates the in vivo capacity of SASC to attenuate proteoglycan depletion in the cartilage extracellular matrix while also improving biomechanical properties of the resulting cartilage. We report the first of many applications of the SASC system, which provides a promising step toward clinical translation of a minimally immunogenic stem cell with many commercial advantages over its biological counterpart. Stem cells are of great interest in tissue regeneration due to their ability to modulate the local microenvironment by secreting bioactive factors (collectively, secretome). However, secretome delivery through conditioned media still requires time-consuming cell isolation and maintenance and also may contain factors antagonistic to targeted tissue regeneration. We have therefore engineered a synthetic artificial stem cell (SASC) system which mimics the paracrine effect of the stem cell secretome and provides tailorability of the composition for targeted tissue regeneration. We report the first of many applications of the SASC system we have formulated to treat osteoarthritis (OA). Choosing growth factors important to chondrogenesis and encapsulating respective recombinant proteins in poly (lactic-coglycolic acid) 85:15 (PLGA) we fabricated the SASC system. We compared the antiinflammatory and chondroprotective effects of SASC to that of adipose-derived stem cells (ADSCs) using in vitro interleukin 1B-induced and in vivo collagenase-induced osteoarthritis rodent models. We have designed SASC as an injectable therapy with controlled release of the formulated secretome. In vitro, SASC showed significant antiinflammatory and chondroprotective effects as seen by the up-regulation of SOX9 and reduction of nitric oxide, ADAMTS5, and PRG4 genes compared to ADSCs. In vivo, treatment with SASC and ADSCs significantly attenuated cartilage degeneration and improved the biomechanical properties of the articular cartilage in comparison to OA control. This SASC system demonstrates the feasibility of developing a completely synthetic, tailorable stem cell secretome which reinforces the possibility of developing a new therapeutic strategy that provides better control over targeted tissue engineering applications.
Collapse
|
42
|
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.
Collapse
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
| |
Collapse
|
43
|
Ashmeik W, Baal JD, Foreman SC, Joseph GB, Bahroos E, Han M, Krug R, Link TM. Investigating the Association of Metabolic Biomarkers With Knee Cartilage Composition and Structural Abnormalities Using MRI: A Pilot Study. Cartilage 2021; 13:630S-638S. [PMID: 32757831 PMCID: PMC8808851 DOI: 10.1177/1947603520946376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The goal of this study was to explore the metabolic syndrome-associated phenotype of osteoarthritis by investigating the cross-sectional associations of glycemic markers and serum lipids with knee cartilage composition and structural abnormalities in middle-aged adults. DESIGN Twenty participants between 40 to 70 years of age with Kellgren-Lawrence score 0-1 in at least one knee were recruited at a single center. Knee cartilage composition was assessed using 3.0 T cartilage T2 and T1ρ mapping. Evaluation of structural knee abnormalities was performed using the modified Whole-Organ Magnetic Resonance Imaging Score (WORMS). Linear regression was used to assess the associations of standardized fasting glucose (FG), hemoglobin A1c (HbA1c), insulin, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), non-HDL cholesterol, and triglycerides with cartilage T2 and T1ρ as well as WORMS subscores, adjusting for body mass index. RESULTS Higher FG and higher HbA1c were associated with higher WORMS meniscus sum (beta coefficient 1.31 [95% confidence interval (CI): 0.57, 2.05], P = 0.002 per standard deviation [SD] increase in FG; beta coefficient 0.90 [95% CI: 0.07, 1.73], P = 0.035 per SD increase in HbA1c). Also, higher total cholesterol and higher non-HDL cholesterol were associated with higher WORMS cartilage sum (beta coefficient 0.94 [95% CI: 0.01, 1.86], P = 0.048 per SD increase in total cholesterol; beta coefficient 1.05 [95% CI: 0.14, 1.96], P = 0.03 per SD increase in non-HDL cholesterol). CONCLUSIONS Higher FG and HbA1c were associated with increased meniscal degeneration while higher total and non-HDL cholesterol were associated with increased cartilage degeneration.
