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Eckstein F, Wirth W, Putz R. Sexual dimorphism in articular tissue anatomy - Key to understanding sex differences in osteoarthritis? Osteoarthritis Cartilage 2024:S1063-4584(24)01212-3. [PMID: 38871022 DOI: 10.1016/j.joca.2024.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 05/06/2024] [Accepted: 05/31/2024] [Indexed: 06/15/2024]
Abstract
OBJECTIVE Osteoarthritis (OA) prevalence and incidence varies between women and men, but it is unknown whether this follows sex-specific differences in systemic factors (e.g. hormones) and/or differences in pre-morbid joint anatomy. We recognize that classifications of sex within humans cannot be reduced to female/male, but given the lack of literature on non-binary individuals, this review is limited to the sexual dimorphism of articular morphotypes. METHODS Based on a Pubmed search using relevant terms, and input from experts, we selected articles based on the authors' judgment of their relevance, interest, originality, and scientific quality; no "hard" bibliometric measures were used to evaluate their quality or importance. Focus was on clinical rather than pre-clinical studies, with most (imaging) data being available for the knee joint. RESULTS After introducing "sexual dimorphism", the specific literature on articular morphotypes is reviewed, structured by: radiographic joint space width (JSW), meniscus, ligaments, articular cartilage morphology, articular cartilage composition and deformation, and articular tissue response to treatment. CONCLUSIONS Sex-specific differences were clearly observed for JSW, meniscus damage, ligament size, and cartilage morphometry (volume, thickness, and surface areas) but not for cartilage composition. Ligament and cartilage measures were smaller in women even after matching for confounders. Taken together, the findings indicate that female (knee) joints may be structurally more vulnerable and at greater risk of OA. The "one size/sex fits all" approach must be abandoned in OA research, and all observational and interventional studies should report their results for sex-specific strata, at least in pre-specified secondary or post-hoc analyses.
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Affiliation(s)
- Felix Eckstein
- Research Program for Musculoskeletal Imaging, Center for Anatomy and Cell Biology, Paracelsus Medical University, Salzburg, Austria; Ludwig Boltzmann Institute for Arthritis and Rehabilitation (LBIAR), Paracelsus Medical University, Salzburg, Austria; Chondrometrics GmbH, Freilassing, Germany.
| | - Wolfgang Wirth
- Research Program for Musculoskeletal Imaging, Center for Anatomy and Cell Biology, Paracelsus Medical University, Salzburg, Austria; Ludwig Boltzmann Institute for Arthritis and Rehabilitation (LBIAR), Paracelsus Medical University, Salzburg, Austria; Chondrometrics GmbH, Freilassing, Germany
| | - Reinhard Putz
- Anatomische Anstalt, Ludwig Maximilians Universität München, Munich, Germany
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2
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Norton NM, Fischer KJ. Effects of micropipette handle diameter and inclusion of finger rest on basilar thumb joint contact mechanics. Med Eng Phys 2023; 111:103940. [PMID: 36792232 DOI: 10.1016/j.medengphy.2022.103940] [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: 10/29/2021] [Revised: 10/27/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022]
Abstract
Micropipette users commonly experience problems in the hand and upper limbs. Mechanical factors are thought to contribute to osteoarthritis (OA) initiation and progression in the basilar thumb joint. Finite element analysis can be used to examine the effects of micropipette design on contact mechanics measures within the basilar thumb joint. This pilot study examined the effect of micropipette handle diameter (12 mm, 25 mm, and 40 mm) and the presence of a finger rest on contact area, contact force, and peak contact pressure in the basilar thumb joint. All contact mechanics measures decreased with increasing handle diameter with significant differences between the 12 mm diameter and the 40 mm diameter handles (contact area down about 30 mm2, contact force down about 15 N, and peak pressure down about 1 MPa). Decreasing contact mechanics measures with increasing diameter matched our expectations that contact measures would decrease with a more open grip. Contact mechanics measures were higher (p < 0.05) with a finger rest for contact area and force. We expected peak contact pressure and contact area to decrease with the presence of a finger rest. The unexpected outcome may have been due to non-randomized testing order and fatigue during testing.
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Affiliation(s)
- Nolan M Norton
- Bioengineering Program, University of Kansas, 1132 Learned Hall 1530 W 15th St., Lawrence, KS 66045, United States
| | - Kenneth J Fischer
- Bioengineering Program, University of Kansas, 1132 Learned Hall 1530 W 15th St., Lawrence, KS 66045, United States; Mechanical Engineering, University of Kansas, 3138 Learned Hall 1530 W 15th St., Lawrence, KS 66045, United States; Orthopedics and Sports Medicine, University of Kansas Medical Center, Mail Stop 3107, 3901 Rainbow Boulevard, Kansas City, KS 66160, United States.
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3
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Norton NM, Fischer K. A Modular MRI-Compatible Pipette Simulator to Evaluate How Design Effects the Basilar Thumb Joint Mechanics. J Med Device 2022. [DOI: 10.1115/1.4054725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Abstract
People who frequently use micropipettes experience hand and upper limb disorders. The basilar thumb joint, also known as the first carpometacarpal or trapeziometacarpal joint, is commonly affected by osteoarthritis (OA). Mechanical factors are associated with OA initiation and progression. We developed a MRI-compatible modular micropipette simulator to improve understanding of how micropipette design affects basilar thumb joint contact mechanics. The micropipette simulator also addresses limitations of current techniques for studying pipetting and basilar thumb joint mechanics. Its modularity will allow future studies to examine handle design parameters such as handle diameter, cross-sectional shape, and other features. A micropipette simulator with a cylindrical handle (length 127 mm, diameter 25 mm) was used with one subject to demonstrate the system's feasibility. Contact areas were within the range of prior data from basilar thumb joint models in power grasp and lateral pinch, and contact pressures were the same order of magnitude.
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Affiliation(s)
- Nolan M Norton
- Bioengineering Program, University of Kansas , Lawrence, KS, United States
| | - Kenneth Fischer
- Bioengineering Program, University of Kansas, Lawrence, KS, United States; Orthopedics and Sports Medicine, University of Kansas Medical Center, Kansas City, KS, United States; Mechanical Engineering, University of Kansas , Lawrence, KS, United States
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4
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Terracciano R, Carcamo-Bahena Y, Royal ALR, Demarchi D, Labis JS, Harris JD, Weiner BK, Gupta N, Filgueira CS. Quantitative high-resolution 7T MRI to assess longitudinal changes in articular cartilage after anterior cruciate ligament injury in a rabbit model of post-traumatic osteoarthritis. OSTEOARTHRITIS AND CARTILAGE OPEN 2022; 4:100259. [DOI: 10.1016/j.ocarto.2022.100259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 02/28/2022] [Accepted: 03/30/2022] [Indexed: 11/25/2022] Open
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Cutcliffe HC, Kottamasu PK, McNulty AL, Goode AP, Spritzer CE, DeFrate LE. Mechanical metrics may show improved ability to predict osteoarthritis compared to T1rho mapping. J Biomech 2021; 129:110771. [PMID: 34627074 PMCID: PMC8744537 DOI: 10.1016/j.jbiomech.2021.110771] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/08/2021] [Accepted: 09/22/2021] [Indexed: 01/01/2023]
Abstract
Changes in cartilage structure and composition are commonly observed during the progression of osteoarthritis (OA). Importantly, quantitative magnetic resonance imaging (MRI) methods, such as T1rho relaxation imaging, can noninvasively provide in vivo metrics that reflect changes in cartilage composition and therefore have the potential for use in early OA detection. Changes in cartilage mechanical properties are also hallmarks of OA cartilage; thus, measurement of cartilage mechanical properties may also be beneficial for earlier OA detection. However, the relative predictive ability of compositional versus mechanical properties in detecting OA has yet to be determined. Therefore, we developed logistic regression models predicting OA status in an ex vivo environment using several mechanical and compositional metrics to assess which metrics most effectively predict OA status. Specifically, in this study the compositional metric analyzed was the T1rho relaxation time, while the mechanical metrics analyzed were the stiffness and recovery (defined as a measure of how quickly cartilage returns to its original shape after loading) of the cartilage. Cartilage recovery had the best predictive ability of OA status both alone and in a multivariate model including the T1rho relaxation time. These findings highlight the potential of cartilage recovery as a non-invasive marker of in vivo cartilage health and motivate future investigation of this metric clinically.
