Physical indicators of cartilage health: the relevance of compliance, thickness, swelling and fibrillar texture

Structural clues to articular calcified cartilage function: A descriptive review of this crucial interface tissue

Articular calcified cartilage (ACC) has been dismissed, by some, as a remnant of endochondral ossification without functional relevance to joint articulation or weight-bearing. Recent research indicates that morphologic and metabolic ACC features may be important, reflecting knee joint osteoarthritis (OA) predisposition. ACC is less investigated than neighbouring joint tissues, with its component chondrocytes and mineralised matrix often being either ignored or integrated into analyses of hyaline articular cartilage and subchondral bone tissue respectively. Anatomical variation in ACC is recognised between species, individuals and age groups, but the selective pressures underlying this variation are unknown. Consequently, optimal ACC biomechanical features are also unknown as are any potential locomotory roles. This review collates descriptions of ACC anatomy and biology in health and disease, with a view to revealing its structure/function relationship and highlighting potential future research avenues. Mouse models of healthy and OA joint ageing have shown disparities in ACC load-induced deformations at the knee joint. This raises the hypothesis that ACC response to locomotor forces over time may influence, or even underlie, the bony and hyaline cartilage symptoms characteristic of OA. To effectively investigate the ACC, greater resolution of joint imaging and merging of hierarchical scale data will be required. An appreciation of OA as a 'whole joint disease' is expanding, as is the possibility that the ACC may be a key player in healthy ageing and in the transition to OA joint pathology.

Comparative Assessment of Primary Osteoarthritis Progression Using Conventional Histopathology, Polarized Light Microscopy, and Immunohistochemistry

OBJECTIVE

Evaluation of collagen orientation and arrangement in articular cartilage can improve our understanding of primary osteoarthritis (OA) progression and targeted therapies. Our goal was to determine if polarized light microscopy (PLM) for collagen organization is useful in identifying early primary OA features in comparison to current standard histopathological methods.

DESIGN

Osteochondral specimens from 90 total knee arthroplasty patients with relatively preserved lateral femoral condyle were scored using (1) histological-histochemical grading system (HHGS); (2) Osteoarthritis Research Society International (OARSI); (3) PLM-Changoor system for repair cartilage, scores ranging between 0 (totally disorganized cartilage) and 5 (healthy adult cartilage); and (4) new PLM system for primary OA cartilage with superficial zone PLM (PLM-SZ) and deep zone PLM (PLM-DZ) scores, each ranging between 0 (healthy adult SZ and DZ collagen organization) and 4 (total loss of collagen organization). Serial sections were stained for collagen I and II antibodies. Spearman correlation coefficients (r_s) were determined.

RESULTS

The associations between: (1) PLM-Changoor and HHGS or OARSI were weak (r_s = -0.36) or moderate (r_s = -0.56); (2) PLM-SZ and HHGS or OARSI were moderate (r_s = 0.46 or r_s = 0.53); and (3) PLM-DZ and HHGS or OARSI were poor (r_s = 0.31 or r_s = 0.21), respectively. Specimens exhibiting early and mild OA (HHGS < 5 and OARSI < 8.6) had PLM-SZ and PLM-DZ scores between 0 and 4 and between 0 and 3, respectively, and indicated new histopathological features not currently considered by HHGS/OARSI.

CONCLUSIONS

PLM was effective at identifying early SZ and DZ collagen alterations that were not evident in the traditional scoring systems. Incorporating PLM scores and/or additional HHGS/OARSI features can help improve characterization of early primary OA cartilage.

Anisotropy and inhomogeneity of permeability and fibrous network response in the pars intermedia of the human lateral meniscus

Within the human tibiofemoral joint, meniscus plays a key role due to its peculiar time-dependent mechanical characteristics, inhomogeneous structure and compositional features. To better understand the pathophysiological mechanisms underlying this essential component, it is mandatory to analyze in depth the relationship between its structure and the function it performs in the joint. Accordingly, the aim of this study was to evaluate the behavior of both solid and fluid phases of human meniscus in response to compressive loads, by integrating mechanical assessment and histological analysis. Cubic specimens were harvested from seven knee lateral menisci, specifically from anterior horn, pars intermedia and posterior horn; unconfined compressive tests were then performed according to three main loading directions (i.e., radial, circumferential and vertical). Fibril modulus, matrix modulus and hydraulic permeability of the tissue were thence estimated through a fibril-network-reinforced biphasic model. Tissue porosity and collagen fibers arrangement were assessed through histology for each region and related to the loading directions adopted during mechanical tests. Regional and strain-dependent constitutive parameters were finally proposed for the human lateral meniscus, suggesting an isotropic behavior of both the horns, and a transversely isotropic response of the pars intermedia. Furthermore, the histological findings supported the evidences highlighted by the compressive tests. Indeed, this study provided novel insights concerning the functional behavior of human menisci by integrating mechanical and histological characterizations and thus highlighting the key role of this component in knee contact mechanics and presenting fundamental information that can be used in the development of tissue-engineered substitutes. STATEMENT OF SIGNIFICANCE: This work presents an integration to the approaches currently used to model the mechanical behavior of the meniscal tissue. This study assessed in detail the regional and directional contributions of both the meniscal solid and fluid phases during compressive response, providing also complementary histological evidence. Within this updated perspective, both knee computational modeling and meniscal tissue engineering can be improved to have an effective impact on the clinical practice.

Protein Levels and Microstructural Changes in Localized Regions of Early Cartilage Degeneration Compared with Adjacent Intact Cartilage

OBJECTIVE

It was hypothesized that the respective protein profiles of bovine cartilage from sites of localized mild to moderate (GI to GII) degeneration versus adjacent sites of intact tissue would vary in accordance with the tissue microstructural changes associated with a pre-osteoarthritic state.

METHODS

A total of 15 bovine patellae were obtained for this study. Paired samples of tissue were collected from the lateral region of each patella. If the patella contained a site of degeneration, a paired tissue set involved taking one sample each from the degenerated site and the intact tissue adjacent to it. Sufficient tissue was collected to facilitate 2 arms of investigation: microstructural imaging and proteome analysis. The microstructural analysis used a bespoke tissue preparation technique imaged with differential interference contrast optical microscopy to assess fibrillar scale destructuring and underlying bone spicule formation. An iTRAQ-based proteome analysis was performed using liquid chromatography-tandem mass spectrometry to identify the differential levels of proteins across the intact and degenerated cartilage and further, the results were validated with multiple reaction monitoring assay.

