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Hung VT, Dee DT, McGarry MH, Lee TQ. Evaluation of Tibiofemoral Contact Mechanics After a Novel Hybrid Procedure for Femoral Osteochondral Defect Repairs With a Subchondral Implant and Dermal Matrix. Orthop J Sports Med 2024; 12:23259671241266332. [PMID: 39286524 PMCID: PMC11403705 DOI: 10.1177/23259671241266332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 02/12/2024] [Indexed: 09/19/2024] Open
Abstract
Background There is a lack of procedures that adequately address the subchondral bone structure and function for reconstructing osteochondral defects in the femoral condyles. Purpose To biomechanically evaluate the tibiofemoral joint contact characteristics before and after reconstruction of femoral condylar osteochondral defects using a novel hybrid reconstructive procedure, which was hypothesized to restore the contact characteristics to the intact condition. Study Design Controlled laboratory study. Methods Tibiofemoral contact areas, contact forces, and mean contact pressures were measured in 8 cadaveric knees (mean age 52 ± 11 years; 6 women, 2 men) using a custom testing system and pressure mapping sensors. Five conditions were tested for each condyle: intact, 8-mm defect, 8-mm repair, 10-mm defect, and 10-mm repair. Medial femoral condylar defects were evaluated at 30° of knee flexion and lateral condylar defects were evaluated at 60° of knee flexion, with compressive loads of 50, 100, and 150 N. The defects were reconstructed with a titanium fenestrated threaded implant countersunk in the subchondral bone and an acellular dermal matrix allograft. Repeated-measures analysis of variance with Bonferroni correction for multiple comparisons was used to compare the results between the 5 testing conditions at each load. Results Medial condylar defects significantly increased mean contact pressure on the lateral side (P < .042), which was restored to the intact levels with repair. The lateral condylar defect decreased the mean contact pressure laterally while increasing the mean pressure medially. The lateral and medial mean contact pressures were restored to intact levels with the 8-mm lateral condylar defect repair. The medial mean contact pressure was restored to intact levels with the 10-mm lateral condylar defect repair. The lateral mean contact pressure decreased compared with the intact state with the lateral condylar 10-mm defect repair. Conclusion Tibiofemoral joint contact pressure was restored to the intact condition after reconstruction of osteochondral defects with dermal allograft matrix and subchondral implants for the repair of both 8- and 10-mm lateral condylar defects as well as 8-mm medial condylar defects but not completely for 10-mm medial condylar defects. Clinical Relevance The novel hybrid procedure for osteochondral defect repair restored tibiofemoral joint contact characteristics to normal in a cadaveric model.
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Affiliation(s)
- Victor T Hung
- Orthopaedic Biomechanics Laboratory, Congress Medical Foundation, Pasadena, California, USA
| | - Derek T Dee
- Dee Sports Orthopaedics, Huntington Beach, California, USA
| | - Michelle H McGarry
- Orthopaedic Biomechanics Laboratory, Congress Medical Foundation, Pasadena, California, USA
| | - Thay Q Lee
- Orthopaedic Biomechanics Laboratory, Congress Medical Foundation, Pasadena, California, USA
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Li M, Teng M, Mao G, Sun Y, Liu S, Li R, Wang X, Qiu Y. PUD@HA/PEEK Scaffold Induces Subchondral Bone Regeneration to Repair Osteochondral Defect in Rabbits. ACS Biomater Sci Eng 2024; 10:1006-1017. [PMID: 38252806 DOI: 10.1021/acsbiomaterials.3c01352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Osteochondral defects (OCDs) pose a significant challenge in clinical practice, and recent advancements in their repair indicate that satisfying subchondral bone repair may be critical for this. Herein, a series of hydroxyapatite/poly(ether ether ketone) (HA/PEEK) scaffolds were fabricated with varying mass percentages (0, 20, 30, and 40%) to induce subchondral bone regeneration. Subsequently, an optimal scaffold with 40% HA/PEEK was selected to establish osteochondral scaffolds with poly(ether urethane) urea-Danshensu (PUD) for repairing the OCD. The material characteristics of HA/PEEK and PUD were investigated using scanning electron microscopy, tensile, swelling, and fatigue tests, and cytological experiments. The effects of serial HA/PEEK scaffolds on subchondral bone repair were then assessed by using microcomputed tomography, hard tissue slicing, and histological staining. Furthermore, the optimal 40% HA/PEEK scaffold was used to develop osteochondral scaffolds with PUD to observe the effect on the OCD repair. HA/PEEK materials exhibited an even HA distribution in PEEK. However, when composited with HA, PEEK exhibited inferior mechanical strength. 40%HA/PEEK scaffolds showed an optimum effect on in vivo subchondral bone repair. Cartilage regeneration on 40%HA/PEEK scaffolds was pronounced. After PUD was introduced onto the HA/PEEK, the PUD@40%HA/PEEK scaffold produced the expected effect on the repair of the OCD in rabbits. Therefore, achieving satisfactory subchondral bone repair can benefit surficial cartilage repair. The PUD@40%HA/PEEK scaffold could induce subchondral bone regeneration to repair the OCD in rabbits and could provide a novel approach for the repair of the OCD in clinical practice.