Collapse
Affiliation(s)
- Walid Ashmeik
- Department of Radiology and Biomedical
Imaging, University of California San Francisco, San Francisco, CA, USA,Walid Ashmeik, Department of Radiology and
Biomedical Imaging, University of California, San Francisco, 185 Berry Street,
Suite 350, San Francisco, CA 94107, USA.
| | - Joe D. Baal
- Department of Radiology and Biomedical
Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Sarah C. Foreman
- Department of Radiology and Biomedical
Imaging, University of California San Francisco, San Francisco, CA, USA,Department of Radiology, Klinikum Rechts
der Isar, Technische Universität München, Munich, Germany
| | - Gabby B. Joseph
- Department of Radiology and Biomedical
Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Emma Bahroos
- Department of Radiology and Biomedical
Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Misung Han
- Department of Radiology and Biomedical
Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Roland Krug
- Department of Radiology and Biomedical
Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Thomas M. Link
- Department of Radiology and Biomedical
Imaging, University of California San Francisco, San Francisco, CA, USA
| |
Collapse
|
44
|
Kabir W, Di Bella C, Choong PF, O’Connell CD. Assessment of Native Human Articular Cartilage: A Biomechanical Protocol. Cartilage 2021; 13:427S-437S. [PMID: 33218275 PMCID: PMC8804788 DOI: 10.1177/1947603520973240] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Recapitulating the mechanical properties of articular cartilage (AC) is vital to facilitate the clinical translation of cartilage tissue engineering. Prior to evaluation of tissue-engineered constructs, it is fundamental to investigate the biomechanical properties of native AC under sudden, prolonged, and cyclic loads in a practical manner. However, previous studies have typically reported only the response of native AC to one or other of these loading regimes. We therefore developed a streamlined testing protocol to characterize the elastic and viscoelastic properties of human knee AC, generating values for several important parameters from the same sample. DESIGN Human AC was harvested from macroscopically normal regions of distal femoral condyles of patients (n = 3) undergoing total knee arthroplasty. Indentation and unconfined compression tests were conducted under physiological conditions (temperature 37 °C and pH 7.4) and testing parameters (strain rates and loading frequency) to assess elastic and viscoelastic parameters. RESULTS The biomechanical properties obtained were as follows: Poisson ratio (0.4 ± 0.1), instantaneous modulus (52.14 ± 9.47 MPa) at a loading rate of 1 mm/s, Young's modulus (1.03 ± 0.48 MPa), equilibrium modulus (7.48 ± 4.42 MPa), compressive modulus (10.60 ± 3.62 MPa), dynamic modulus (7.71 ± 4.62 MPa) at 1 Hz and loss factor (0.11 ± 0.02). CONCLUSIONS The measurements fell within the range of reported values for human knee AC biomechanics. To the authors' knowledge this study is the first to report such a range of biomechanical properties for human distal femoral AC. This protocol may facilitate the assessment of tissue-engineered composites for their functionality and biomechanical similarity to native AC prior to clinical trials.
Collapse
Affiliation(s)
- Wassif Kabir
- Faculty of Medicine, Dentistry and
Health Sciences, University of Melbourne, Parkville, Victoria, Australia,BioFab3D, Aikenhead Centre for Medical
Discovery, St. Vincent’s Hospital, Fitzroy, Victoria, Australia
| | - Claudia Di Bella
- BioFab3D, Aikenhead Centre for Medical
Discovery, St. Vincent’s Hospital, Fitzroy, Victoria, Australia,Department of Orthopaedics, St.
Vincent’s Hospital, Fitzroy, Victoria, Australia,Department of Surgery, University of
Melbourne, Parkville, Victoria, Australia
| | - Peter F.M. Choong
- BioFab3D, Aikenhead Centre for Medical
Discovery, St. Vincent’s Hospital, Fitzroy, Victoria, Australia,Department of Orthopaedics, St.
Vincent’s Hospital, Fitzroy, Victoria, Australia,Department of Surgery, University of
Melbourne, Parkville, Victoria, Australia
| | - Cathal D. O’Connell
- BioFab3D, Aikenhead Centre for Medical
Discovery, St. Vincent’s Hospital, Fitzroy, Victoria, Australia,Discipline of Electrical and Biomedical
Engineering, School of Engineering, RMIT University, Melbourne, Victoria,
Australia,Cathal D. O’Connell, BioFab3D, Aikenhead
Centre for Medical Discovery, St. Vincent’s Hospital, BioFab3D, 1st Floor,
Clinical Sciences Building, 29 Regent Street, Fitzroy, Victoria 3065, Australia.