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Affiliation(s)
- Hattie C Cutcliffe
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC 27710, United States; Department of Biomedical Engineering, Duke University, Durham, NC 27708, United States
| | - Pavan K Kottamasu
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC 27710, United States
| | - Amy L McNulty
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC 27710, United States; Department of Pathology, Duke University School of Medicine, Durham, NC 27710, United States
| | - Adam P Goode
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC 27710, United States; Department of Population Health Sciences, Duke University School of Medicine, Durham, NC 27710, United States; Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC 27710, United States
| | - Charles E Spritzer
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, United States; Department of Radiology, Duke University School of Medicine, Durham, NC 27710, United States
| | - Louis E DeFrate
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC 27710, United States; Department of Biomedical Engineering, Duke University, Durham, NC 27708, United States; Department of Mechanical Engineering and Materials Science, Duke University, Durham, NC 27708, United States.
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Linus A, Ebrahimi M, Turunen MJ, Saarakkala S, Joukainen A, Kröger H, Koistinen A, Finnilä MA, Afara IO, Mononen ME, Tanska P, Korhonen RK. High-resolution infrared microspectroscopic characterization of cartilage cell microenvironment. Acta Biomater 2021; 134:252-260. [PMID: 34365039 DOI: 10.1016/j.actbio.2021.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 07/15/2021] [Accepted: 08/02/2021] [Indexed: 01/06/2023]
Abstract
The lateral resolution of infrared spectroscopy has been inadequate for accurate biochemical characterization of the cell microenvironment, a region regulating biochemical and biomechanical signals to cells. In this study, we demonstrate the capacity of a high-resolution Fourier transform infrared microspectroscopy (HR-FTIR-MS) to characterize the collagen content of this region. Specifically, we focus on the collagen content in the cartilage cell (chondrocyte) microenvironment of healthy and osteoarthritic (OA) cartilage. Human tibial cartilage samples (N = 28) were harvested from 7 cadaveric donors and graded for OA severity (healthy, early OA, advanced OA). HR-FTIR-MS was used to analyze the collagen content of the chondrocyte microenvironment of five distinct zones across the tissue depth. HR-FTIR-MS successfully showed collagen content distribution across chondrocytes and their environment. In zones 2 and 3 (10 - 50% of the tissue thickness), we observed that collagen content was smaller (P < 0.05) in early OA compared to the healthy tissue in the vicinity of cells (pericellular region). The collagen content loss was extended to the extracellular matrix in advanced OA tissue. No significant differences in the collagen content of the chondrocyte microenvironment were observed between the groups in the most superficial (0-10%) and deep zones (50-100%). HR-FTIR-MS revealed collagen loss in the early OA cartilage pericellular region before detectable changes in the extracellular matrix in advanced OA. HR-FTIR-MS-based compositional assessment enables a better understanding of OA-related changes in tissues. This technique can be used to identify new disease mechanisms enabling better intervention strategies. STATEMENT OF SIGNIFICANCE: Osteoarthritis (OA) is the most common degenerative joint disease causing pain and disability. While significant progress has been made in OA research, OA pathogenesis is still poorly understood and current OA treatments are mainly palliative. This study demonstrates that high-resolution FTIR microspectroscopy (HR-FTIR-MS) can characterize OA-induced compositional changes in the cell microenvironment (pericellular matrix) during the early disease stages before tissue changes in the extracellular matrix become apparent. This technique may further enable the identification of new OA mechanisms and improve our current understanding of OA pathogenesis, thus, enabling the development of better treatment methods.
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Fontaine C, D'Agostino P, Maes-Clavier C, Boutan M, Sturbois-Nachef N. Anatomy and biomechanics of healthy and arthritic trapeziometacarpal joints. HAND SURGERY & REHABILITATION 2021; 40S:S3-S14. [PMID: 34118467 DOI: 10.1016/j.hansur.2020.09.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 09/18/2020] [Accepted: 09/29/2020] [Indexed: 10/21/2022]
Abstract
Understanding the biomechanics of the trapeziometacarpal (TMC) or first carpometacarpal (CMC1) joint, the pathophysiology of basal thumb arthritis, the design and performance of surgical procedures require a solid anatomical basis. This review of literature summarizes the most recent data on the descriptive, functional, and comparative anatomy of healthy and arthritic TMC joints.
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Affiliation(s)
- C Fontaine
- Laboratoire d'Anatomie et Organogenèse, Faculté de Médecine Henri Warembourg, Université de Lille, Rue Michel Polonovski, 59045 Lille cedex, France; Laboratoire d'Automatique, de Mécanique et d'Informatique Industrielle et Humaine LAMIH, Université de Valenciennes et du Hainaut-Cambrésis, Le Mont Houy, 59313 Valenciennes cedex, France; Clinique de Traumatologie-Orthopédie, Hôpital Roger Salengro, Rue du Professeur Emile Laine, CHRU de Lille, 59037 Lille cedex, France.
| | - P D'Agostino
- Clinique de la Main, Bruxelles et Brabant-Wallon, Avenue Louise 284, 1050 Bruxelles, Belgique
| | - C Maes-Clavier
- Service de Chirurgie Orthopédique et Traumatologique, CHU Amiens-Picardie, Site sud Route départementale 408, 80054 Amiens cedex 1, France
| | - M Boutan
- Résidence Dryades, Bâtiment A1, 1, rue du 11 novembre, 40990 Saint-Paul-les-Dax, France
| | - N Sturbois-Nachef
- Clinique de Traumatologie-Orthopédie, Hôpital Roger Salengro, Rue du Professeur Emile Laine, CHRU de Lille, 59037 Lille cedex, France
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8
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Trapeziometacarpal joint ligament reconstruction in early stages of first carpometacarpal joint osteoarthritis. HAND SURGERY & REHABILITATION 2021; 40S:S42-S45. [PMID: 33401008 DOI: 10.1016/j.hansur.2020.04.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/16/2020] [Accepted: 04/17/2020] [Indexed: 11/23/2022]
Abstract
Trapeziometacarpal joint ligament reconstruction is a surgical option in the early stages of thumb basal joint arthritis when the joint is painful and unstable without chondropathy. Arthroscopy is invaluable here to ensuring the joint surfaces are intact, which is often underestimated by radiography. The Eaton-Littler procedure using a distally pedicled flexor carpi radialis slip has been studied the most in this context. This reconstruction provides pain relief while slowing the rapid development of osteoarthritis.