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Affiliation(s)
- Meng Li
- Department of Orthopedics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061 Shaanxi, China
| | - Menghao Teng
- Department of Orthopedics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061 Shaanxi, China
| | - Genwen Mao
- Department of Orthopedics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China
| | - Yiqing Sun
- The Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Shenghang Liu
- The Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Run Li
- The Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Xiangyu Wang
- Department of Orthopedics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China
| | - Yusheng Qiu
- Department of Orthopedics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061 Shaanxi, China
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Zheng S, Li D, Liu Q, Tang C, Hu W, Ma S, Xu Y, Ma Y, Guo Y, Wei B, Du C, Wang L. Surface-Modified Nano-Hydroxyapatite Uniformly Dispersed on High-Porous GelMA Scaffold Surfaces for Enhanced Osteochondral Regeneration. Int J Nanomedicine 2023; 18:5907-5923. [PMID: 37886722 PMCID: PMC10599329 DOI: 10.2147/ijn.s428965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 10/07/2023] [Indexed: 10/28/2023] Open
Abstract
Purpose This study aims to investigate the impact of enhancing subchondral bone repair on the efficacy of articular cartilage restoration, thereby achieving improved osteochondral regeneration outcomes. Methods In this study, we modified the surface of nano-hydroxyapatite (n-HAp) through alkylation reactions to prepare n-HApMA. Characterization techniques, including X-ray diffraction, infrared spectroscopy scanning, thermogravimetric analysis, particle size analysis, and electron microscopy, were employed to analyze n-HApMA. Bioinks were prepared using n-HApMA, high porosity GelMA hydrogel, and adipose tissue derived stromal cells (ADSCs). The rheological properties of the bioinks during photocuring were investigated using a rheometer. Based on these bioinks, a biphasic scaffold was constructed. The viability of cells within the scaffold was observed using live-dead cell staining, while the internal morphology was examined using scanning electron microscopy. The stiffness of the scaffold was evaluated through compression testing. Scaffolds were implanted into the osteochondral defects of New Zealand rabbit knees, and microCT was utilized to observe the subchondral bone repair. Hematoxylin and eosin (H&E) staining, Masson's trichrome staining, and Safranin O/Fast Green staining were performed to assess the regeneration of subchondral bone and cartilage. Furthermore, immunohistochemical staining was employed to detect the expression of osteogenic and chondrogenic-related molecules. Results Scaffold characterization revealed that surface modification enables the uniform distribution of n-HApMA within the GelMA matrix. The incorporation of 5% n-HApMA notably enhanced the elastic modulus and stiffness of the 6% high-porosity GelMA in comparison to n-HAp. Moreover, in-vivo study showed that the homogeneous dispersion of n-HApMA on the GelMA matrix facilitated the osteogenic differentiation of adipose-derived stem cells (ADSCs) and promoted osteochondral tissue regeneration. Conclusion These findings suggest potential applications of the n-HApMA/GelMA composite in the field of tissue engineering and regenerative medicine.
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Affiliation(s)
- Suyang Zheng
- Department of Orthopedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, People’s Republic of China
| | - Dong Li
- Department of Orthopedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, People’s Republic of China
- Department of Trauma Center, The Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu Province, People’s Republic of China
| | - Qingbai Liu
- Department of Orthopedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, People’s Republic of China
- Department of Orthopedics, Lianshui People’s Hospital of Kangda College Affiliated to Nanjing Medical University, Huai’an, Jiangsu Province, People’s Republic of China
| | - Cheng Tang
- Department of Orthopedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, People’s Republic of China
| | - Wenhao Hu
- Department of Orthopedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, People’s Republic of China
- Department of Orthopedics, The Affiliated Huai’an No.1 People’s Hospital of Nanjing Medical University, Huai’an, Jiangsu Province, People’s Republic of China
| | - Shengshan Ma
- Department of Orthopedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, People’s Republic of China
- Department of Sports Medicine, The First People’s Hospital of Lianyungang, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, Jiangsu Province, People’s Republic of China
| | - Yan Xu
- Department of Orthopedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, People’s Republic of China
- Key Laboratory of Additive Manufacturing Technology, Institute of Digital Medicine, Nanjing Medical University, Nanjing, Jiangsu Province, People’s Republic of China
- Cartilage Regeneration Center, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, People’s Republic of China
| | - Yong Ma
- Laboratory of New Techniques of Restoration and Reconstruction of Orthopedics and Traumatology, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, People’s Republic of China
| | - Yang Guo
- Laboratory of New Techniques of Restoration and Reconstruction of Orthopedics and Traumatology, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, People’s Republic of China
| | - Bo Wei