| |
Collapse
|
45
|
Paatela T, Vasara A, Nurmi H, Kautiainen H, Jurvelin JS, Kiviranta I. Biomechanical Changes of Repair Tissue after Autologous Chondrocyte Implantation at Long-Term Follow-Up. Cartilage 2021; 13:1085S-1091S. [PMID: 32447977 PMCID: PMC8808830 DOI: 10.1177/1947603520921433] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Objective. This study aims to describe biomechanical maturation process of repair tissue after cartilage repair with autologous chondrocyte implantation (ACI) at long-term follow-up. Design. After ACI, 40 patients underwent altogether 60 arthroscopic biomechanical measurements of the repair tissue at various time points during an up to 11-year follow-up period. Of these patients, 30 patients had full-thickness cartilage lesions and 10 had an osteochondritis dissecans (OCD) defect. The mean lesion area was 6.5 cm2 (SD 3.2). A relative indentation stiffness value for each individually measured lesion was calculated as a ratio of repair tissue and surrounding cartilage indentation value to enable interindividual comparison. Results. Repair tissue stiffness improved during approximately 5 years after surgery. Most of the increase in stiffness occurred during the first 2 years. The curvilinear correlation between relative stiffness values and the follow-up time was 0.31 (95% CI 0.07-0.52), P = 0.017. The interindividual variation of the stiffness was high. Lesion properties or demographic factors showed no significant correlation to biomechanical outcome. The overall postoperative average relative stiffness was 0.75 (SD 0.47). Conclusions. Our clinical study describes a biomechanical maturation process of cartilage repair that may continue even longer than expected. A substantial increase in tissue stiffness proceeds for the first two years postoperatively. Minor progression proceeds for even longer. In some repairs, the biomechanical result was equal to native cartilage, suggesting hyaline-type repair. The variation in biomechanical results suggests substantial inconsistency in the structural outcome following ACI.
Collapse
Affiliation(s)
- Teemu Paatela
- Department of Orthopaedics and
Traumatology, University of Helsinki and Helsinki University Hospital,
Helsinki, Finland,Teemu Paatela, Department of
Orthopaedics and Traumatology, Helsinki University Hospital, P.O. Box
900 (Topeliuksenkatu 5), Helsinki, FI-00029 HUS, Finland.
| | - Anna Vasara
- Department of Orthopaedics and
Traumatology, University of Helsinki and Helsinki University Hospital,
Helsinki, Finland
| | | | - Hannu Kautiainen
- Primary Health Care Unit, Kuopio
University Hospital, Kys, Pohjois-Savo, Finland,Folkhälsan Research Center,
Helsinki, Finland
| | - Jukka S. Jurvelin
- Department of Applied Physics,
University of Eastern Finland, Kuopio, Finland
| | - Ilkka Kiviranta
- Department of Orthopaedics and
Traumatology, University of Helsinki and Helsinki University Hospital,
Helsinki, Finland
| |
Collapse
|
46
|
Janssen M, Peters M, Steijvers-Peeters E, Szomolanyi P, Jutten E, van Rhijn L, Peterson L, Lindahl A, Trattnig S, Emans P. 7-Tesla MRI Evaluation of the Knee, 25 Years after Cartilage Repair Surgery: The Influence of Intralesional Osteophytes on Biochemical Quality of Cartilage. Cartilage 2021; 13:767S-779S. [PMID: 34836478 PMCID: PMC8808805 DOI: 10.1177/19476035211060506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE To evaluate the morphological and biochemical quality of cartilage transplants and surrounding articular cartilage of patients 25 years after perichondrium transplantation (PT) and autologous chondrocyte transplantation (ACT) as measured by ultra-high-field 7-Tesla (7T) magnetic resonance imaging (MRI) and to present these findings next to clinical outcome. DESIGN Seven PT patients and 5 ACT patients who underwent surgery on the femoral condyle between 1986 and 1996 were included. Patient-reported outcome measures (PROMs) were assessed by the clinical questionnaires: Knee injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC), and Visual Analogue Scale (VAS) for knee pain. The morphological (MOCART score) and biochemical quality (glycosaminoglycans [GAGs] content and collagen integrity) of cartilage transplants and surrounding articular cartilage were analyzed by 7T MRI. The results of the PT and ACT patients were compared. Finally, a detailed morphological analysis of the grafts alone was performed. RESULTS No statistically significant difference was found for the PROMs and MOCART scores of PT and ACT patients. Evaluation of the graft alone showed poor repair tissue quality and high prevalence of intralesional osteophyte formation in both the PT and ACT patients. Penetration of the graft surface by the intralesional osteophyte was related to biochemically damaged opposing tibial cartilage; GAG content was significantly lower in patients with an osteophyte penetrating the graft surface. CONCLUSIONS Both PT and ACT patients have a high incidence of intralesional osteophyte formation 25 years after surgery. The resulting biochemical damage to the opposing tibial cartilage might be dependent on osteophyte morphology.