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9
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Cutcliffe HC, Davis KM, Spritzer CE, DeFrate L. The Characteristic Recovery Time as a Novel, Noninvasive Metric for Assessing In Vivo Cartilage Mechanical Function. Ann Biomed Eng 2020; 48:2901-2910. [PMID: 32666421 PMCID: PMC7723945 DOI: 10.1007/s10439-020-02558-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 06/25/2020] [Indexed: 12/01/2022]
Abstract
Osteoarthritis (OA) is a disease characterized by the degeneration of cartilage tissue, and is a leading cause of disability in the United States. The clinical diagnosis of OA includes the presence of pain and radiographic imaging findings, which typically do not present until advanced stages of the disease when treatment is difficult. Therefore, identifying new methods of OA detection that are sensitive to earlier pathological changes in cartilage, which may be addressed prior to the development of irreversible OA, is critical for improving OA treatment. A potentially promising avenue for developing early detection methods involves measuring the tissue’s in vivo mechanical response to loading, as changes in mechanical function are commonly observed in ex vivo studies of early OA. However, thus far the mechanical function of cartilage has not been widely assessed in vivo. Therefore, the purpose of this study was to develop a novel methodology that can be used to measure an in vivo mechanical property of cartilage: the characteristic recovery time. Specifically, in this study we quantified the characteristic recovery time of cartilage thickness after exercise in relatively young subjects with asymptomatic cartilage. Additionally, we measured baseline cartilage thickness and T1rho and T2 relaxation times (quantitative MRI) prior to exercise in these subjects to assess whether baseline MRI measures are predictive of the characteristic recovery time, to understand whether or not the characteristic recovery time provides independent information about cartilage’s mechanical state. Our results show that the mean recovery strain response across subjects was well-characterized by an exponential approach with a characteristic time of 25.2 min, similar to literature values of human characteristic times measured ex vivo. Further, we were unable to detect a statistically significant linear relationship between the characteristic recovery time and the baseline metrics measured here (T1rho relaxation time, T2 relaxation time, and cartilage thickness). This might suggest that the characteristic recovery time has the potential to provide additional information about the mechanical state of cartilage not captured by these baseline MRI metrics. Importantly, this study presents a noninvasive methodology for quantifying the characteristic recovery time, an in vivo mechanical property of cartilage. As mechanical response may be indicative of cartilage health, this study underscores the need for future studies investigating the characteristic recovery time and in vivo cartilage mechanical response at various stages of OA.
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Affiliation(s)
- Hattie C Cutcliffe
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA.,Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Keithara M Davis
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA
| | - Charles E Spritzer
- Department of Radiology, Duke University School of Medicine, Durham, NC, USA
| | - Louis DeFrate
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA. .,Department of Biomedical Engineering, Duke University, Durham, NC, USA. .,Department of Mechanical Engineering and Materials Science, Duke University, Durham, NC, USA.
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10
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Comparison of Cartilage Mechanical Properties Measured During Creep and Recovery. Sci Rep 2020; 10:1547. [PMID: 32005844 PMCID: PMC6994684 DOI: 10.1038/s41598-020-58220-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 01/02/2020] [Indexed: 12/23/2022] Open
Abstract
The diagnosis of osteoarthritis (OA) currently depends on the presence of pain and radiographic imaging findings, which generally do not present until later stages of the disease when the condition is difficult to treat. Therefore, earlier detection of OA pathology is needed for improved disease management. Ex vivo cartilage studies indicate that changes in the mechanical function of cartilage occur as degeneration progresses during OA. Thus, measurement of the in vivo cartilage mechanical response may serve as an earlier indicator of OA pathology. Though mechanical characterization is classically performed during loading, the unloading (recovery) response of cartilage may also enable determination of mechanical response. Therefore, the purpose of this study was to validate the use of the recovery response for mechanical characterization of cartilage in a controlled, ex vivo environment. To do so, confined compression creep and recovery tests were conducted on cartilage explants (N = 10), and the resulting mechanical properties from both the creep and recovery phases were compared. No statistically significant differences were found in the mechanical properties between the two phases, reinforcing the hypothesis that unloading (recovery) may be a good surrogate for loading.
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Miyamura S, Oka K, Sakai T, Tanaka H, Shiode R, Shimada S, Mae T, Sugamoto K, Yoshikawa H, Murase T. Cartilage wear patterns in severe osteoarthritis of the trapeziometacarpal joint: a quantitative analysis. Osteoarthritis Cartilage 2019; 27:1152-1162. [PMID: 30954554 DOI: 10.1016/j.joca.2019.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 03/12/2019] [Accepted: 03/27/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The present quantitative study aimed to assess the three-dimensional (3-D) cartilage wear patterns of the first metacarpal and trapezium in the advanced stage of osteoarthritis (OA) and compare cartilage measurements with radiographic severity. DESIGN Using 19 cadaveric trapeziometacarpal (TMC) joints, 3-D cartilage surface models of the first metacarpal and trapezium were created with a laser scanner, and 3-D bone surface model counterparts were similarly created after dissolving the cartilage. These two models were superimposed, and the interval distance on the articular surface as the cartilage thickness was measured. All measurements were obtained in categorized anatomic regions on the articular surface of the respective bone, and we analyzed the 3-D wear patterns on the entire cartilage surface. Furthermore, we compared measurements of cartilage thickness with radiographic OA severity according to the Eaton grading system using Pearson correlation coefficients (r). RESULTS In the first metacarpal, the cartilage thickness declined volarly (the mean cartilage thickness of the volar region was 0.32 ± 0.16 mm, whereas that of the dorsal region was 0.53 ± 0.18 mm). Conversely, the cartilage evenly degenerated throughout the articular surface of the trapezium. Measurements of the categorized regions where cartilage thinning was remarkable exhibited statistical correlations with radiographic staging (r = -0.48 to -0.72). CONCLUSIONS Our findings indicate that cartilage wear patterns differ between the first metacarpal and trapezium in the late stage of OA. There is a need for further studies on cartilage degeneration leading to symptomatic OA in the TMC joint.
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Affiliation(s)
- S Miyamura
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan.
| | - K Oka
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan.
| | - T Sakai
- Department of Orthopaedic Surgery, Yamaguchi University, Graduate School of Medicine, 1-1-1, Minamikogushi, Ube 755-8505, Japan.
| | - H Tanaka
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan.
| | - R Shiode
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan.
| | - S Shimada
- Department of Neuroscience and Cell Biology, Osaka University, Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan.
| | - T Mae
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan.
| | - K Sugamoto
- Department of Orthopaedic Biomaterial Science, Osaka University, Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan.
| | - H Yoshikawa
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan.
| | - T Murase
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan.
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Unal M, Akkus O, Sun J, Cai L, Erol UL, Sabri L, Neu CP. Raman spectroscopy-based water content is a negative predictor of articular human cartilage mechanical function. Osteoarthritis Cartilage 2019; 27:304-313. [PMID: 30359723 DOI: 10.1016/j.joca.2018.10.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 09/11/2018] [Accepted: 10/08/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Probing the change in water content is an emerging approach to assess early diagnosis of osteoarthritis (OA). We herein developed a new method to assess hydration status of cartilage nondestructively using Raman spectroscopy (RS), and showed association of Raman-based water and organic content measurement with mechanical properties of cartilage. We further compared Raman-based water measurement to gravimetric and magnetic resonance imaging (MRI)-based water measurement. DESIGN Eighteen cadaveric human articular cartilage plugs from 6 donors were evenly divided into two age groups: young (n = 9, mean age: 29.3 ± 6.6) and old (n = 9, mean age: 64.0 ± 1.5). Water content in cartilage was measured using RS, gravimetric, and MRI-based techniques. Using confined compression creep test, permeability and aggregate modulus were calculated. Regression analyses were performed among RS parameters, MRI parameter, permeability, aggregate modulus and gravimetrically measured water content. RESULTS Regardless of the method used to calculate water content (gravimetric, RS and MRI), older cartilage group consistently had higher water content compared to younger group. There was a stronger association between gravimetric and RS-based water measurement (Rg2 = 0.912) than between gravimetric and MRI-based water measurement (Rc2 = 0.530). Gravimetric and RS-based water contents were significantly correlated with permeability and aggregate modulus whereas MRI-based water measurement was not. CONCLUSION RS allows for quantification of different water compartments in cartilage nondestructively, and estimation of up to 82% of the variation observed in the permeability and aggregate modulus of articular cartilage. RS has the potential to be used clinically to monitor cartilage quality noninvasively or minimally invasively with Raman probe during arthroscopy procedures.