- Department of Orthopedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, People’s Republic of China
| | - Chuanlin Du
- Department of Orthopedics, Ganyu District People’s Hospital of Lianyungang, Lianyungang, Jiangsu Province, People’s Republic of China
| | - Liming Wang
- Department of Orthopedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, People’s Republic of China
- Key Laboratory of Additive Manufacturing Technology, Institute of Digital Medicine, Nanjing Medical University, Nanjing, Jiangsu Province, People’s Republic of China
- Cartilage Regeneration Center, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, People’s Republic of China
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Ma J, Ge J, Cheng L, Wang B, Yue D, Wang W. Subchondral Bone Plate Classification: A New and More Sensitive Approach for Predicting the Prognosis of Osteonecrosis of the Femoral Head. Cartilage 2023; 14:269-277. [PMID: 37211723 PMCID: PMC10601559 DOI: 10.1177/19476035231173096] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 01/27/2023] [Accepted: 04/15/2023] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND This study explores the impact of subchondral bone plate necrosis on the development of the osteonecrosis of femoral head (ONFH) and its joint collapse. METHODS This retrospective study included 76 ONFH patients (89 consecutive hips) with Association for Research on Osseous Circulation stage II who received conservative treatment without surgical intervention. The mean follow-up time was 15.60 ± 12.29 months. ONFH was divided into 2 types (I and II): Type I with a necrotic lesion involving subchondral bone plate and Type II with a necrotic lesion not involving subchondral bone plate. The radiological evaluations were based on plain x-rays. The data were analyzed using SPSS 26.0 statistical software. RESULTS The collapse rate in Type I ONFH was significantly higher than that in Type II ONFH (P < 0.001). The survival time of hips with Type I ONFH was significantly shorter than those with Type II ONFH and with the endpoint of the femoral head collapse (P < 0.001). The collapse rate of Type I in the new classification (80.95%) was higher compared with that of the China-Japan Friendship Hospital (CJFH) classification (63.64%), and the difference was statistically significant (χ2 = 1.776, P = 0.024). CONCLUSION Subchondral bone plate necrosis is an important factor that affects ONFH collapse and prognosis. Current classification using subchondral bone plate necrosis is more sensitive for predicting collapse compared with the CJFH classification. Effective treatments should be taken to prevent collapse if ONFH necrotic lesions involve the subchondral bone plate.
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Affiliation(s)
- Jinhui Ma
- Department of Orthopaedic Surgery, Center for Osteonecrosis and Joint Preserving & Reconstruction, China-Japan Friendship Hospital, Beijing, China
| | - Juncheng Ge
- Department of Orthopaedic Surgery, Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China
| | - Liming Cheng
- Department of Orthopaedic Surgery, Center for Osteonecrosis and Joint Preserving & Reconstruction, China-Japan Friendship Hospital, Beijing, China
| | - Bailiang Wang
- Department of Orthopaedic Surgery, Center for Osteonecrosis and Joint Preserving & Reconstruction, China-Japan Friendship Hospital, Beijing, China
| | - Debo Yue
- Department of Orthopaedic Surgery, Center for Osteonecrosis and Joint Preserving & Reconstruction, China-Japan Friendship Hospital, Beijing, China
| | - Weiguo Wang
- Department of Orthopaedic Surgery, Center for Osteonecrosis and Joint Preserving & Reconstruction, China-Japan Friendship Hospital, Beijing, China
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Fan X, Lee KM, Jones MWM, Howard D, Sun AR, Crawford R, Prasadam I. Spatial distribution of elements during osteoarthritis disease progression using synchrotron X-ray fluorescence microscopy. Sci Rep 2023; 13:10200. [PMID: 37353503 PMCID: PMC10290122 DOI: 10.1038/s41598-023-36911-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 06/12/2023] [Indexed: 06/25/2023] Open
Abstract
The osteochondral interface is a thin layer that connects hyaline cartilage to subchondral bone. Subcellular elemental distribution can be visualised using synchrotron X-ray fluorescence microscopy (SR-XFM) (1 μm). This study aims to determine the relationship between elemental distribution and osteoarthritis (OA) progression based on disease severity. Using modified Mankin scores, we collected tibia plates from 9 knee OA patients who underwent knee replacement surgery and graded them as intact cartilage (non-OA) or degraded cartilage (OA). We used a tape-assisted system with a silicon nitride sandwich structure to collect fresh-frozen osteochondral sections, and changes in the osteochondral unit were defined using quantified SR-XFM elemental mapping at the Australian synchrotron's XFM beamline. Non-OA osteochondral samples were found to have significantly different zinc (Zn) and calcium (Ca) compositions than OA samples. The tidemark separating noncalcified and calcified cartilage was rich in zinc. Zn levels in OA samples were lower than in non-OA samples (P = 0.0072). In OA samples, the tidemark had less Ca than the calcified cartilage zone and subchondral bone plate (P < 0.0001). The Zn-strontium (Sr) colocalisation index was higher in OA samples than in non-OA samples. The lead, potassium, phosphate, sulphur, and chloride distributions were not significantly different (P > 0.05). In conclusion, SR-XFM analysis revealed spatial elemental distribution at the subcellular level during OA development.