Collapse
Affiliation(s)
- M.P.F. Janssen
- Department of Orthopaedic Surgery,
CAPHRI School for Public Health and Primary Care, Maastricht University Medical
Center+, Maastricht, The Netherlands,M.P.F. Janssen, Department of Orthopaedic
Surgery, CAPHRI School for Public Health and Primary Care, Maastricht University
Medical Center+, PO Box 5800, 6202 AZ Maastricht, The Netherlands.
| | - M.J.M. Peters
- Department of Orthopaedic Surgery,
CAPHRI School for Public Health and Primary Care, Maastricht University Medical
Center+, Maastricht, The Netherlands
| | | | - P. Szomolanyi
- High-Field MR Center, Department of
Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna,
Austria
| | - E.M.C. Jutten
- Department of Orthopaedic Surgery,
CAPHRI School for Public Health and Primary Care, Maastricht University Medical
Center+, Maastricht, The Netherlands
| | - L.W. van Rhijn
- Department of Orthopaedic Surgery,
CAPHRI School for Public Health and Primary Care, Maastricht University Medical
Center+, Maastricht, The Netherlands
| | - L. Peterson
- Department of Laboratory Medicine,
Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg,
Sweden
| | - A. Lindahl
- Sahlgrenska Academy, University of
Gothenburg, Gothenburg, Sweden
| | - S. Trattnig
- High-Field MR Center, Department of
Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna,
Austria
| | - P.J. Emans
- Department of Orthopaedic Surgery,
CAPHRI School for Public Health and Primary Care, Maastricht University Medical
Center+, Maastricht, The Netherlands
| |
Collapse
|
47
|
Hafezi M, Nouri Khorasani S, Zare M, Esmaeely Neisiany R, Davoodi P. Advanced Hydrogels for Cartilage Tissue Engineering: Recent Progress and Future Directions. Polymers (Basel) 2021; 13:4199. [PMID: 34883702 PMCID: PMC8659862 DOI: 10.3390/polym13234199] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 12/18/2022] Open
Abstract
Cartilage is a tension- and load-bearing tissue and has a limited capacity for intrinsic self-healing. While microfracture and arthroplasty are the conventional methods for cartilage repair, these methods are unable to completely heal the damaged tissue. The need to overcome the restrictions of these therapies for cartilage regeneration has expanded the field of cartilage tissue engineering (CTE), in which novel engineering and biological approaches are introduced to accelerate the development of new biomimetic cartilage to replace the injured tissue. Until now, a wide range of hydrogels and cell sources have been employed for CTE to either recapitulate microenvironmental cues during a new tissue growth or to compel the recovery of cartilaginous structures via manipulating biochemical and biomechanical properties of the original tissue. Towards modifying current cartilage treatments, advanced hydrogels have been designed and synthesized in recent years to improve network crosslinking and self-recovery of implanted scaffolds after damage in vivo. This review focused on the recent advances in CTE, especially self-healing hydrogels. The article firstly presents the cartilage tissue, its defects, and treatments. Subsequently, introduces CTE and summarizes the polymeric hydrogels and their advances. Furthermore, characterizations, the advantages, and disadvantages of advanced hydrogels such as multi-materials, IPNs, nanomaterials, and supramolecular are discussed. Afterward, the self-healing hydrogels in CTE, mechanisms, and the physical and chemical methods for the synthesis of such hydrogels for improving the reformation of CTE are introduced. The article then briefly describes the fabrication methods in CTE. Finally, this review presents a conclusion of prevalent challenges and future outlooks for self-healing hydrogels in CTE applications.