RESULTS

In the healthy cartilage pairs, there was no significant variation in protein profiles between 2 adjacent sample sites. In pairs of tissue that contained a sample of GI/GII tissue, there were both significant microstructural changes as well as the difference in abundance levels of 24 proteins.

CONCLUSIONS

From the known functions of the 24 proteins, found to be strongly aligned with the specific microstructural changes observed, a unique "proteins ensemble" involved in the initiation and progression of early cartilage degeneration is proposed.

Transient stiffening of cartilage during joint articulation: A microindentation study

As a mechanoactive tissue, articular cartilage undergoes compression and shear on a daily basis. With the advent of high resolution and sensitive mechanical testing methods, such as micro- and nanoindentation, it has become possible to assess changes in small-scale mechanical properties due to compression and shear of the tissue. However, investigations on the changes of these properties before and after joint articulation have been limited. To simulate articular loading of cartilage in the context of human gait, a previously developed bioreactor system was used. Immediately after bioreactor testing, the stiffness was measured using microindentation. Specifically, we investigated whether the mechanical response of the tissue was transient or permanent, dependent on counterface material, and an effect limited to the superficial zone of cartilage. We found that cartilage surface stiffness increases immediately after articular loading and returns to baseline values within 3 hr. Cartilage-on-cartilage stiffening was found to be higher compared to both alumina- and cobalt chromium-on-cartilage stiffening, which were not significantly different from each other. This stiffening response was found to be unique to the superficial zone, as articular loading on cartilage with the superficial zone removed showed no changes in stiffness. The findings of this study suggest that the cartilage superficial zone may adapt its stiffness as a response to articular loading. As the superficial zone is often compromised during the course of osteoarthritic disease, this finding is of clinical relevance, suggesting that the load-bearing function deteriorates over time.

Embrittlement of collagen in early-stage human osteoarthritis

Articular cartilage is a remarkable material with mechanical performance that surpasses engineering standards. Collagen, the most abundant protein in cartilage, plays an important role in this performance, and also in disease. Building on observations of network-level collagen changes at the earliest stages of osteoarthritis, this study explores the physical role of the collagen fibril in the disease process. Specifically, we focus on the material properties of collagen fibrils in the cartilage surface. Ten human tibial plateaus were characterised by atomic force microscopy (AFM) and Raman spectroscopy, with histological scoring used to define disease state. Measures of tropocollagen remained stable with disease progression, yet a marked mechanical change was observed. A slight stiffening coupled with a substantial decrease in loss tangent suggests a physical embrittlement caused by increased inter-molecular interactions.

Potential enhancement of articular cartilage histological grading with collagen integrity

BACKGROUND

Histological evaluation of articular cartilage, such as using the Mankin scoring system, is the gold standard for characterization of tissue integrity. This scoring system takes into account several parameters indicative of the tissue's health; however, the collagen integrity, which is a primary indicator of cartilage health is not taken into consideration. Thus, there is need to enhance histological grading of articular cartilage by incorporating explicit scoring of collagen degeneration into the Modified Mankin grading system. This paper explores a new histological grading parameter for collagen network degradation and how this information can be used to augment a widely used grading scheme like the Modified Mankin grading system.

METHODS

Intact and degenerated human cartilage were examined histologically and then subjected to second harmonic generation imaging, leading to qualitative and quantitative description of collagen disruption emanating from the surface to subsurface layers of the tissue. This data was then incorporated into the Modified Mankin grading system.

FINDINGS

Second harmonic generation image analysis reveals a relationship between changes in collagen architecture and histologically observed tissue disruption in degenerated articular cartilage.

INTERPRETATION

Histological tissue disruption in degenerated human articular cartilage is directly related to the reorganization of collagen fibrils in the form of intense fibril aggregation, either as a result of degeneration or aging. This method of mapping disrupted tissue regions to quantitative collagen fibril damage can be coded into cartilage grading systems and could inform clinical practice and scientific research.

How changes in interconnectivity affect the bulk properties of articular cartilage: a fibre network study

The remarkable compressive strength of articular cartilage arises from the mechanical interactions between the tension-resisting collagen fibrils and swelling proteoglycan proteins within the tissue. These interactions are facilitated by a significant level of interconnectivity between neighbouring collagen fibrils within the extracellular matrix. A reduction in interconnectivity is suspected to occur during the early stages of osteoarthritic degeneration. However, the relative contribution of these interconnections towards the bulk mechanical properties of articular cartilage has remained an open question. In this study, we present a simple 2D fibre network model which explicitly represents the microstructure of articular cartilage as collection of discrete nodes and linear springs. The transverse stiffness and swelling properties of this fibre network are studied, and a semi-analytic relationship which relates these two macroscopic properties via microscopic interconnectivity is derived. By comparing this derived expression to previously published experimental data, we show that although a reduction in network interconnectivity accounts for some of the observed changes in the mechanical properties of articular cartilage as degeneration occurs, a decrease in matrix interconnectivity alone do not provide a full account of this process.

How a decreased fibrillar interconnectivity influences stiffness and swelling properties during early cartilage degeneration

OBJECTIVE

The functional coupling between the fibrillar network and the high-swelling proteoglycans largely determines the mechanical properties of the articular cartilage matrix. The objective of this new study was to show specifically how changes in fibrillar interconnectivity arising from early cartilage degeneration influence transverse stiffness and swelling properties at the tissue level.

DESIGN

Radial zone transverse layers of cartilage matrix were obtained from intact and mildly degenerate bovine patellae. Each layer was then subdivided to assess tensile stiffness, free-swelling response, glycosaminoglycan (GAG) content, and micro- and ultra-structural features.

RESULTS

The tensile modulus was significantly lower and the degree of swelling significantly higher for the degenerate matrix compared to the intact. Scanning electron microscopy revealed a homogeneous response to transverse strain in the intact cartilage, whereas large non-fibrillar spaces between fibril aggregates were visible in the degenerate matrix. Although there were no significant differences in GAG content it did correlate significantly with stiffness and swelling in the intact samples but not in the degenerate.