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Affiliation(s)
- Xiwei Fan
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, 60 Musk Ave/Cnr. Blamey St, Kelvin Grove, QLD, 4059, Australia
| | - Kah Meng Lee
- Central Analytical Research Facility, Queensland University of Technology, Brisbane, 4059, Australia
| | - Michael W M Jones
- Central Analytical Research Facility, Queensland University of Technology, Brisbane, 4059, Australia
- School of Chemistry and Physics, Queensland University of Technology, Brisbane, 4000, Australia
| | - Daryl Howard
- Australian Synchrotron, Melbourne, 3168, Australia
| | - Antonia Rujia Sun
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, 60 Musk Ave/Cnr. Blamey St, Kelvin Grove, QLD, 4059, Australia
| | - Ross Crawford
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, 60 Musk Ave/Cnr. Blamey St, Kelvin Grove, QLD, 4059, Australia
- The Prince Charles Hospital, Brisbane, 4032, Australia
| | - Indira Prasadam
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, 60 Musk Ave/Cnr. Blamey St, Kelvin Grove, QLD, 4059, Australia.
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Pasculli RM, Kenyon CD, Berrigan WA, Mautner K, Hammond K, Jayaram P. Mesenchymal stem cells for subchondral bone marrow lesions: From bench to bedside. Bone Rep 2022; 17:101630. [PMID: 36310763 PMCID: PMC9615138 DOI: 10.1016/j.bonr.2022.101630] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 10/04/2022] [Accepted: 10/19/2022] [Indexed: 11/21/2022] Open
Abstract
Subchondral bone marrow lesions (BMLs) are areas of disease within subchondral bone that appear as T1 hypointense and T2 hyperintense ill-defined areas of bone marrow on magnetic resonance imaging. The most common bone marrow lesions include subchondral lesions related to osteoarthritis, osteochondral defects, and avascular necrosis. Emerging therapies include autologous biologic therapeutics, in particular mesenchymal stem cells (MSCs), to maintain and improve cartilage health; MSCs have become a potential treatment option for BMLs given the unmet need for disease modification. Active areas in the preclinical research of bone marrow lesions include the paracrine function of MSCs in pathways of angiogenesis and inflammation, and the use of bioactive scaffolds to optimize the environment for implanted MSCs by facilitating chondrogenesis and higher bone volumes. A review of the clinical data demonstrates improvements in pain and functional outcomes when patients with knee osteoarthritis were treated with MSCs, suggesting that BM-MSCs can be a safe and effective treatment for patients with painful knee osteoarthritis with or without bone marrow lesions. Preliminary data examining MSCs in osteochondral defects suggest they can be beneficial as a subchondral injection alone, or as a surgical augmentation. In patients with hip avascular necrosis, those with earlier stage disease have improved outcomes when core decompression is augmented with MSCs, whereas patients in later stages post-collapse have equivalent outcomes with or without MSC treatment. While the evidence for the use of MSCs in conditions with associated bone marrow lesions seems promising, there remains a need for continued investigation into this treatment as a viable treatment option. Common BMLs include osteoarthritis, osteochondral defects, and avascular necrosis. Patients with knee osteoarthritis treated with MSCs show improved pain and function. MSCs used as subchondral injection or surgical augmentation in osteochondral defects Improved outcomes of early hip avascular necrosis after core decompression with MSCs Additional preclinical and clinical evidence of MSCs as treatment for BMLs is needed.
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Wang W, Ye R, Xie W, Zhang Y, An S, Li Y, Zhou Y. Roles of the calcified cartilage layer and its tissue engineering reconstruction in osteoarthritis treatment. Front Bioeng Biotechnol 2022; 10:911281. [PMID: 36131726 PMCID: PMC9483725 DOI: 10.3389/fbioe.2022.911281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 07/28/2022] [Indexed: 11/16/2022] Open
Abstract
Sandwiched between articular cartilage and subchondral bone, the calcified cartilage layer (CCL) takes on both biomechanical and biochemical functions in joint development and ordinary activities. The formation of CCL is not only unique in articular cartilage but can also be found in the chondro-osseous junction adjacent to the growth plate during adolescence. The formation of CCL is an active process under both cellular regulation and intercellular communication. Abnormal alterations of CCL can be indications of degenerative diseases including osteoarthritis. Owing to the limited self-repair capability of articular cartilage and core status of CCL in microenvironment maintenance, tissue engineering reconstruction of CCL in damaged cartilage can be of great significance. This review focuses on possible tissue engineering reconstruction methods targeting CCL for further OA treatment.