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Affiliation(s)
- M Unal
- Department of Mechanical Engineering, Karamanoğlu Mehmetbey University, Karaman 70100, Turkey; Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, OH 44106, USA; Center for Applied Raman Spectroscopy, Case Western Reserve University, Cleveland, OH 44106, USA.
| | - O Akkus
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, OH 44106, USA; Center for Applied Raman Spectroscopy, Case Western Reserve University, Cleveland, OH 44106, USA; Department of Orthopaedics, Case Western Reserve University, Cleveland, OH 44106, USA; Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, USA.
| | - J Sun
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH 44106, USA
| | - L Cai
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN 47907, USA
| | - U L Erol
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, OH 44106, USA
| | - L Sabri
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, OH 44106, USA
| | - C P Neu
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN 47907, USA; Department of Mechanical Engineering, University of Colorado Boulder, Boulder, CO 80309, USA
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13
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Kotelsky A, Woo CW, Delgadillo LF, Richards MS, Buckley MR. An Alternative Method to Characterize the Quasi-Static, Nonlinear Material Properties of Murine Articular Cartilage. J Biomech Eng 2018; 140:2657496. [PMID: 29049670 DOI: 10.1115/1.4038147] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Indexed: 11/08/2022]
Abstract
With the onset and progression of osteoarthritis (OA), articular cartilage (AC) mechanical properties are altered. These alterations can serve as an objective measure of tissue degradation. Although the mouse is a common and useful animal model for studying OA, it is extremely challenging to measure the mechanical properties of murine AC due to its small size (thickness < 50 μm). In this study, we developed novel and direct approach to independently quantify two quasi-static mechanical properties of mouse AC: the load-dependent (nonlinear) solid matrix Young's modulus (E) and drained Poisson's ratio (ν). The technique involves confocal microscope-based multiaxial strain mapping of compressed, intact murine AC followed by inverse finite element analysis (iFEA) to determine E and ν. Importantly, this approach yields estimates of E and ν that are independent of the initial guesses used for iterative optimization. As a proof of concept, mechanical properties of AC on the medial femoral condyles of wild-type mice were obtained for both trypsin-treated and control specimens. After proteolytic tissue degradation induced through trypsin treatment, a dramatic decrease in E was observed (compared to controls) at each of the three tested loading conditions. A significant decrease in ν due to trypsin digestion was also detected. These data indicate that the method developed in this study may serve as a valuable tool for comparative studies evaluating factors involved in OA pathogenesis using experimentally induced mouse OA models.
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Affiliation(s)
- Alexander Kotelsky
- Department of Biomedical Engineering, University of Rochester, 207 Goergen Hall, Box 270168, Rochester, NY 14627 e-mail:
| | - Chandler W Woo
- Department of Biomedical Engineering, University of Rochester, 207 Goergen Hall, Box 270168, Rochester, NY 14627 e-mail:
| | - Luis F Delgadillo
- Department of Biomedical Engineering, University of Rochester, 207 Goergen Hall, Box 270168, Rochester, NY 14627 e-mail:
| | - Michael S Richards
- Department of Surgery, School of Medicine and Dentistry, University of Rochester Medical Center, 601 Elmwood Avenue, Rm 2.4153, Rochester, NY 14627 e-mail:
| | - Mark R Buckley
- Department of Biomedical Engineering, University of Rochester, 207 Goergen Hall, Box 270168, Rochester, NY 14627 e-mail:
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Hatcher CC, Collins AT, Kim SY, Michel LC, Mostertz WC, Ziemian SN, Spritzer CE, Guilak F, DeFrate LE, McNulty AL. Relationship between T1rho magnetic resonance imaging, synovial fluid biomarkers, and the biochemical and biomechanical properties of cartilage. J Biomech 2017; 55:18-26. [PMID: 28237185 DOI: 10.1016/j.jbiomech.2017.02.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 01/27/2017] [Accepted: 02/01/2017] [Indexed: 01/01/2023]
Abstract
Non-invasive techniques for quantifying early biochemical and biomechanical changes in articular cartilage may provide a means of more precisely assessing osteoarthritis (OA) progression. The goals of this study were to determine the relationship between T1rho magnetic resonance (MR) imaging relaxation times and changes in cartilage composition, cartilage mechanical properties, and synovial fluid biomarker levels and to demonstrate the application of T1rho imaging to evaluate cartilage composition in human subjects in vivo. Femoral condyles and synovial fluid were harvested from healthy and OA porcine knee joints. Sagittal T1rho relaxation MR images of the condyles were acquired. OA regions of OA joints exhibited an increase in T1rho relaxation times as compared to non-OA regions. Furthermore in these regions, cartilage sGAG content and aggregate modulus decreased, while percent degraded collagen and water content increased. In OA joints, synovial fluid concentrations of sGAG decreased and C2C concentrations increased compared to healthy joints. T1rho relaxation times were negatively correlated with cartilage and synovial fluid sGAG concentrations and aggregate modulus and positively correlated with water content and permeability. Additionally, we demonstrated the application of these in vitro findings to the study of human subjects. Specifically, we demonstrated that walking results in decreased T1rho relaxation times, consistent with water exudation and an increase in proteoglycan concentration with in vivo loading. Together, these findings demonstrate that cartilage MR imaging and synovial fluid biomarkers provide powerful non-invasive tools for characterizing changes in the biochemical and biomechanical environments of the joint.
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Affiliation(s)
- Courtney C Hatcher
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Amber T Collins
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Sophia Y Kim
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Lindsey C Michel
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - William C Mostertz
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Sophia N Ziemian
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Charles E Spritzer
- Department of Radiology, Duke University Medical Center, Durham, NC, USA
| | - Farshid Guilak
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Louis E DeFrate
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Amy L McNulty
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA.
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15
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Hung CT, Ateshian GA. Grading of osteoarthritic cartilage: Correlations between histology and biomechanics. J Orthop Res 2016; 34:8-9. [PMID: 26694218 DOI: 10.1002/jor.23067] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Clark T Hung
- Professor of Biomedical Engineering, Associate Editor, Journal of Orthopaedic Research, Columbia University
| | - Gerard A Ateshian
- Andrew Walz Professor of Mechanical Engineering & Professor of Biomedical Engineering, Columbia University
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Chondrogenic capability of osteoarthritic chondrocytes from the trapeziometacarpal and hip joints. Cell Tissue Bank 2015; 17:171-7. [PMID: 26150189 DOI: 10.1007/s10561-015-9519-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 06/22/2015] [Indexed: 10/23/2022]
Abstract
Osteoarthritis is the most common degenerative disease of joints like the hip and the trapeziometacarpal joint (rhizarthrosis). In this in vitro study, we compared the chondrogenesis of chondrocytes derived from the trapezium and the femoral head cartilage of osteoarthritic patients to have a deeper insight on trapezium chondrocyte behavior as autologous cell source for the repair of cartilage lesions in rhizarthrosis. Chondrocytes collected from trapezium and femoral head articular cartilage were cultured in pellets and analyzed for chondrogenic differentiation, cell proliferation, glycosaminoglycan production, gene expression of chondrogenic and fibrous markers, histological and immunohistochemical analyses. Our results showed a higher cartilaginous matrix deposition and a lower fibrocartilaginous phenotype of the femoral chondrocytes with respect to the trapezium chondrocytes assessed by a higher absolute glycosaminoglycan and type II collagen production, thus demonstrating a superior chondrogenic potential of the femoral with respect to the trapezium chondrocytes. The differences in chondrogenic potential between trapezium and femoral head chondrocytes confirmed a lower regenerative capability in the trapezium than in the femoral head cartilage due to the different environment and loading acting on these joints that affects the metabolism of the resident cells. This could represent a limitation to apply the cell therapy for rhizoarthrosis.