CONCLUSIONS

The lower degree of fibril network interconnectivity in the degenerate matrix led to both a decreased transverse stiffness and reduced resistance to osmotic swelling. This network 'de-structuring' also resulted in a reduced functional interaction between the fibrillar network and the proteoglycans. The study provides new insights into the role of the fibrillar network and how changes in the network arising from the degenerative cascade will influence tissue level behaviour.

The influence of early degenerative changes on the vulnerability of articular cartilage to impact-induced injury

BACKGROUND

Recently, the structural changes in a bovine model of early degeneration were validated by our research group to be analogous to that in early human osteoarthritis. The hypothesis of this study was that the structural changes associated with increasing levels of degeneration would lead to higher levels of tissue damage in response to impact induced injury.

METHODS

A total of forty bovine patellae were obtained for this study. Cartilage-on-bone samples were extracted from the distal lateral quarter, a region known to be affected by varying levels of degeneration. A single impact drop test was applied to these samples delivering 2.3J of energy. A dynamic load cell and image capture at 2000fps allowed for the calculation of the reaction stress and coefficient of restitution. The extent of tissue damage was examined from the micro to ultrastructural levels using differential interference contrast optical microscopy and scanning electron microscopy respectively.

FINDINGS

The impact mechanical properties of mildly degenerate articular cartilage were not significantly different but showed a significantly larger amount of structural damage. From comparing the mechanical and structural response of intact and mildly degenerate cartilage, to tissue showing increased macro-scale tissue degeneration, the significance of the surface layer and fibrillar scale transverse interconnectivity in effectively attenuating impact loads is demonstrated in this study.

INTERPRETATION

This study shows that even though articular cartilage can appear visibly normal under macroscopic observation, the micro-scale structural changes associated with very early stage osteoarthritis can have a significant effect on its vulnerability to impact damage.

The Impact of Collagen Fibril Polarity on Second Harmonic Generation Microscopy

In this work, we report the implementation of interferometric second harmonic generation (SHG) microscopy with femtosecond pulses. As a proof of concept, we imaged the phase distribution of SHG signal from the complex collagen architecture of juvenile equine growth cartilage. The results are analyzed in respect to numerical simulations to extract the relative orientation of collagen fibrils within the tissue. Our results reveal large domains of constant phase together with regions of quasi-random phase, which are correlated to respectively high- and low-intensity regions in the standard SHG images. A comparison with polarization-resolved SHG highlights the crucial role of relative fibril polarity in determining the SHG signal intensity. Indeed, it appears that even a well-organized noncentrosymmetric structure emits low SHG signal intensity if it has no predominant local polarity. This work illustrates how the complex architecture of noncentrosymmetric scatterers at the nanoscale governs the coherent building of SHG signal within the focal volume and is a key advance toward a complete understanding of the structural origin of SHG signals from tissues.

The bovine patella as a model of early osteoarthritis

The bovine patella model has been used extensively for studying important structure-function aspects of articular cartilage, including its degeneration. However, the degeneration seen in this model has, to our knowledge, never been adequately compared with human osteoarthritis (OA). In this study, bovine patellae displaying normal to severely degenerate states were compared with human tissue displaying intact cartilage to severe OA. Comparisons of normal and OA features were made with histological scoring, morphometric measurements, and qualitative observations. Differential interference contrast microscopy was used to image early OA changes in the articular cartilage matrix and to investigate whether this method provided comparable quality of visualisation of key structural features with standard histology. The intact bovine cartilage was found to be similar to healthy human cartilage and the degenerate bovine cartilage resembled the human OA tissues with regard to structural disruption, cellularity changes, and staining loss. The extent of degeneration in the bovine tissues matched the mild to moderate range of human OA tissues; however, no bovine samples exhibited late-stage OA. Additionally, in both bovine and human tissues, cartilage degeneration was accompanied by calcified cartilage thickening, tidemark duplication, and the advancement of the cement line by protrusions of bony spicules into the calcified cartilage. This comparison of degeneration in the bovine and human tissues suggests a common pathway for the progression of OA and thus the bovine patella is proposed to be an appropriate model for investigating the structural changes associated with early OA.

How changes in fibril-level organization correlate with the macrolevel behavior of articular cartilage

The primary structural components of articular cartilage are the zonally differentiated interconnected network of collagen fibrils and proteoglycans, the latter having the potential to bind large amounts of water. Both components exist in a coupled relationship that gives rise to its remarkable mechanical properties. The response of cartilage to compression is governed both by the degree to which the hydrated proteoglycans are constrained within this fibrillar network and the ease with which the matrix fluid can be displaced. The functional properties of cartilage are therefore closely linked to the integrity of the fibrillar network. Our current understanding of this network has been derived via studies conducted at the macro, micro, and ultrastructural levels. Of particular interest to joint researchers and clinicians are issues relating to how the network structure varies both directionally and with zonal depth, how its integrity is maintained via mechanisms of fibril interconnectivity, and how it is modified by ageing, degeneration, and trauma. Physical models have been developed to explore modes of interconnectivity. Combined micromechanical and structural studies confirm the critical role that this interconnectivity must play but detailed descriptions at the molecular level remain elusive. Current computationally based models of cartilage have in some cases implemented the fibrillar component, albeit simplistically, as a separate structure. Considering how important a role fibril network interconnectivity plays in actual tissue structure and mechanical behavior, and especially how it changes with degeneration, a major challenge facing joint tissue modellers is how to incorporate such a feature in their models.

Load-unloading response of intact and artificially degraded articular cartilage correlated with near infrared (NIR) absorption spectra

The conventional mechanical properties of articular cartilage, such as compressive stiffness, have been demonstrated to be limited in their capacity to distinguish intact (visually normal) from degraded cartilage samples. In this paper, we explore the correlation between a new mechanical parameter, namely the reswelling of articular cartilage following unloading from a given compressive load, and the near infrared (NIR) spectrum. The capacity to distinguish mechanically intact from proteoglycan-depleted tissue relative to the "reswelling" characteristic was first established, and the result was subsequently correlated with the NIR spectral data of the respective tissue samples. To achieve this, normal intact and enzymatically degraded samples were subjected to both NIR probing and mechanical compression based on a load-unload-reswelling protocol. The parameter δr, characteristic of the osmotic "reswelling" of the matrix after unloading to a constant small load in the order of the osmotic pressure of cartilage, was obtained for the different sample types. Multivariate statistics was employed to determine the degree of correlation between δr and the NIR absorption spectrum of relevant specimens using Partial Least Squared (PLS) regression. The results show a strong relationship (R(2)=95.89%, p<0.0001) between the spectral data and δr. This correlation of δr with NIR spectral data suggests the potential for determining the reswelling characteristics non-destructively. It was also observed that δr values bear a significant relationship with the cartilage matrix integrity, indicated by its proteoglycan content, and can therefore differentiate between normal and artificially degraded proteoglycan-depleted cartilage samples. It is therefore argued that the reswelling of cartilage, which is both biochemical (osmotic) and mechanical (hydrostatic pressure) in origin, could be a strong candidate for characterizing the tissue, especially in regions surrounding focal cartilage defects in joints.