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Affiliation(s)
- Weiyang Wang
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, China
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Ruixi Ye
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, China
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Wenqing Xie
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yueyao Zhang
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, China
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Senbo An
- Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- *Correspondence: Senbo An, ; Yusheng Li, ; Yang Zhou,
| | - Yusheng Li
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Senbo An, ; Yusheng Li, ; Yang Zhou,
| | - Yang Zhou
- Department of Clinical Nursing, Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Senbo An, ; Yusheng Li, ; Yang Zhou,
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Lesage C, Lafont M, Guihard P, Weiss P, Guicheux J, Delplace V. Material-Assisted Strategies for Osteochondral Defect Repair. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2022; 9:e2200050. [PMID: 35322596 PMCID: PMC9165504 DOI: 10.1002/advs.202200050] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/25/2022] [Indexed: 05/08/2023]
Abstract
The osteochondral (OC) unit plays a pivotal role in joint lubrication and in the transmission of constraints to bones during movement. The OC unit does not spontaneously heal; therefore, OC defects are considered to be one of the major risk factors for developing long-term degenerative joint diseases such as osteoarthritis. Yet, there is currently no curative treatment for OC defects, and OC regeneration remains an unmet medical challenge. In this context, a plethora of tissue engineering strategies have been envisioned over the last two decades, such as combining cells, biological molecules, and/or biomaterials, yet with little evidence of successful clinical transfer to date. This striking observation must be put into perspective with the difficulty in comparing studies to identify overall key elements for success. This systematic review aims to provide a deeper insight into the field of material-assisted strategies for OC regeneration, with particular considerations for the therapeutic potential of the different approaches (with or without cells or biological molecules), and current OC regeneration evaluation methods. After a brief description of the biological complexity of the OC unit, the recent literature is thoroughly analyzed, and the major pitfalls, emerging key elements, and new paths to success are identified and discussed.
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Affiliation(s)
- Constance Lesage
- Université de NantesOnirisCHU NantesINSERMRegenerative Medicine and SkeletonRMeSUMR 1229NantesF‐44000France
- HTL Biotechnology7 Rue Alfred KastlerJavené35133France
| | - Marianne Lafont
- Université de NantesOnirisCHU NantesINSERMRegenerative Medicine and SkeletonRMeSUMR 1229NantesF‐44000France
| | - Pierre Guihard
- Université de NantesOnirisCHU NantesINSERMRegenerative Medicine and SkeletonRMeSUMR 1229NantesF‐44000France
| | - Pierre Weiss
- Université de NantesOnirisCHU NantesINSERMRegenerative Medicine and SkeletonRMeSUMR 1229NantesF‐44000France
| | - Jérôme Guicheux
- Université de NantesOnirisCHU NantesINSERMRegenerative Medicine and SkeletonRMeSUMR 1229NantesF‐44000France
| | - Vianney Delplace
- Université de NantesOnirisCHU NantesINSERMRegenerative Medicine and SkeletonRMeSUMR 1229NantesF‐44000France
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Tee CA, Yang Z, Wu Y, Ren X, Baranski M, Lin DJ, Hassan A, Han J, Lee EH. A Pre-Clinical Animal Study for Zonal Articular Cartilage Regeneration Using Stratified Implantation of Microcarrier Expanded Zonal Chondrocytes. Cartilage 2022; 13:19476035221093063. [PMID: 35446156 PMCID: PMC9152227 DOI: 10.1177/19476035221093063] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE The zonal properties of articular cartilage critically contribute to the mechanical support and lubrication of the tissue. Current treatments for articular cartilage have yet to regenerate this zonal architecture, thus compromising the functional efficacy of the repaired tissue and leading to tissue degeneration in the long term. In this study, the efficacy of zonal cartilage regeneration through bilayered implantation of expanded autologous zonal chondrocytes was investigated in a porcine chondral defect model. DESIGN Autologous chondrocytes extracted from articular cartilage in the non-weight bearing trochlea region of the knee were subjected to an expansion-sorting strategy, integrating dynamic microcarrier (dMC) culture, and spiral microchannel size-based zonal chondrocyte separation. Zonal chondrocytes were then implanted as bilayered fibrin hydrogel construct in a porcine knee chondral defect model. Repair efficacy was compared with implantation with cell-free fibrin hydrogel and full thickness (FT) cartilage-derived heterogenous chondrocytes. Cartilage repair was evaluated 6 months after implantation. RESULTS Sufficient numbers of zonal chondrocytes for implantation were generated from the non-weight bearing cartilage. Six-month repair outcomes showed that bilayered implantation of dMC-expanded zonal chondrocytes resulted in substantial recapitulation of zonal architecture, including chondrocyte arrangement, specific Proteoglycan 4 distribution, and collagen alignment, that was accompanied by healthier underlying subchondral bone. CONCLUSION These results demonstrate that with appropriate expansion and isolation of zonal chondrocytes, the strategy of stratified zonal chondrocyte implantation represents a significant advancement to Autologous Chondrocyte Implantation-based cartilage regeneration, with the potential to improve the long-term integrity of the regenerated tissues.