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Turunen SM, Han SK, Herzog W, Korhonen RK. Cell deformation behavior in mechanically loaded rabbit articular cartilage 4 weeks after anterior cruciate ligament transection. Osteoarthritis Cartilage 2013; 21:505-13. [PMID: 23247212 DOI: 10.1016/j.joca.2012.12.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Revised: 11/27/2012] [Accepted: 12/07/2012] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Chondrocyte stresses and strains in articular cartilage are known to modulate tissue mechanobiology. Cell deformation behavior in cartilage under mechanical loading is not known at the earliest stages of osteoarthritis. Thus, the aim of this study was to investigate the effect of mechanical loading on volume and morphology of chondrocytes in the superficial tissue of osteoarthritic cartilage obtained from anterior cruciate ligament transected (ACLT) rabbit knee joints, 4 weeks after intervention. METHODS A unique custom-made microscopy indentation system with dual-photon microscope was used to apply controlled 2 MPa force-relaxation loading on patellar cartilage surfaces. Volume and morphology of chondrocytes were analyzed before and after loading. Also global and local tissue strains were calculated. Collagen content, collagen orientation and proteoglycan content were quantified with Fourier transform infrared microspectroscopy, polarized light microscopy and digital densitometry, respectively. RESULTS Following the mechanical loading, the volume of chondrocytes in the superficial tissue increased significantly in ACLT cartilage by 24% (95% confidence interval (CI) 17.2-31.5, P < 0.001), while it reduced significantly in contralateral group tissue by -5.3% (95% CI -8.1 to -2.5, P = 0.003). Collagen content in ACLT and contralateral cartilage were similar. PG content was reduced and collagen orientation angle was increased in the superficial tissue of ACLT cartilage compared to the contralateral cartilage. CONCLUSIONS We found the novel result that chondrocyte deformation behavior in the superficial tissue of rabbit articular cartilage is altered already at 4 weeks after ACLT, likely because of changes in collagen fibril orientation and a reduction in PG content.
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Affiliation(s)
- S M Turunen
- Department of Applied Physics, University of Eastern Finland, POB 1627, FI-70211 Kuopio, Finland.
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Lee AT, Williams AA, Lee J, Cheng R, Lindsey DP, Ladd AL. Trapezium trabecular morphology in carpometacarpal arthritis. J Hand Surg Am 2013; 38:309-15. [PMID: 23267754 PMCID: PMC3932241 DOI: 10.1016/j.jhsa.2012.10.038] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Revised: 10/25/2012] [Accepted: 10/29/2012] [Indexed: 02/02/2023]
Abstract
PURPOSE In thumb carpometacarpal osteoarthritis, current evidence suggests that degenerative, bony remodeling primarily occurs within the trapezium. Nevertheless, the pathomechanics involved and the most common sites of wear remain controversial. Quantifying structural bone morphology characteristics with high-resolution computed tomography CT (micro-CT) infer regions of load transmission. Using micro-CT, we investigated whether predominant trabecular patterns exist in arthritic versus normal trapeziums. METHODS We performed micro-CT analysis on 13 normal cadaveric trapeziums and 16 Eaton stage III to IV trapeziums. We computationally divided each specimen into 4 quadrants: volar-ulnar, volar-radial, dorsal-radial, and dorsal-ulnar. Measurements of trabecular bone morphologic parameters included bone volume ratio, connectivity, trabecular number, and trabecular thickness. Using analysis of variance with post hoc Bonferroni/Dunn correction, we compared osteoarthritic and normal specimen quadrant measurements. RESULTS No significant difference existed in bone volume fraction between the osteoarthritic and normal specimens. Osteoarthritic trapeziums, however, demonstrated significantly higher trabecular number and connectivity than nonosteoarthritic trapeziums. Comparing the volar-ulnar quadrant of osteoarthritis and normal specimens collectively, this quadrant in both consistently possessed significantly higher bone volume fraction, trabecular number, and connectivity than the dorsal-radial and volar-radial quadrants. CONCLUSIONS The significantly greater trabecular bone volume, thickness, and connectivity in the volar-ulnar quadrant compared with the dorsal-radial and dorsal-ulnar quadrants provides evidence that the greatest compressive loads at the first carpometacarpal joint occur at the volar-ulnar quadrant of the trapezium, representing a consistently affected region of wear in both normal and arthritic states. CLINICAL RELEVANCE These findings suggest that trapezial trabecular morphology undergoes pathologic alteration. This provides indirect evidence that changes in load transmission occur with thumb carpometacarpal joint arthritis development.
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Affiliation(s)
- Arthur T Lee
- Department of Orthopaedic Surgery, Robert A Chase Hand and Upper Limb Center, Stanford University School of Medicine, Stanford, CA 94304, USA
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Korhonen RK, Julkunen P, Jurvelin JS, Saarakkala S. Structural and Compositional Changes in Peri- and Extracellular Matrix of Osteoarthritic Cartilage Modulate Chondrocyte Morphology. Cell Mol Bioeng 2011. [DOI: 10.1007/s12195-011-0178-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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20
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Dvinskikh N, Blankevoort L, Strackee S, Grimbergen C, Streekstra G. The effect of lunate position on range of motion after a four-corner arthrodesis: A biomechanical simulation study. J Biomech 2011; 44:1387-92. [DOI: 10.1016/j.jbiomech.2010.12.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2010] [Revised: 12/22/2010] [Accepted: 12/25/2010] [Indexed: 12/21/2022]
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Saarakkala S, Julkunen P, Kiviranta P, Mäkitalo J, Jurvelin JS, Korhonen RK. Depth-wise progression of osteoarthritis in human articular cartilage: investigation of composition, structure and biomechanics. Osteoarthritis Cartilage 2010; 18:73-81. [PMID: 19733642 DOI: 10.1016/j.joca.2009.08.003] [Citation(s) in RCA: 168] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2009] [Revised: 06/22/2009] [Accepted: 08/20/2009] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Osteoarthritis (OA) is characterized by the changes in structure and composition of articular cartilage. However, it is not fully known, what is the depth-wise change in two major components of the cartilage solid matrix, i.e., collagen and proteoglycans (PGs), during OA progression. Further, it is unknown how the depth-wise changes affect local tissue strains during compression. Our aim was to address these issues. METHODS Data from the previous microscopic and biochemical measurements of the collagen content, distribution and orientation, PG content and distribution, water content and histological grade of normal and degenerated human patellar articular cartilage (n=73) were reanalyzed in a depth-wise manner. Using this information, a composition-based finite element (FE) model was used to estimate tissue function solely based on its composition and structure. RESULTS The orientation angle of collagen fibrils in the superficial zone of cartilage was significantly less parallel to the surface (P<0.05) in samples with early degeneration than in healthy samples. Similarly, PG content was reduced in the superficial zone in early OA (P<0.05). However, collagen content decreased significantly only at the advanced stage of OA (P<0.05). The composition-based FE model showed that under a constant stress, local tissue strains increased as OA progressed. CONCLUSION For the first time, depth-wise point-by-point statistical comparisons of structure and composition of human articular cartilage were conducted. The present results indicated that early OA is primarily characterized by the changes in collagen orientation and PG content in the superficial zone, while collagen content does not change until OA has progressed to its late stage. Our simulation results suggest that impact loads in OA joint could create a risk for tissue failure and cell death.
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Affiliation(s)
- S Saarakkala
- Department of Physics, University of Kuopio, Kuopio, Finland.
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Keenan KE, Kourtis LC, Besier TF, Lindsey DP, Gold GE, Delp SL, Beaupre GS. New resource for the computation of cartilage biphasic material properties with the interpolant response surface method. Comput Methods Biomech Biomed Engin 2009; 12:415-22. [PMID: 19675978 DOI: 10.1080/10255840802654319] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Cartilage material properties are important for understanding joint function and diseases, but can be challenging to obtain. Three biphasic material properties (aggregate modulus, Poisson's ratio and permeability) can be determined using an analytical or finite element model combined with optimisation to find the material properties values that best reproduce an experimental creep curve. The purpose of this study was to develop an easy-to-use resource to determine biphasic cartilage material properties. A Cartilage Interpolant Response Surface was generated from interpolation of finite element simulations of creep indentation tests. Creep indentation tests were performed on five sites across a tibial plateau. A least-squares residual search of the Cartilage Interpolant Response Surface resulted in a best-fit curve for each experimental condition with corresponding material properties. These sites provided a representative range of aggregate moduli (0.48-1.58 MPa), Poisson's ratio (0.00-0.05) and permeability (1.7 x 10(- 15)-5.4 x 10(- 15) m(4)/N s) values found in human cartilage. The resource is freely available from https://simtk.org/home/va-squish.