Articular cartilage surface failure: An investigation of the rupture rate and morphology in relation to tissue health and hydration

This study investigates the rupture rate and morphology of articular cartilage by altering the bathing environments of healthy and degenerate bovine cartilage. Soaking tissues in either distilled water or 1.5 M NaCl saline was performed in order to render the tissues into a swollen or dehydrated state, respectively. Creep compression was applied using an 8 mm flat-ended polished indenter that contained a central pore of 450 µm in diameter, providing a consistent region for rupture to occur across all 105 tested specimens. Rupture rates were determined by varying the nominal compressive stress and the loading time. Similar rupture rates were observed with the swollen healthy and degenerate specimens, loaded with either 6 or 7 MPa of nominal compressive stress over 11 and 13 min. The observed rupture rates for the dehydrated specimens loaded with 7 MPa over 60 and 90 s were 20% versus 40% and 20% versus 60% for healthy and degenerate tissues, respectively. At 8 MPa of nominal compressive stress over 60 and 90 s the observed rupture rates were 20% versus 60% and 40% versus 80% for healthy and degenerate tissues, respectively; with all dehydrated degenerate tissues exhibiting a greater tendency to rupture (Barnard’s exact test, p < 0.05). Rupture morphologies were only different in the swollen degenerate tissues ( p < 0.05). The mechanisms by which dehydration and swelling induce initial surface rupture of mildly degenerate articular cartilage differ. Dehydration increases the likelihood that the surface will rupture, however, swelling alters the observed rupture morphology.

ASSESSMENT OF THREE-DIMENSIONAL ARCHITECTURE OF COLLAGEN FIBERS IN THE SUPERFICIAL ZONE OF BOVINE ARTICULAR CARTILAGE

The aim of this study is to investigate the structure and the collagen matrix of the superficial zone of articular cartilage using a 3D imaging technique. The split line thought to represent the orientation of the collagen fibres in the superficial zone was found using Hultkrantz's method. A semitransparent membrane was physically peeled off from the most superficial surface of bovine articular cartilage. Using fibre optic laser scanning confocal microscopy, the collagen matrix in normal cartilage, the membrane and the cartilage with the membrane peeled off were studied. The superficial zone was found to contain a more sophisticated 3D collagenous matrix than previously reported. The collagen matrix in the membrane consists of interwoven long collagen bundles, and the collagen fibres immediately subjacent to it align spatially in a predominantly oblique direction to the articular surface. The split line does not represent the orientation of the collagen in the membrane. This study presents a 3D visualization technique for a minimal-invasive examination of the 3D architecture of the collagen fibres in the superficial zone of articular cartilage, and offers a new insight into the 3D structure of the collagen matrix in the superficial zone of native cartilage.

ISSUES AND ADVANCES IN THE EARLY STAGE DIAGNOSIS OF OSTEOARTHRITIS

With the progress of localized treatment procedures such as unicompartmental knee replacement, chondrocyte implantation and osteochondral grafting, it has become important to develop a means of assessing early stage cartilage and bone degradation. This review outlines the recent advances in arthroscopic tools, and discusses the major problems and issues faced in developing effective assessment methods. The central problem in joint tissue assessment is to discriminate degradation from the wide variation in normal tissue. This discrimination, however, is far from being realized by current methodologies, and is compounded by the difficulty in correlating structural features with pain and mobility in the joint. In response to these findings, an argument is provided for a new direction in quantitative tissue evaluation using an integrated chemical, structural, and functional approach, and the importance of structure–function–pain relationships.

Structural analysis of articular cartilage using multiphoton microscopy: input for biomechanical modeling

The 3-D morphology of chicken articular cartilage was quantified using multiphoton microscopy (MPM) for use in continuum-mechanical modeling. To motivate this morphological study we propose aspects of a new, 3-D finite strain constitutive model for articular cartilage focusing on the essential load-bearing morphology: an inhomogeneous, poro-(visco)elastic solid matrix reinforced by an anisotropic, (visco)elastic dispersed fiber fabric which is saturated by an incompressible fluid residing in strain-dependent pores. Samples of fresh chicken cartilage were sectioned in three orthogonal planes and imaged using MPM, specifically imaging the collagen fibers using second harmonic generation. Employing image analysis techniques based on Fourier analysis, we derived the principal directionality and dispersion of the collagen fiber fabric in the superficial layer. In the middle layer, objective thresholding techniques were used to extract the volume fraction occupied by extracellular collagen matrix. In conjunction with information available in the literature, or additional experimental testing, we show how this data can be used to derive a 3-D map of the initial solid volume fraction and Darcy permeability.

Damage initiation and progression in the cartilage surface probed by nonlinear optical microscopy

With increasing interest in treating osteoarthritis at its earliest stages, it has become important to understand the mechanisms by which the disease progresses across a joint. Here, second harmonic generation (SHG) microscopy, coupled with a two-dimensional spring-mass network model, was used to image and investigate the collagen meshwork architecture at the cartilage surface surrounding osteoarthritic lesions. We found that minor weakening of the collagen meshwork leads to the bundling of fibrils at the surface under normal loading. This bundling appears to be an irreversible step in the degradation process, as the stress concentrations drive the progression of damage, forming larger bundles and cracks that eventually form lesions.