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Affiliation(s)
- Ching Ann Tee
- Department of Orthopaedic Surgery, National University of Singapore, Singapore,Critical Analytics for Manufacturing Personalised-Medicine, Interdisciplinary Research Group, Singapore-MIT Alliance for Research and Technology, Singapore
| | - Zheng Yang
- Department of Orthopaedic Surgery, National University of Singapore, Singapore,NUS Tissue Engineering Program, Life Science Institute, National University of Singapore, Singapore
| | - Yingnan Wu
- Department of Orthopaedic Surgery, National University of Singapore, Singapore,NUS Tissue Engineering Program, Life Science Institute, National University of Singapore, Singapore
| | - Xiafei Ren
- Department of Orthopaedic Surgery, National University of Singapore, Singapore,NUS Tissue Engineering Program, Life Science Institute, National University of Singapore, Singapore
| | - Maciej Baranski
- Critical Analytics for Manufacturing Personalised-Medicine, Interdisciplinary Research Group, Singapore-MIT Alliance for Research and Technology, Singapore
| | - Daryl Jimian Lin
- Department of Orthopaedic Surgery, National University of Singapore, Singapore,NUS Tissue Engineering Program, Life Science Institute, National University of Singapore, Singapore
| | - Afizah Hassan
- Department of Orthopaedic Surgery, National University of Singapore, Singapore,NUS Tissue Engineering Program, Life Science Institute, National University of Singapore, Singapore
| | - Jongyoon Han
- Critical Analytics for Manufacturing Personalised-Medicine, Interdisciplinary Research Group, Singapore-MIT Alliance for Research and Technology, Singapore,Department of Electrical Engineering and Computer Science, Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Eng Hin Lee
- Department of Orthopaedic Surgery, National University of Singapore, Singapore,Critical Analytics for Manufacturing Personalised-Medicine, Interdisciplinary Research Group, Singapore-MIT Alliance for Research and Technology, Singapore,NUS Tissue Engineering Program, Life Science Institute, National University of Singapore, Singapore,Eng Hin Lee, Department of Orthopaedic Surgery, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block 11, 119288 Singapore.
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10
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Fan X, Wu X, Trevisan Franca De Lima L, Stehbens S, Punyadeera C, Webb R, Hamilton B, Ayyapann V, McLauchlan C, Crawford R, Zheng M, Xiao Y, Prasadam I. The deterioration of calcified cartilage integrity reflects the severity of osteoarthritis-A structural, molecular, and biochemical analysis. FASEB J 2022; 36:e22142. [PMID: 35032407 DOI: 10.1096/fj.202101449r] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 12/03/2021] [Accepted: 12/20/2021] [Indexed: 12/11/2022]
Abstract
The calcified cartilage zone (CCZ) is a thin interlayer between the hyaline articular cartilage and the subchondral bone and plays an important role in maintaining the joint homeostasis by providing biological and mechanical support from unmineralized cartilage to the underlying mineralized subchondral bone. The hallmark of CCZ characteristics in osteoarthritis (OA) is less well known. The aim of our study is to evaluate the structural, molecular, and biochemical composition of CCZ in tissues affected by primary knee OA and its relationship with disease severity. We collected osteochondral tissue samples stratified according to disease severity, from 16 knee OA patients who underwent knee replacement surgery. We also used meniscectomy-induced rat samples to confirm the pathophysiologic changes of human samples. We defined the characteristics of the calcified cartilage layer using a combination of morphological, biochemical, proteomic analyses on laser micro-dissected tissue. Our results demonstrated that the Calcium/Phosphate ratio is unchanged during the OA progression, but the calcium-binding protein and cadherin binding protein, as well as carbohydrate metabolism-related proteins, undergo significant changes. These changes were further accompanied by thinning of the CCZ, loss of collagen and proteoglycan content, the occurrence of the endochondral ossification, neovasculature, loss of the elastic module, loss of the collagen direction, and increase of the tortuosity indicating an altered structural and mechanical properties of the CCZ in OA. In conclusion, our results suggest that the calcified cartilage changes can reflect the disease progression.
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Affiliation(s)
- Xiwei Fan
- Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Xiaoxin Wu
- Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Queensland, Australia.,Department of Orthopaedic Surgery, the Second Xiangya Hospital, Central South University, Changsha, China
| | | | - Samantha Stehbens
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
| | - Chamindie Punyadeera
- Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Queensland, Australia.,Translational Research Institute, Brisbane, Queensland, Australia
| | - Richard Webb
- Centre for Microscopy and Microanalysis, University of Queensland, Brisbane, Queensland, Australia
| | - Brett Hamilton
- Centre for Microscopy and Microanalysis, University of Queensland, Brisbane, Queensland, Australia
| | - Vijay Ayyapann
- Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Connor McLauchlan
- Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Ross Crawford
- Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Queensland, Australia.,The Prince Charles Hospital, Brisbane, Queensland, Australia
| | - Minghao Zheng
- Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Yin Xiao
- Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Queensland, Australia.,Australia-China Centre for Tissue Engineering and Regenerative Medicine, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Indira Prasadam
- Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Queensland, Australia
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11
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Santos-Beato P, Midha S, Pitsillides AA, Miller A, Torii R, Kalaskar DM. Biofabrication of the osteochondral unit and its applications: Current and future directions for 3D bioprinting. J Tissue Eng 2022; 13:20417314221133480. [PMID: 36386465 PMCID: PMC9643769 DOI: 10.1177/20417314221133480] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/30/2022] [Indexed: 07/20/2023] Open
Abstract
Multiple prevalent diseases, such as osteoarthritis (OA), for which there is no cure or full understanding, affect the osteochondral unit; a complex interface tissue whose architecture, mechanical nature and physiological characteristics are still yet to be successfully reproduced in vitro. Although there have been multiple tissue engineering-based approaches to recapitulate the three dimensional (3D) structural complexity of the osteochondral unit, there are various aspects that still need to be improved. This review presents the different pre-requisites necessary to develop a human osteochondral unit construct and focuses on 3D bioprinting as a promising manufacturing technique. Examples of 3D bioprinted osteochondral tissues are reviewed, focusing on the most used bioinks, chosen cell types and growth factors. Further information regarding the applications of these 3D bioprinted tissues in the fields of disease modelling, drug testing and implantation is presented. Finally, special attention is given to the limitations that currently hold back these 3D bioprinted tissues from being used as models to investigate diseases such as OA. Information regarding improvements needed in bioink development, bioreactor use, vascularisation and inclusion of additional tissues to further complete an OA disease model, are presented. Overall, this review gives an overview of the evolution in 3D bioprinting of the osteochondral unit and its applications, as well as further illustrating limitations and improvements that could be performed explicitly for disease modelling.