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Affiliation(s)
- Kathryn E Keenan
- VA Rehabilitation Research and Development Center, Palo Alto, CA, USA.
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Investigation of the frictional response of osteoarthritic human tibiofemoral joints and the potential beneficial tribological effect of healthy synovial fluid. Osteoarthritis Cartilage 2009; 17:1327-32. [PMID: 19410031 PMCID: PMC2753744 DOI: 10.1016/j.joca.2009.03.020] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2008] [Revised: 03/25/2009] [Accepted: 03/26/2009] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This study tests the hypothesis that the natural progression of osteoarthritis (OA) in human joints leads to an increase in the friction coefficient. This hypothesis is based on the expectation that the wear observed in OA may be exacerbated by higher friction coefficients. A corollary hypothesis is that healthy synovial fluid (SF) may help mitigate the increase in the friction coefficient in diseased joints. DESIGN The friction coefficient of human tibiofemoral joints with varying degrees of OA was measured in healthy bovine SF and physiological buffered saline (PBS). Two testing configurations were adopted, one that promotes sustained cartilage interstitial fluid pressurization to investigate the effectiveness of this mechanism with advancing OA, and another that allows interstitial fluid pressure to subside to investigate the effectiveness of boundary lubrication. RESULTS Seven specimens were visually staged to be normal or mildly degenerated (stages< or =2 on a scale of 1 to 4) and nine others had progressive degeneration (stages>2 and< or =3). No statistical differences were found in the friction coefficient with increasing OA, whether in migrating or stationary contact area configurations; however, the friction coefficient was significantly lower in SF than PBS in both configurations. CONCLUSIONS The friction coefficient of human tibiofemoral cartilage does not necessarily increase with naturally increasing OA, for visual stages ranging from 1 to 3. This outcome may be explained by the fact that interstitial fluid pressurization is not necessarily defeated by advancing degeneration. This study also demonstrates that healthy SF decreases the friction coefficient of OA joints relative to PBS.
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Palmer AW, Wilson CG, Baum EJ, Levenston ME. Composition-function relationships during IL-1-induced cartilage degradation and recovery. Osteoarthritis Cartilage 2009; 17:1029-39. [PMID: 19281879 PMCID: PMC2745941 DOI: 10.1016/j.joca.2009.02.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2008] [Revised: 11/24/2008] [Accepted: 02/16/2009] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To examine the relationships between biochemical composition and mechanical properties of articular cartilage explants during interleukin-1 (IL-1)-induced degradation and post-exposure recovery. DESIGN Bovine articular cartilage explants were cultured for up to 32 days with or without 20 ng/mL IL-1. The dynamic shear modulus |G*(dyn)| and equilibrium and dynamic unconfined compression moduli (E(equil) and |E*(dyn)|) were measured at intervals throughout the culture period. In a subsequent recovery study, explants were cultured for 4 days with or without 20ng/mL IL-1 and for an additional 16 days in control media. The dynamic moduli |E*(dyn)| and |G*(dyn)| were measured at intervals during degeneration and recovery. Conditioned media and explant digests were assayed for sulfated glycosaminoglycans (sGAG) and collagen content. RESULTS Continuous IL-1 stimulation triggered progressive decreases in E(equil), |E*(dyn)|, and |G*(dyn)| concomitant with the sequential release of sGAG and collagen from the explants. Brief IL-1 exposure resulted in a short release of sGAG but not collagen, followed by a gradual and incomplete repopulation of sGAG. The temporary sGAG depletion was associated with decreases in both |E*(dyn)| and |G*(dyn)| which also recovered after removal of IL-1. During IL-1-induced degradation and post-exposure recovery, explant mechanical properties correlated well with tissue sGAG concentration. CONCLUSIONS As previously shown for developing cartilages and engineered cartilage constructs, cytokine-induced changes in sGAG concentration (i.e., fixed charge density) are coincident with changes in compressive and shear properties of articular cartilage. Further, recovery of cartilage mechanical properties can be achieved by relief from proinflammatory stimuli and subsequent restoration of tissue sGAG concentration.
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Affiliation(s)
- Ashley W. Palmer
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA 30332,Parker H. Petit Institute for Bioengineering and Bioscience, Atlanta, GA 30332
| | - Christopher G. Wilson
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332,Parker H. Petit Institute for Bioengineering and Bioscience, Atlanta, GA 30332
| | - Elyse J. Baum
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332,Parker H. Petit Institute for Bioengineering and Bioscience, Atlanta, GA 30332
| | - Marc E. Levenston
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA 30332,Parker H. Petit Institute for Bioengineering and Bioscience, Atlanta, GA 30332,To whom correspondence should be addressed: Marc E. Levenston, Ph.D. Stanford University Department of Mechanical Engineering 233 Durand Building Stanford, CA 94305-4038 phone: (650) 723-9464 fax: (650) 725-1587
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Mahmoodian R, Leasure J, Gadikota H, Capaldi F, Siegler S. Mechanical properties of human fetal talus. Clin Orthop Relat Res 2009; 467:1186-94. [PMID: 19142689 PMCID: PMC2664425 DOI: 10.1007/s11999-008-0693-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2008] [Accepted: 12/17/2008] [Indexed: 01/31/2023]
Abstract
Mechanical characterization of human cartilage anlagen is required to effectively model congenital musculoskeletal deformities. Such modeling can effectively explore the effect of treatment procedures and potentially suggest enhanced treatment methods. Using serial MRI, we have noted shape changes of the cartilaginous hindfoot anlagen in patients with clubfoot, suggesting they are soft and deformable. We therefore determined the stress relaxation behavior of cartilage plugs obtained from third-trimester stillborn fetuses in unconfined and confined compression geometries. The material parameters determined were the aggregate modulus H(A) = 0.15 +/- 0.07 MPa, Poisson's ratio nu = 0.4 +/- 0.06, Young's modulus E(s) = 0.06 +/- 0.03 MPa, and permeability coefficients k(0) = 2.01 +/- 0.8 x 10(-14) m(4) N(-1) s(-1) and M = 4.6 +/- 1.0. As compared with adult articular cartilage, stiffness was an order of magnitude lower than the values reported in the literature, suggesting the relative softness of the tissue, and the permeability was an order of magnitude higher, indicating relative ease of flow in the tissue. Poisson's ratio also was close to the higher end of the range reported in previous studies. Such material is expected to deform and relax to larger extents. These findings are consistent with the deformability of the cartilage anlagen during manipulation and casting for treatment of clubfoot.
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Affiliation(s)
- Roza Mahmoodian
- Department of Mechanical Engineering and Mechanics, College of Engineering, Drexel University, Philadelphia, PA 19104 USA
| | - Jeremi Leasure
- Department of Mechanical Engineering and Mechanics, College of Engineering, Drexel University, Philadelphia, PA 19104 USA
| | - Hemanth Gadikota
- Department of Mechanical Engineering and Mechanics, College of Engineering, Drexel University, Philadelphia, PA 19104 USA
| | - Franco Capaldi
- Department of Mechanical Engineering and Mechanics, College of Engineering, Drexel University, Philadelphia, PA 19104 USA
| | - Sorin Siegler
- Department of Mechanical Engineering and Mechanics, College of Engineering, Drexel University, Philadelphia, PA 19104 USA
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Davenport BJ. An investigation into therapists' management of osteoarthritis of the carpometacarpal joint of the thumb in the UK. HAND THERAPY 2009. [DOI: 10.1258/ht.2009.009001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
ObjectiveOsteoarthritis (OA) of the first carpometacarpal (CMC) joint is common and causes pain and loss of function. Conservative management is widely used to manage this condition and this study aimed to investigate the current conservative management employed by therapists in the UK.MethodsA survey design was selected using a self-completed questionnaire as the data collection tool. The questionnaire was designed by the author and distributed to therapists by post to a range of therapy departments and to delegates attending a hand therapy course.ResultsA total of 115 out of 330 therapists (35%) responded with a completed questionnaire and the majority of the sample (97%) treated OA of the first CMC joint. Therapists used a variety of treatments for OA of the first CMC joint and the severity of the OA influenced the treatments used. Advice on activities of daily living, ergonomic advice, splints and exercise were the most commonly used treatment modalities. Therapists varied greatly in how effective they felt the different treatment modalities were in treating OA of the first CMC joint and how strong they felt the evidence base was to support their use. Most therapists used outcome measures, but many different ones were in use. Few therapists were aware of a classification system to grade the severity of OA of the first CMC joint.ConclusionsThere is a need for further research into the conservative management of this condition in order to establish the most effective treatments for each stage of the disease process.