Articular cartilage surface rupture during compression: investigating the effects of tissue hydration in relation to matrix health

This study aimed at investigating articular cartilage rupture by investigating the response of healthy and degenerate cartilage through altering the osmotic swelling environment of surface-intact, cartilage-on-bone specimens. The osmotic environment in healthy and degenerate bovine cartilage was varied by soaking tissues in either distilled water or 1.5 M NaCl saline to render the tissues into a swollen or dehydrated state (respectively). Creep compression was applied using an 8 mm flat-ended polished indenter that contained a central pore of 450 μm diameter, providing a consistent region for rupture to occur across all specimens. In the first set of experiments, surface rupture of healthy and degenerate specimens required similar levels of nominal compressive stress (8 MPa) when dehydrated than when swollen (7 MPa). In the second set of experiments, the time required for surface rupture to occur (for healthy and degenerate specimens) occurred over similar loading times (p>0.05). However, the time required for surface rupture for the swollen specimens occurred over a significantly longer time (approximately one order of magnitude) than that required for the dehydrated specimens (p<0.05). The compressive strains that were measured at rupture in the dehydrated degenerate specimens were significantly lower than those measured in the dehydrated healthy tissues (p<0.05). Rupture in dehydrated degenerate cartilage suggested a weakened articular surface, and it also suggested that dehydrated cartilage may undergo failure due to stress concentrations as it is unable to redistribute stress away from the site of loading.

New insights into the role of the superficial tangential zone in influencing the microstructural response of articular cartilage to compression

OBJECTIVE

The purpose of this study was to characterize the microstructural response of healthy cartilage in a perturbed physical environment to compressive loading with a novel channel indentation device. Manipulation of the cartilage physical environment was achieved through (1) removal of the superficial tangential zone (STZ) and (2) varying the saline bathing solution concentration.

DESIGN

Cartilage-on-bone blocks were subjected to creep loading under a nominal stress of 4.5 MPa via an indenter consisting of two rectangular platens separated by a narrow channel relief space to create a specific region where cartilage would not be directly loaded. Each sample was fixed in its near-equilibrium deformed state, after which the cartilage microstructure was examined using differential interference contrast (DIC) optical microscopy and scanning electron microscopy (SEM). The cartilage bulge in the channel relief space was studied in detail.

RESULTS

STZ removal altered the indentation response at the macro- and microstructural levels. Specifically, the strain in the directly compressed regions was reduced (P=0.012) and the bulge height in the channel relief space was greater (P<0.0001) in the STZ-removed compared with the surface-intact samples. The bulge height in the STZ-removed group was always less than the preloaded cartilage thickness. There was intense shear in the non-directly-loaded regions of intact-cartilage but not in STZ-removed cartilage. Bathing solution concentration influenced only the STZ-removed group, where lower concentrations produced significantly abrupt transitions in matrix continuity between the directly compressed and adjacent non-directly-loaded cartilage (P=0.012).

CONCLUSIONS

This study showed that while the surface layer was important in distributing loads away from directly-loaded regions, so were other factors such as the matrix fibrillar interconnectivity, swelling potential, and tissue anisotropy.

How subtle structural changes associated with maturity and mild degeneration influence the impact-induced failure modes of cartilage-on-bone

BACKGROUND

Implicit structural changes in the joint tissues, not apparent in gross appearance and related to age and mild degeneration, represent potentially important biomechanical factors that could influence the vulnerability of the joint to trauma. The hypothesis of this study was that micro-level structural differences in the cartilage tissue matrix, and its interface with the underlying bone, would result in different fracture responses to single impact loading.

METHODS

For this study a range of cartilage-on-bone samples, from intact to mildly degenerate, were obtained from bovine patellae. These samples were subjected to a single impact, via a cylindrical 6-mm diameter plane-ended indenter, sufficient to create a visible fracture on the articular surface. Microstructural assessment of the region of failure was carried out using differential interference contrast optical imaging. Distinct differences in the modes of fracture propagation were correlated with microstructural changes.

FINDINGS

It was found that the intact tissues required impact energies of approximately 2.3J to induce surface rupture. These ruptures advanced to a variable radial depth that depended on the age of the animal from which the tissue was obtained. In the intact tissues from adult animals, the ruptures were largely confined to the upper third of the cartilage thickness. In the intact tissues from adolescent animals the ruptures progressed into the deep matrix zone and crossed the underdeveloped calcified cartilage region and underlying bone. For the mildly degenerate tissue cohort, lower impact energies of approximately 1.6J was sufficient to cause extensive detachment of the articular cartilage at or near the osteochondral junction.

INTERPRETATION

The subtle microstructural differences in intact cartilage-bone tissue obtained from adolescent versus mature animals are important as they correlate with the observed differences in impact response. Any mechanical model or structural analogue of cartilage should consider such implicit structural variations and their implications for overall joint function during weight-bearing.

Articular cartilage compression: how microstructural response influences pore pressure in relation to matrix health

Our research investigated the influence of degeneration on both the pore-pressure development and microstructural response of cartilage during indentation with a flat-porous-indenter. Experiments were conducted to link the mechanical and structural responses of normal and degenerate articular cartilage. We found that from the instant of loading the degenerate matrix generated a higher peak hydrostatic excess pore pressure in a shorter period of time than the normal matrix. Following the attainment of this peak value the pore pressure in both tissue groups then gradually decayed toward zero over time, thus demonstrating a classical consolidation response. The microstructural analysis provided a unique insight into the influence of degeneration on the mechanisms of internal stress-sharing within the loaded matrix. Both disruption of the articular surface and general matrix destructuring results in an altered deformation field in both the directly loaded and nondirectly loaded regions. It is argued that the higher levels of matrix shear combined with less of the applied load being redirected into the wider cartilage continuum accounts for the elevated levels of peak hydrostatic pore pressure generated in the degenerate matrix.

DT-MRI based computation of collagen fiber deformation in human articular cartilage: a feasibility study

Accurate techniques for simulating the deformation of soft biological tissues are an increasingly valuable tool in many areas of biomechanical analysis and medical image computing. To model the complex morphology and response of articular cartilage, a hyperviscoelastic (dispersed) fiber-reinforced constitutive model is employed to complete two specimen-specific finite element (FE) simulations of an indentation experiment, with and without considering fiber dispersion. Ultra-high field Diffusion Tensor Magnetic Resonance Imaging (17.6 T DT-MRI) is performed on a specimen of human articular cartilage before and after indentation to approximately 20% compression. Based on this DT-MRI data, we detail a novel FE approach to determine the geometry (edge detection from first eigenvalue), the meshing (semi-automated smoothing of DTI measurement voxels), and the fiber structural input (estimated principal fiber direction and dispersion). The global and fiber fabric deformations of both the un-dispersed and dispersed fiber models provide a satisfactory match to that estimated experimentally. In both simulations, the fiber fabric in the superficial and middle zones becomes more aligned with the articular surface, although the dispersed model appears more consistent with the literature. In the future, a multi-disciplinary combination of DT-MRI and numerical simulation will allow the functional state of articular cartilage to be determined in vivo.