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Affiliation(s)
| | - Swati Midha
- Kennedy Institute of Rheumatology,
University of Oxford, Oxford, UK
| | | | - Aline Miller
- Department of Chemical Engineering,
University of Manchester, Manchester, UK
| | - Ryo Torii
- Department of Mechanical Engineering,
University College London, London, UK
| | - Deepak M Kalaskar
- Institute of Orthopaedics and
Musculoskeletal Science, Division of Surgery & Interventional Science,
University College London (UCL), UK
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12
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Pitta Kruize C, Panahkhahi S, Putra NE, Diaz-Payno P, van Osch G, Zadpoor AA, Mirzaali MJ. Biomimetic Approaches for the Design and Fabrication of Bone-to-Soft Tissue Interfaces. ACS Biomater Sci Eng 2021. [PMID: 34784181 DOI: 10.1021/acsbiomaterials.1c00620] [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] [Indexed: 12/31/2022]
Abstract
Bone-to-soft tissue interfaces are responsible for transferring loads between tissues with significantly dissimilar material properties. The examples of connective soft tissues are ligaments, tendons, and cartilages. Such natural tissue interfaces have unique microstructural properties and characteristics which avoid the abrupt transitions between two tissues and prevent formation of stress concentration at their connections. Here, we review some of the important characteristics of these natural interfaces. The native bone-to-soft tissue interfaces consist of several hierarchical levels which are formed in a highly specialized anisotropic fashion and are composed of different types of heterogeneously distributed cells. The characteristics of a natural interface can rely on two main design principles, namely by changing the local microarchitectural features (e.g., complex cell arrangements, and introducing interlocking mechanisms at the interfaces through various geometrical designs) and changing the local chemical compositions (e.g., a smooth and gradual transition in the level of mineralization). Implementing such design principles appears to be a promising approach that can be used in the design, reconstruction, and regeneration of engineered biomimetic tissue interfaces. Furthermore, prominent fabrication techniques such as additive manufacturing (AM) including 3D printing and electrospinning can be used to ease these implementation processes. Biomimetic interfaces have several biological applications, for example, to create synthetic scaffolds for osteochondral tissue repair.
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Affiliation(s)
- Carlos Pitta Kruize
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands
| | - Sara Panahkhahi
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands
| | - Niko Eka Putra
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands
| | - Pedro Diaz-Payno
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands
| | - Gerjo van Osch
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands
| | - Amir A Zadpoor
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands
| | - Mohammad J Mirzaali
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands
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13
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Fan X, Wu X, Crawford R, Xiao Y, Prasadam I. Macro, Micro, and Molecular. Changes of the Osteochondral Interface in Osteoarthritis Development. Front Cell Dev Biol 2021; 9:659654. [PMID: 34041240 PMCID: PMC8142862 DOI: 10.3389/fcell.2021.659654] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 04/12/2021] [Indexed: 01/05/2023] Open
Abstract
Osteoarthritis (OA) is a long-term condition that causes joint pain and reduced movement. Notably, the same pathways governing cell growth, death, and differentiation during the growth and development of the body are also common drivers of OA. The osteochondral interface is a vital structure located between hyaline cartilage and subchondral bone. It plays a critical role in maintaining the physical and biological function, conveying joint mechanical stress, maintaining chondral microenvironment, as well as crosstalk and substance exchange through the osteochondral unit. In this review, we summarized the progress in research concerning the area of osteochondral junction, including its pathophysiological changes, molecular interactions, and signaling pathways that are related to the ultrastructure change. Multiple potential treatment options were also discussed in this review. A thorough understanding of these biological changes and molecular mechanisms in the pathologic process will advance our understanding of OA progression, and inform the development of effective therapeutics targeting OA.