Collapse
Affiliation(s)
- Mahshid Hafezi
- Department of Chemical Engineering, Isfahan University of Technology, Isfahan 84156-83111, Iran;
| | - Saied Nouri Khorasani
- Department of Chemical Engineering, Isfahan University of Technology, Isfahan 84156-83111, Iran;
| | - Mohadeseh Zare
- School of Metallurgy and Materials, University of Birmingham, Birmingham B15 2TT, UK;
| | - Rasoul Esmaeely Neisiany
- Department of Materials and Polymer Engineering, Faculty of Engineering, Hakim Sabzevari University, Sabzevar 96179-76487, Iran;
| | - Pooya Davoodi
- School of Pharmacy and Bioengineering, Hornbeam Building, Keele University, Staffordshire ST5 5BG, UK
- Guy Hilton Research Centre, Institute of Science and Technology in Medicine, Keele University, Staffordshire ST4 7QB, UK
| |
Collapse
|
48
|
Alenezi B, Kazaili A, Akhtar R, Radhakrishnan H. Corneal biomechanical properties following corneal cross-linking: Does age have an effect? Exp Eye Res 2021; 214:108839. [PMID: 34785203 DOI: 10.1016/j.exer.2021.108839] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 10/28/2021] [Accepted: 11/09/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE To explore the effect of age on corneal biomechanical properties following corneal cross-linking (CXL). METHODS A total of 12 pairs of human eye-banked corneas (24 corneas, from 14 females and 10 males) were used in the study. The mean donor age was 48.5 years (ranging from 26 to 71 years). Corneas were divided into three age groups: A (26-41 years), B (42-57 years) and C (58-71 years), with four pairs in each group. For each pair, the right corneas were cross-linked using accelerated CXL with UVA (10 mW/cm2) and riboflavin, while the left corneas served as controls and were not exposed to either UVA irradiation or riboflavin. The corneal elastic modulus of the anterior, mid and posterior corneal stroma was measured using nanoindentation. RESULTS The difference in the corneal elastic modulus following CXL was significant in the anterior (p = 0.00002) and mid stroma (p = 0.001); however, the difference was not significant in the posterior stroma (p = 0.27) when compared to control corneas. The corneal elastic modulus of the anterior stroma increased by 178.44% in Group A, 119.7% in Group B and 50.73% in Group C compared to control corneas. For the mid stroma, the elastic modulus increased by 47.35% in Group A, 25% in Group B and 24.56% in Group C. No differences were observed in the posterior stroma between age groups. CONCLUSIONS Corneal elasticity showed a greater response to CXL in the younger group compared to older groups. CXL treatment showed effectiveness in enhancing stromal strength, and the effect was concentrated in the anterior and mid stroma with minimal impact on the posterior stroma in all age groups.
Collapse
Affiliation(s)
- Bandar Alenezi
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; College of Applied Medical Sciences, Qassim University, Buraidah, Qassim, Saudi Arabia.
| | - Ahmed Kazaili
- Department of Mechanical, Materials and Aerospace Engineering, School of Engineering, University of Liverpool, UK; Department of Biomedical Engineering, College of Engineering, University of Babylon, Hillah, Iraq
| | - Riaz Akhtar
- Department of Mechanical, Materials and Aerospace Engineering, School of Engineering, University of Liverpool, UK
| | - Hema Radhakrishnan
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
| |
Collapse
|
49
|
Sulaiman SZS, Tan WM, Radzi R, Shafie INF, Ajat M, Mansor R, Mohamed S, Ng AMH, Lau SF. Comparison of bone and articular cartilage changes in osteoarthritis: a micro-computed tomography and histological study of surgically and chemically induced osteoarthritic rabbit models. J Orthop Surg Res 2021; 16:663. [PMID: 34749769 PMCID: PMC8577030 DOI: 10.1186/s13018-021-02781-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 10/06/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Osteoarthritis (OA) is a multifaceted condition that affects both the subchondral bones and the articular cartilage. Animal models are widely used as an effective supplement and simulation for human OA studies in investigating disease mechanisms and pathophysiology. This study is aimed to evaluate the temporal changes of bone and cartilage in surgically and chemically induced osteoarthritis using micro-computed tomography and histology. METHODS Thirty rabbits underwent either anterior cruciate ligament transection (ACLT) procedure or injected intraarticularly with monosodium iodoacetate (MIA, 8 mg) at the right knee joint. The subchondral bones were scanned via micro-CT, and articular cartilage was assessed histologically at 4-, 8- and 12-week post-induction. RESULTS Based on bone micro-architecture parameters, the surgically induced group revealed bone remodelling processes, indicated by increase bone volume, thickening of trabeculae, reduced trabecular separation and reduced porosity. On the other hand, the chemically induced group showed active bone resorption processes depicted by decrease bone volume, thinning of trabeculae, increased separation of trabecular and increased porosity consistently until week 12. Histologically, the chemically induced group showed more severe articular cartilage damage compared to the surgically induced group. CONCLUSIONS It can be concluded that in the ACLT group, subchondral bone remodelling precedes articular cartilage damage and vice versa in the MIA group. The findings revealed distinct pathogenic pathways for both induction methods, providing insight into tailored therapeutic strategies, as well as disease progression and treatment outcomes monitoring.