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Beatus J, Beatus RA. Management of the basal joint of the thumb following interposition arthroplasty for pain and instability. Physiother Theory Pract 2008; 24:299-309. [PMID: 18574755 DOI: 10.1080/09593980701738665] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Derangement of the carpometacarpal (CMC) joint of the thumb secondary to osteoarthritis (OA) or rheumatoid arthritis (RA) is a source of pain and disability in many postmenopausal women. If surgery becomes necessary, the goals of postsurgical management are directed to relief of pain, joint protection and rest, and restoration of functional activity. This article describes the successful postsurgical rehabilitation of two patients with CMC joint arthritis of differing etiologies, and medical complexity, OA and RA, respectively, and different levels of medical complexity. Basal joint protection, passive range of motion, and gentle active exercise resulted in rapid functional recovery for these two patients.
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Affiliation(s)
- Joseph Beatus
- Associate Professor, Department of Physical Therapy, University of Maryland Eastern Shore, Princess Anne, MD 21853, USA
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Taylor ZA, Kirk TB, Miller K. Confocal arthroscopy-based patient-specific constitutive models of cartilaginous tissues—I: development of a microstructural model. Comput Methods Biomech Biomed Engin 2007; 10:307-16. [PMID: 17671863 DOI: 10.1080/10255840701336794] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Current development of a laser scanning confocal arthroscope within our school will enable 3D microscopic imaging of joint tissues in vivo. Such an instrument could be useful, for example, in assessing the microstructural condition of the living tissues without physical biopsy. It is envisaged also that linked to a suitable microstructural constitutive formulation, such imaging could allow non-invasive patient-specific estimation of tissue mechanical performance. Such a procedure could have applications in surgical planning and simulation, and assessment of engineered tissue replacements, where tissue biopsy is unacceptable. In this first of two papers the development of a suitable constitutive framework for generating such estimates is reported. A microstructure-based constitutive formulation for cartilaginous tissues is presented. The model extends existing fibre composite-type models and accounts for strain-rate sensitivity of the tissue mechanical response through incorporation of a viscoelastic fibre phase. Importantly, the model is constructed so as to allow direct incorporation of structural data from confocal images. A finite element implementation of the formulation suitable for incorporation within commercial codes is also presented.
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Affiliation(s)
- Zeike A Taylor
- Intelligent Systems for Medicine Laboratory, School of Mechanical Engineering, The University of Western Australia, Crawley/Perth, WA, Australia
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Knecht S, Vanwanseele B, Stüssi E. A review on the mechanical quality of articular cartilage - implications for the diagnosis of osteoarthritis. Clin Biomech (Bristol, Avon) 2006; 21:999-1012. [PMID: 16979270 DOI: 10.1016/j.clinbiomech.2006.07.001] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2005] [Revised: 07/03/2006] [Accepted: 07/05/2006] [Indexed: 02/07/2023]
Abstract
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.
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Affiliation(s)
- Sven Knecht
- Institute for Biomechanics, Swiss Federal Institute of Technology Zurich, CH-8093 Zurich, Switzerland.
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Wheaton AJ, Dodge GR, Elliott DM, Nicoll SB, Reddy R. Quantification of cartilage biomechanical and biochemical properties via T1rho magnetic resonance imaging. Magn Reson Med 2006; 54:1087-93. [PMID: 16200568 DOI: 10.1002/mrm.20678] [Citation(s) in RCA: 112] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The aim of this study is to develop T1rho as an MR marker of the compositional and functional condition of cartilage. Specifically, we investigate the correlation of changes in cartilage biomechanical and biochemical properties with T1rho relaxation rate in a cytokine-induced model of degeneration. Bovine cartilage explants were cultured with 30 ng/mL of interleukin-1beta to mimic the cartilage degradation of early osteoarthritis. The average rate of T1rho relaxation was calculated from T(1rho) maps acquired on a 4.7 T research scanner. Stress-relaxation biomechanical tests were conducted with a confined compression apparatus to measure uniaxial aggregate modulus (HA) and hydraulic permeability (k0) using linear biphasic theory. Proteoglycan, collagen, and water content were measured via biochemical assays. Average T(1rho) relaxation rate was strongly correlated with proteoglycan content (R2 = 0.926), HA (R2 = 0.828), and log10 k0 (R2 = 0.862). Results of this study demonstrate that T1rho MRI can detect changes in proteoglycan content and biomechanical properties of cartilage in a physiologically relevant model of cartilage degeneration. The T1rho technique can potentially be used to noninvasively and quantitatively assess the biochemical and biomechanical characteristics of articular cartilage in humans during the progression of osteoarthritis.
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Affiliation(s)
- Andrew J Wheaton
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
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Li G, Thomson M, Dicarlo E, Yang X, Nestor B, Bostrom MPG, Camacho NP. A chemometric analysis for evaluation of early-stage cartilage degradation by infrared fiber-optic probe spectroscopy. APPLIED SPECTROSCOPY 2005; 59:1527-33. [PMID: 16390593 DOI: 10.1366/000370205775142593] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
In vivo identification of early-stage cartilage degradation could positively impact disease progression in osteoarthritis, but to date remains a challenge. The primary goal of this study was to develop an infrared fiber-optic probe (IFOP) chemometric method using partial least squares (PLS1) to objectively determine the degree of cartilage degradation. Arthritic human tibial plateaus (N = 61) were obtained during knee replacement surgery and analyzed by IFOP. IFOP data were collected from multiple regions of each specimen and the cartilage graded according to the Collins Visual Grading Scale of 0, 1, 2, or 3. These grades correspond to cartilage morphology that displayed normal, swelling or softening, superficially slight fibrillation, and deeper fibrillation or serious fibrillation, respectively. The model focused on detecting early cartilage degradation and therefore utilized data from grades 0, 1, and 2. The best PLS1 calibration utilized the spectral range 1733-984 cm(-1), and independent validation of the model utilizing 206 spectra to create a model and 105 independent test spectra resulted in a correlation between the predicted and actual Collins grade of R2 = 0.8228 with a standard error of prediction of 0.258 with a PLS1 rank of 15 PLS factors. A preliminary PLS1 calibration that utilized a cross-validation technique to investigate the possibility of correlation with histological tissue grade (33 spectra from 18 tissues) resulted in R2 = 0.8408 using only eight PLS factors, a very encouraging outcome. Thus, the groundwork for use of IFOP-based chemometric determination of early cartilage degradation has been established.