Influence of early conditioning exercise on the development of gross cartilage defects and swelling behavior of cartilage extracellular matrix in the equine midcarpal joint

OBJECTIVE

To investigate the influence of early conditioning exercise on the development of gross cartilage defects and swelling behavior of cartilage extracellular matrix (ECM) in the midcarpal joint of horses.

ANIMALS

12 Thoroughbreds.

PROCEDURES

6 horses underwent early conditioning exercise from birth to 18 months of age (CONDEX group), and 6 horses were used as control animals (PASTEX group). The horses were euthanized at 18 months of age, and the midcarpal joints were harvested. Gross defects of the cartilage surface were classified and mapped. Opposing surfaces of the third and radial carpal bones were used to quantify swelling behavior of the cartilage ECM.

RESULTS

A wide range of gross defects was detected in the cartilage on the opposing surfaces of the bones of the midcarpal joint; however, there was no significant difference between the CONDEX and PASTEX groups. Similarly, no significant difference in swelling behavior of the cartilage ECM was evident between the CONDEX and PASTEX groups.

CONCLUSIONS AND CLINICAL RELEVANCE

In the study reported here, we did not detect negative influences of early conditioning exercise on the prevalence of gross defects in cartilage of the midcarpal joint or the quality of the cartilage ECM as defined by swelling behavior. These results suggested that early conditioning exercise may be used without negative consequences for the midcarpal joint and the cartilage ECM of the third and radial carpal bones.

Cartilage collagen matrix reorientation and displacement in response to surface loading

An investigation of collagen fiber reorientation, as well as fluid and matrix movement of equine articular cartilage and subchondral bone under compressive mechanical loads, was undertaken using small angle X-ray scattering measurements and optical microscopy. Small angle X-ray scattering measurements were made on healthy and diseased samples of equine articular cartilage and subchondral bone mounted in a mechanical testing apparatus on station ID18F of ESRF, Grenoble, together with fiber orientation analysis using polarized light and displacement measurements of the cartilage matrix and fluid using tracers. At surface pressures of up to approximately 1.5 MPa, there was reversible compression of the tangential surface fibers and immediately subjacent zone. As load increased, deformation in these zones reached a maximum and then reorientation propagated to the radial deep zone. Between surface pressures of 4.8 MPa and 6.0 MPa, fiber orientation above the tide mark rotated 10 deg from the radial direction, with an overall loss of alignment. With further increase in load, the fibers "crimped" as shown by the appearance of subsidiary peaks approximately +/-10 deg either side of the principal fiber orientation direction. Failure at higher loads was characterized by a radial split in the deep cartilage, which propagated along the tide mark while the surface zone remained intact. In lesions, the fiber organization was disrupted and the initial response to load was consistent with early rupture of fibers, but the matrix relaxed to an organization very similar to that of the unloaded tissue. Tracer measurements revealed anisotropic solid and fluid displacement, which depended strongly on depth within the tissue.

Assessment of common hyperelastic constitutive equations for describing normal and osteoarthritic articular cartilage

With the aim of providing information for modelling joint and limb systems, widely available constitutive hyperelastic laws are evaluated in this paper for their ability to predict the mechanical responses of normal and osteoarthritic articular cartilage. Load—displacement data from mechanical indentation were obtained for normal and osteoarthritic cartilage at 0.1 s−1 and 0.025 s−1 and converted to the stress—stretch ratio. The data were then fitted to the ArrudA—Boyce, Mooney—Rivlin, neo-Hookean, Ogden, polynomial, and Yeoh hyperelastic laws in the MATLAB environment. Although each of the hyperelastic laws performed satisfactorily at the higher rate of loading, their ability to fit experimental data at the lower loading rate varied considerably. For the preferred models, coefficients were provided for stiff, soft, and average tissues to represent normal and degraded tissue at high and low loading rates. The present authors recommend the use of the Mooney—Rivlin or the Yeoh models for describing both normal and degraded articular cartilage, with the Mooney—Rivlin model providing the best compromise between accuracy and required computational power.

An alternative mechanical parameter for assessing the viability of articular cartilage

This paper is a sequel to previously published findings showing that mechanical indentation alone cannot clearly discriminate between normal and degraded articular cartilage. Consequently, the structural elasticity potential ℜc = ɛr/ σi, which combines indentation stress σi with near-instantaneous rebound ɛr following unloading, is hypothesized as a potential cartilage assessment parameter, which arguably measures the integrity of the collagen fibre—proteoglycan entrapment system. To establish the validity of our hypothesis, samples of normal intact, artificially degraded, and osteoarthritic bovine cartilage were subjected to quasi-static compression at 0.1 s−1 and 0.025 s−1 to 30 per cent strain and then unloaded. A significant reduction in recovery was observed for artificially and naturally degraded samples in the first 5 s following unloading ( p<0.01). The structural elasticity potential provided a considerable improvement over the results obtained using the individual indentation and rebound parameters to distinguish between paired normal and artificially degraded samples and indicated a high statistical significance of p<0.005 when applied to the differentiation of normal and osteoarthritic samples.

Primary cilia in osteoarthritic chondrocytes: from chondrons to clusters

Osteoarthritis (OA) is a common joint disease characterized by articular cartilage degeneration. The etiology of OA is unknown. Because several previous studies have shown that primary cilia play critical roles in joint development, this study examined the incidence and morphology of primary cilia in chondrocytes during joint degeneration in a naturally occurring bovine model of OA. Primary cilia were detected using antibodies to acetylated alpha-tubulin in normal cartilage as well as in mild and severe OA tissue. In normal cartilage, cilia number and length were lowest in the superficial zone and increased with distance from the articular surface. In OA tissue, the incidence and length of cilia increased at the eroding articulating surface, resulting in an overall increased proportion of cilia. This is the first study to show that primary cilia are present on chondrocytes throughout OA progression and that the overall percentage of ciliated cells within the degenerating cartilage increases with OA severity.