Collapse
Affiliation(s)
- Sharifah Zakiah Syed Sulaiman
- Department of Veterinary Clinical Studies, Faculty of Veterinary Medicine, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia
| | - Wei Miao Tan
- Department of Veterinary Clinical Studies, Faculty of Veterinary Medicine, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia
| | - Rozanaliza Radzi
- Department of Veterinary Clinical Studies, Faculty of Veterinary Medicine, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia
| | - Intan Nur Fatiha Shafie
- Department of Veterinary Clinical Studies, Faculty of Veterinary Medicine, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia
| | - Mokrish Ajat
- Department of Veterinary Preclinical Studies, Faculty of Veterinary Medicine, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia
| | - Rozaihan Mansor
- Department of Farm and Exotic Animals Medicine and Surgery, Faculty of Veterinary Medicine, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia
| | - Suhaila Mohamed
- UPM-Makna Cancer Research Laboratory (CANRES), Institute of Bioscience, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia
| | - Angela Min Hwei Ng
- Tissue Engineering Centre, Universiti Kebangsaan Malaysia Medical Centre, 56000, Cheras, Kuala Lumpur, Malaysia
| | - Seng Fong Lau
- Department of Veterinary Clinical Studies, Faculty of Veterinary Medicine, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia.
- UPM-Makna Cancer Research Laboratory (CANRES), Institute of Bioscience, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia.
| |
Collapse
|
50
|
Jeuken RM, van Hugten PPW, Roth AK, Timur UT, Boymans TAEJ, van Rhijn LW, Bugbee WD, Emans PJ. A Systematic Review of Focal Cartilage Defect Treatments in Middle-Aged Versus Younger Patients. Orthop J Sports Med 2021; 9:23259671211031244. [PMID: 34676269 PMCID: PMC8524698 DOI: 10.1177/23259671211031244] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 03/22/2021] [Indexed: 01/08/2023] Open
Abstract
Background: Focal cartilage defects are often debilitating, possess limited potential for
regeneration, are associated with increased risk of osteoarthritis, and are
predictive for total knee arthroplasty. Cartilage repair studies typically
focus on the outcome in younger patients, but a high proportion of treated
patients are 40 to 60 years of age (ie, middle-aged). The reality of current
clinical practice is that the ideal patient for cartilage repair is not the
typical patient. Specific attention to cartilage repair outcomes in
middle-aged patients is warranted. Purpose: To systematically review available literature on knee cartilage repair in
middle-aged patients and include studies comparing results across different
age groups. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic search was performed in EMBASE, MEDLINE, and the Cochrane
Library database. Articles were screened for relevance and appraised for
quality. Results: A total of 21 articles (mean Coleman Methodology Score, 64 points) were
included. Two out of 3 bone marrow stimulation (BMS) studies, including 1
using the microfracture technique, revealed inferior clinical outcomes in
middle-aged patients in comparison with younger patients. Nine cell-based
studies were included showing inconsistent comparisons of results across age
groups for autologous chondrocyte implantation (ACI). Bone marrow aspirate
concentrate showed age-independent results at up to 8 years of follow-up. A
negative effect of middle age was reported in 1 study for both ACI and BMS.
Four out of 5 studies on bone-based resurfacing therapies (allografting and
focal knee resurfacing implants [FKRIs]) showed age-independent results up
to 5 years. One study in only middle-aged patients reported better clinical
outcomes for FKRIs when compared with biological repairs. Conclusion: Included studies were heterogeneous and had low methodological quality. BMS
in middle-aged patients seems to only result in short-term improvements.
More research is warranted to elucidate the ameliorating effects of
cell-based therapies on the aging joint homeostasis. Bone-based therapies
seem to be relatively insensitive to aging and may potentially result in
effective joint preservation. Age subanalyses in cohort studies, randomized
clinical trials, and international registries should generate more evidence
for the large but underrepresented (in terms of cartilage repair)
middle-aged population in the literature.
Collapse
Affiliation(s)
- Ralph M Jeuken
- Maastricht University Medical Center, Maastricht, the Netherlands
| | | | - Alex K Roth
- Maastricht University Medical Center, Maastricht, the Netherlands
| | - Ufuk Tan Timur
- Maastricht University Medical Center, Maastricht, the Netherlands
| | | | | | - William D Bugbee
- Department of Orthopaedic Surgery, Scripps Clinic, La Jolla, California, USA
| | - Pieter J Emans
- Maastricht University Medical Center, Maastricht, the Netherlands
| |
Collapse
|