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Affiliation(s)
- Guiyang Li
- Musculoskeletal Imaging and Spectroscopy Lab, Research Division, 535 E 70th Street, New York, New York 10021, USA
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Kisiday JD, Jin M, DiMicco MA, Kurz B, Grodzinsky AJ. Effects of dynamic compressive loading on chondrocyte biosynthesis in self-assembling peptide scaffolds. J Biomech 2004; 37:595-604. [PMID: 15046988 DOI: 10.1016/j.jbiomech.2003.10.005] [Citation(s) in RCA: 152] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2003] [Indexed: 10/26/2022]
Abstract
Dynamic mechanical loading has been reported to affect chondrocyte biosynthesis in both cartilage explant and chondrocyte-seeded constructs. In this study, the effects of dynamic compression on chondrocyte-seeded peptide hydrogels were analyzed for extracellular matrix synthesis and retention over long-term culture. Initial studies were conducted with chondrocyte-seeded agarose hydrogels to explore the effects of various non-continuous loading protocols on chondrocyte biosynthesis. An optimized alternate day loading protocol was identified that increased proteoglycan (PG) synthesis over control cultures maintained in free-swelling conditions. When applied to chondrocyte-seeded peptide hydrogels, alternate day loading stimulated PG synthesis up to two-fold higher than that in free-swelling cultures. While dynamic compression also increased PG loss to the medium throughout the 39-day time course, total PG accumulation in the scaffold was significantly higher than in controls after 16 and 39 days of loading, resulting in an increase in the equilibrium and dynamic compressive stiffness of the constructs. Viable cell densities of dynamically compressed cultures differed from free-swelling controls by less than 20%, demonstrating that changes in PG synthesis were due to an increase in the average biosynthesis per viable cell. Protein synthesis was not greatly affected by loading, demonstrating that dynamic compression differentially regulated the synthesis of PGs. Taken together, these results demonstrate the potential of dynamic compression for stimulating PG synthesis and accumulation for applications to in vitro culture of tissue engineered constructs prior to implantation.
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Affiliation(s)
- John D Kisiday
- Biological Engineering Division, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
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Ateshian GA, Chahine NO, Basalo IM, Hung CT. The correspondence between equilibrium biphasic and triphasic material properties in mixture models of articular cartilage. J Biomech 2004; 37:391-400. [PMID: 14757459 PMCID: PMC2819758 DOI: 10.1016/s0021-9290(03)00252-5] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Mixture models have been successfully used to describe the response of articular cartilage to various loading conditions. Mow et al. (J. Biomech. Eng. 102 (1980) 73) formulated a biphasic mixture model of articular cartilage where the collagen-proteoglycan matrix is modeled as an intrinsically incompressible porous-permeable solid matrix, and the interstitial fluid is modeled as an incompressible fluid. Lai et al. (J. Biomech. Eng. 113 (1991) 245) proposed a triphasic model of articular cartilage as an extension of their biphasic theory, where negatively charged proteoglycans are modeled to be fixed to the solid matrix, and monovalent ions in the interstitial fluid are modeled as additional fluid phases. Since both models co-exist in the cartilage literature, it is useful to show how the measured properties of articular cartilage (the confined and unconfined compressive and tensile moduli, the compressive and tensile Poisson's ratios, and the shear modulus) relate to both theories. In this study, closed-form expressions are presented that relate biphasic and triphasic material properties in tension, compression and shear. These expressions are then compared to experimental findings in the literature to provide greater insight into the measured properties of articular cartilage as a function of bathing solutions salt concentrations and proteoglycan fixed-charge density.
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Affiliation(s)
- Gerard A Ateshian
- Departments of Mechanical Engineering and Biomedical Engineering, Columbia University, New York, NY10027, USA.
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Genes NG, Rowley JA, Mooney DJ, Bonassar LJ. Effect of substrate mechanics on chondrocyte adhesion to modified alginate surfaces. Arch Biochem Biophys 2004; 422:161-7. [PMID: 14759603 DOI: 10.1016/j.abb.2003.11.023] [Citation(s) in RCA: 156] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2003] [Revised: 11/17/2003] [Indexed: 11/20/2022]
Abstract
This study characterized the attachment of chondrocytes to RGD-functionalized alginate by examining the effect of substrate stiffness on cell attachment and morphology. Bovine chondrocytes were added to wells coated with 2% alginate or RGD-alginate. The alginate was crosslinked with divalent cations ranging from 1.25 to 62.5 mmol/g alginate. Attachment to RGD-alginate was 10-20 times higher than attachment to unmodified alginate and was significantly inhibited by antibodies to integrin subunits alpha3l and beta1, cytochalasin-D, and soluble RGD peptide. The equilibrium level and rate of attachment increased with crosslink density and substrate stiffness. Substrate stiffness also regulated chondrocyte morphology, which changed from a rounded shape with nebulous actin on weaker substrates to a predominantly flat morphology with actin stress fibers on stiffer substrates. The dependence of attachment on integrins and substrate stiffness suggests that chondrocyte integrins may play a role in sensing the mechanical properties of the matrices to which they are attached.
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Affiliation(s)
- Nicholas G Genes
- Center for Tissue Engineering, University of Massachusetts Medical School, Worcester, MA, USA
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Koff MF, Ugwonali OF, Strauch RJ, Rosenwasser MP, Ateshian GA, Mow VC. Sequential wear patterns of the articular cartilage of the thumb carpometacarpal joint in osteoarthritis. J Hand Surg Am 2003; 28:597-604. [PMID: 12877846 DOI: 10.1016/s0363-5023(03)00145-x] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE The thumb carpometacarpal (CMC) joint is a primary location for osteoarthritis (OA) in the body; however, articular cartilage thickness distribution during progression of OA in the joint has not been reported previously. Determining the cartilage wear patterns within the joint is important in understanding the etiology and treatment of thumb CMC joint OA. This study used cadaveric specimens to investigate the wear patters of the articular surfaces of the trapezium and thumb metacarpal. METHODS A total of 104 fresh-frozen thumb CMC joints were radiographed, disarticulated, and visually staged for OA. Cartilage thickness maps of the trapezium and metacarpal were determined for each joint by using stereophotogrammetry. Average cartilage thickness maps for the trapezium and metacarpal were generated from all specimens for each of 4 stages of OA, showing the progression of cartilage thickness changes with disease. RESULTS In normal joints, the surface-wide mean thickness of the articular layers is 0.8 +/- 0.2 mm for the trapezium and 0.7 +/- 0.2 mm for the metacarpal. The average thickness maps were analyzed by anatomic quadrant (dorsal-radial, dorsal-ulnar, volar-radial, volar-ulnar) within the 4 stages of OA. Corresponding quadrants also were compared across the increasing stages of OA. Results show that cartilage degradation is initiated in the radial quadrants of the metacarpal and progresses to the volar quadrants of the articular surface, while significant wear is seen on the dorsal-radial quadrant of the trapezium and progresses to the volar quadrants in late-stage osteoarthritis. CONCLUSIONS These quantitative results on cartilage thinning agree with previous investigators' reports of high load bearing and low load bearing areas in the CMC joint during functional pinch and grasp positions. Understanding the progression of OA in the thumb CMC joint may aid in the surgical treatment of this disease.
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Affiliation(s)
- Matthew F Koff
- Department of Biomedical Engineering, Columbia University, New York, NY 10027, USA
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Van Giffen N, Van Ransbeeck H, De Smet L. Stabilization of the pre-arthritic trapeziometacarpal joint using ligament reconstruction. CHIRURGIE DE LA MAIN 2002; 21:277-81. [PMID: 12491703 DOI: 10.1016/s1297-3203(02)00129-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Trapeziometacarpal pre-arthrosis is a common condition with only limited therapeutic possibilities. Eaton and Littler designed a tendon stabilization. MATERIALS AND METHODS A series of 21 thumbs with painful carpometacarpal joints, treated with a ligament reconstruction according to Eaton and Littler, is described. Three failed and further surgery was required. The outcome of 18 is evaluated. There were 11 women, 7 men with a mean age of 33.7 years, all having stages I or II of osteoarthritis. Six (30%) had a traumatic event in their history. RESULTS In the early stages of degenerative osteoarthritis, the overall outcome was good with a mean DASH score of 23.2. The carpometacarpal joint was stable but a 43% progression of radiographic osteoarthritic deterioration of the joint occurred. CONCLUSION Stabilization of a painful pre-arthritic trapeziometacarpal joint is useful and reliable. A traumatic instability had worse results and probably is a contraindication to this technique.
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Affiliation(s)
- N Van Giffen
- Department of Orthopaedic Surgery, U.Z. Pellenberg, Weligerveld 1, 3212 Lubbeek, Pellenberg, Belgium
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