Joint laminate degradation assessed by reflected ultrasound from the cartilage surface and osteochondral junction

The ability to quantify and qualify the progression of joint degeneration is becoming increasingly important in surgery. This paper examines the patterns of relative ultrasound reflection from normal, artificially and naturally degraded cartilage-on-bone, particularly investigating the potential of the ratio of reflection coefficients from the surface and osteochondral junction in distinguishing normal from osteoarthritic tissue. To this end, the reflection coefficients from the articular surface and osteochondral junction of normal cartilage-on-bone samples were calculated and compared to samples after the removal of proteoglycans, disruption of the collagen meshwork, delipidization of the articular surface and mechanical abrasion. Our results show that the large variation across normal and degraded joint samples negates the use of an isolated bone reflection measurement and to a lesser extent, an isolated surface reflection. The relative surface to bone reflections, calculated as a ratio of reflection coefficients, provided a more consistent and statistically significant (p < 0.001) method for distinguishing each type of degradation, especially osteoarthritic degradation, and due to the complementary relationship between surface and bone reflections was found to be an effective method for distinguishing degraded from normal tissue in the osteoarthritic joint, independent of the site of initiation of the osteoarthritic process.

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

OBJECTIVE

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

METHOD

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

RESULTS

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

CONCLUSION

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

The influence of lipid-extraction method on the stiffness of articular cartilage

BACKGROUND

One of the known characteristics of osteoarthritis is the loss of articular cartilage lipids. Therefore, it is important to study how lipids influence the functions of the tissue. This can only be done successfully by indirect analysis involving the extraction of lipids and subsequent assessment of the delipidized matrix. Therefore, for accuracy, the procedure for lipid extraction must not induce any other modification in the samples to be assessed. Hence, we compare three rinsing agents and methods in this study.

METHODS

Normal and delipidized articular cartilage samples were tested under compressive loading at 4 loading velocities to obtain and compare their stiffness values.

FINDINGS

Chloroform rinsing resulted in a 45% decrease in the stiffness of cartilage at low strain-rates (10(-2)/s and 10(-1)/s) on average with a corresponding increase of 55% at higher strain-rate of 10/s relative to the normal. Ethanol rinsed cartilage exhibited a corresponding decrease of 40% at the low strain-rates while exhibiting an increase of about 20% at the highest loading rates. Propylene glycol rinsing resulted in a decrease of approximately 20% in stiffness, while an increase of up to 5% at high rates of loading.

INTERPRETATION

The loss of lipids modifies the stiffness of articular cartilage at all loading rates. The relatively larger deviation of the stiffness of chloroform-rinsed samples relative to the normal is probably a consequence of the drying process involved in rinsing protocol. It is probable that the results of milder rinsing agents, used without vacuum drying, are more reflective of physiological delipidization effects on the tissue. Consequently, we recommend propylene glycol and its associated protocol for extracting lipids from articular cartilage.

Indentation stiffness does not discriminate between normal and degraded articular cartilage

BACKGROUND

Relative indentation characteristics are commonly used for distinguishing between normal healthy and degraded cartilage. The application of this parameter in surgical decision making and an appreciation of articular cartilage biomechanics has prompted us to hypothesise that it is difficult to define a reference stiffness to characterise normal articular cartilage.

METHODS

This hypothesis is tested for validity by carrying out biomechanical indentation of articular cartilage samples that are characterised as visually normal and degraded relative to proteoglycan depletion and collagen disruption. Compressive loading was applied at known strain rates to visually normal, artificially degraded and naturally osteoarthritic articular cartilage and observing the trends of their stress-strain and stiffness characteristics.

FINDINGS

While our results demonstrated a 25% depreciation in the stiffness of individual samples after proteoglycan depletion, they also showed that when compared to the stiffness of normal samples only 17% lie outside the range of the stress-strain behaviour of normal samples.

INTERPRETATION

We conclude that the extent of the variability in the properties of normal samples, and the degree of overlap (81%) of the biomechanical properties of normal and degraded matrices demonstrate that indentation data cannot form an accurate basis for distinguishing normal from abnormal articular cartilage samples with consequences for the application of this mechanical process in the clinical environment.

Regional variations of collagen orientation in normal and diseased articular cartilage and subchondral bone determined using small angle X-ray scattering (SAXS)

OBJECTIVE

To determine regional differences in the orientation of collagen in the articular cartilage of the equine metacarpophalangeal joint as well as describing cartilage orientation in lesions using small angle X-ray scattering (SAXS).

DESIGN

SAXS diffraction patterns were taken at the European Synchrotron Radiation Facility (ESRF), with increasing depth into cartilage and bone cross sections. Results for healthy samples were taken at different regions along the joint which receive different loads and differences in collagen orientation were determined. Results were also taken from diseased samples and the collagen orientation changes from that of healthy samples observed.

RESULTS

Regions subject to low loads show a lower degree of orientation and regions exposed to the highest loads possess oriented collagen fibres especially in the radial layer. In early lesions the orientations of the collagen fibres are disrupted. Subchondral bone fibres are twisted in regions where the joint receives shear forces. Changes in fibre orientation are also observed in the calcified cartilage even in regions where the cartilage is intact. In more advanced lesions where there is loss of cartilage the fibres in the calcified layer are realigned tangential to the surface.

CONCLUSIONS

Regional variations in collagen arrangement show that the highly ordered layers of the articular cartilage are the most important elements in supporting high variable loads. In lesions changes occur in the deep tissue whilst the overlying cartilage appeared normal. We therefore suggest that the interface region is a key element in the early stages of the disease.

A novel approach to the development of benchmarking parameters for characterizing cartilage health

This article outlines the motivation and preliminary investigations into a novel method of characterizing cartilage health for potential in vivo application. Current in vivo indentation techniques, which primarily rely on stiffness measurements based on axial data, are unable to adequately distinguish between healthy and degraded tissue. The present in vitro study investigates the effects of controlled artificial degradation on the effective surface stretch, comparing the results with those obtained from the peripheral cartilage surrounding focal osteoarthritis. Results suggest that this technique is highly sensitive, showing a maximum range of 14% effective surface stretch in a normal joint compared with 42% for axial strain measurements. We further demonstrated that the technique can discriminate between degenerative changes and the intrinsic variations in cartilage properties across the normal joint. From these investigations we propose that the relationship between indentation and the in-plane strain field under the indenter can better distinguish degraded tissue than the currently used stiffness techniques.

Ultrasound assessment of articular cartilage: analysis of the frequency profile of reflected signals from naturally and artificially degraded samples

This article investigates in vitro the hypothesis that the frequency profile of ultrasound reflections may be used to characterize degradation and osteoarthritic progression in articular cartilage, irrespective of the effects of transducer orientation. To this end, ultrasound echoes were taken in the time domain from the articular surface and osteochondral junction of normal, collagen meshwork-disrupted, proteoglycan-depleted, and osteoarthritic samples, converted to the frequency domain by fast Fourier transform and analyzed. Our results show the significant effects of specific enzymatic degradation programs on the ultrasound frequency profile of reflections from the cartilage surface and osteochondral junction, and their manifestation in the tissue surrounding a focal osteoarthritic defect. Collagen meshwork disruption was most apparent in the profile of reflections from the articular surface, while proteoglycan depletion was most clearly observed in the reflections from the osteochondral junction. The reflected signals from the osteochondral junction may further contain information about the subchondral bone. From these results we proposed that the analysis of specific frequencies of reflected ultrasound signals has the potential to differentiate normal from degraded articular cartilage-on-bone, when the angle of incidence can be controlled within a +/-1.2 degrees limit. This encourages further research into the effects of progressive artificial degradation of the cartilage matrix and subchondral bone on the spectral profile to quantify the relationship between the frequency profile and the level of specific degradation in naturally degraded joints.

A review on the mechanical quality of articular cartilage - implications for the diagnosis of osteoarthritis

The functional behaviour of articular cartilage in diarthrodial joints is determined by its morphological and biomechanical properties. Whereas morphological changes are mainly detectable in the progressed stages of osteoarthritis, biomechanical properties seem to be more sensitive to early degenerative variations since they are determined by the biochemical composition and structural arrangement of the extracellular matrix. The objective of this paper is to review studies focussing on variations in the mechanical compressive properties during the early pre-osteoarthritic stage. The aim is to quantify the requirements to detect the early cartilage degeneration in pre-osteoarthritis based on the mechanical parameters and to create an updated basis for a better understanding of inherent relationships between characteristic parameters in articular cartilage. Correlations between mechanical and biochemical parameters as well as magnetic resonance, ultrasonic, histological and structural parameters were observed. In early osteoarthritis, static moduli decrease below 80% of healthy controls and dynamic moduli below 30% of controls. To identify osteoarthritic changes of articular cartilage based on static or dynamic mechanical parameters in an early stage of the disease progression the accuracy of a mechanical testing method has to be adequate to detect changes of 10% in cartilage stiffness.

Influence of an initiating microsplit on the resistance to compression-induced rupture of the articular surface

Cartilage-on-bone samples from bovine patellae containing a defined stellar or linear initiating split in the articular surface were incrementally loaded in direct compression with intervening rehydration, until articular surface rupture occurred. All patellae were either normal or exhibited a mild level of surface fibrillation. In all cases the actual loading site was free of disruption. The average rupture stress of the healthy cartilage was significantly higher than that of the mildly degenerate cartilage, and in both tissue categories average rupture stresses were lower for the linear split morphology than for the stellar. We propose that this contrasting rupture behavior is explained by differences in both secondary lineal surface strains associated with the depth of compressive indentation and in the ability of the fibrillar network within the surface layer to re-arrange itself in the localized regions of stress concentration around the initiating split.

An experimental and finite element poroelastic creep response analysis of an intervertebral hydrogel disc model in axial compression

A hydrogel intervertebral disc (IVD) model consisting of an inner nucleus core and an outer anulus ring was manufactured from 30 and 35% by weight Poly(vinyl alcohol) hydrogel (PVA-H) concentrations and subjected to axial compression in between saturated porous endplates at 200 N for 11 h, 30 min. Repeat experiments (n=4) on different samples (N=2) show good reproducibility of fluid loss and axial deformation. An axisymmetric nonlinear poroelastic finite element model with variable permeability was developed using commercial finite element software to compare axial deformation and predicted fluid loss with experimental data. The FE predictions indicate differential fluid loss similar to that of biological IVDs, with the nucleus losing more water than the anulus, and there is overall good agreement between experimental and finite element predicted fluid loss. The stress distribution pattern indicates important similarities with the biological IVD that includes stress transference from the nucleus to the anulus upon sustained loading and renders it suitable as a model that can be used in future studies to better understand the role of fluid and stress in biological IVDs.

Traversing the intact/fibrillated joint surface: a biomechanical interpretation

Cartilage taken from the osteoarthritic bovine patellae was used to investigate the progression of change in the collagenous architecture associated with the development of fibrillated lesions. Differential interference contrast optical microscopy using fully hydrated radial sections revealed a continuity in the alteration of the fibrillar architecture in the general matrix consistent with the progressive destructuring of a native radial arrangement of fibrils repeatedly interconnected in the transverse direction via a non-entwinement-based linking mechanism. This destructuring is shown to occur in the still intact regions adjacent to the disrupted lesion thus rendering them more vulnerable to radial rupture. Two contrasting modes of surface rupture were observed and these are explained in terms of the absence or presence of a skewed structural weakening of the intermediate zone. A mechanism of surface rupture initiation based on simple bi-layer theory is proposed to account for the intensification of surface ruptures observed in the intact regions on advancing towards the fibrillation front. Focusing specifically on the primary collagen architecture in the cartilage matrix, this study proposes a pathway of change from intact to overt disruption within a unified structural framework.

Vulnerability to rupture of the intact articular surface with respect to age and proximity to site of fibrillation: a dynamic and static-investigation

Bovine cartilage-on-bone samples taken from healthy mature patellae and from the intact regions of degenerate patellae were subjected to dynamic and static compressive loading. In-plane articular surface strain and rupture behavior were investigated and compared with previously published data obtained from immature bovine patellae. Both aging and proximity of the intact tested region to the fibrillated lesion increase the likelihood of articular surface rupture under both impact and static loading. Substantially higher levels of stress can be applied dynamically than statically without increasing the risk of articular surface rupture. Articular surface rupture is a result of lineal strains generated by the indentation profile, but any direct measurement of its in situ rupture strength is not possible. However, differences in both measured articular surface strains and rupture characteristics between the three categories of tissue suggest that there is a progressive reduction in the intrinsic strength of the intact surface layer of cartilage with both aging and proximity to site of fibrillation.