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Affiliation(s)
- Xiwei Fan
- Faculty of Science and Engineering, School of Mechanical, Medical and Process Engineering, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Xiaoxin Wu
- Faculty of Science and Engineering, School of Mechanical, Medical and Process Engineering, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Ross Crawford
- Faculty of Science and Engineering, School of Mechanical, Medical and Process Engineering, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.,Orthopaedic Department, The Prince Charles Hospital, Brisbane, QLD, Australia
| | - Yin Xiao
- Faculty of Science and Engineering, School of Mechanical, Medical and Process Engineering, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.,Australia-China Centre for Tissue Engineering and Regenerative Medicine, Queensland University of Technology, Brisbane, QLD, Australia
| | - Indira Prasadam
- Faculty of Science and Engineering, School of Mechanical, Medical and Process Engineering, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
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14
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Silvers BL, Leatherwood JL, Arnold CE, Nielsen BD, Huseman CJ, Dominguez BJ, Glass KG, Martinez RE, Much ML, Bradbery AN. Effects of aquatic conditioning on cartilage and bone metabolism in young horses. J Anim Sci 2020; 98:5876845. [PMID: 32717078 DOI: 10.1093/jas/skaa239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 07/20/2020] [Indexed: 11/12/2022] Open
Abstract
While beneficial in rehabilitation, aquatic exercise effects on cartilage and bone metabolism in young, healthy horses has not been well described. Therefore, 30 Quarter Horse yearlings (343 ± 28 kg; 496 ± 12 d of age) were stratified by age, body weight (BW), and sex and randomly assigned to 1 of 3 treatments for 140-d to evaluate effects of aquatic, dry, or no exercise on bone and cartilage metabolism in young horses transitioning to an advanced workload. Treatments included nonexercise control (CON; n = 10), dry treadmill (DRY; n = 10), or aquatic treadmill exercise (H2O; n = 10; water: 60% wither height, WH). Horses were housed individually (3.6 × 3.6 m) from 0600 to 1800 hours, allowed turnout (74 × 70 m) from 1800 to 0600 hours, and fed to meet or exceed requirements. During phase I (days 0 to 112), DRY and H2O walked on treadmills 30 min/d, 5 d/wk. Phase II (days 113 to 140) transitioned to an advanced workload 5 d/wk. Every 14-d, WH, hip height (HH), and BW were recorded. Left third metacarpal radiographs on days 0, 112, and 140 were analyzed for radiographic bone aluminum equivalence (RBAE). Every 28-d, serum samples were analyzed for osteocalcin and C-telopeptide crosslaps of type I collagen (CTX-1), and synovial fluid samples were analyzed for prostaglandin E2, collagenase cleavage neopeptide (C2C), collagenase of type I and type II collagen, and carboxypeptide of type II collagen using ELISAs. All data were analyzed using PROC MIXED of SAS, including random effect of horse within treatment, and repeated effect of day. Baseline treatment differences were accounted for using a covariate. There were treatment × day interactions (P < 0.01) where OC and CTX-1 remained consistent in both exercise groups while inconsistently increasing in CON. There were no treatment differences (P > 0.30) in RBAE, BW, or HH, but all increased over time (P < 0.01). There were no treatment × day interactions of synovial inflammation or markers of cartilage metabolism; however, there was an effect of day for each marker (P<0.03). Changes in biomarkers of cartilage turnover in horses exercised at the walk, whether dry or aquatic, could not be distinguished from horses with access to turnout alone. This study indicates that early forced exercise supports consistent bone metabolism necessary for uniform growth and bone development, and that there are no negative effects of buoyancy on cartilage metabolism in yearlings transitioned from aquatic exercise to a 28-d advanced workload.
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Affiliation(s)
| | | | - Carolyn E Arnold
- Department of Large Animal Clinical Sciences, Texas A&M University, College Station, TX
| | - Brian D Nielsen
- Department of Animal Science, Michigan State University, East Lansing, MI
| | - Chelsie J Huseman
- Department of Animal Science, Texas A&M University, College Station, TX
| | - Brandon J Dominguez
- Department of Large Animal Clinical Sciences, Texas A&M University, College Station, TX
| | - Kati G Glass
- Department of Large Animal Clinical Sciences, Texas A&M University, College Station, TX
| | - Rafael E Martinez
- Department of Animal Science, Texas A&M University, College Station, TX
| | - Mattea L Much
- Department of Animal Science, Texas A&M University, College Station, TX
| | - Amanda N Bradbery
- Department of Animal Science, Texas A&M University, College Station, TX
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15
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Szwedowski D, Dallo I, Irlandini E, Gobbi A. Osteo-core Plasty: A Minimally Invasive Approach for Subchondral Bone Marrow Lesions of the Knee. Arthrosc Tech 2020; 9:e1773-e1777. [PMID: 33294339 PMCID: PMC7695615 DOI: 10.1016/j.eats.2020.07.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 07/22/2020] [Indexed: 02/03/2023] Open
Abstract
"Bone marrow lesion" (BML) is a common term used to describe the presence of fluid in the bone marrow. Although various pathologies can cause BMLs seen on magnetic resonance imaging, in this Technical Note we focus on treating the lesions associated with osteoarthritis in the knee joint. The role of the subchondral bone in transferring loads within the knee joint, as well as in cartilage homeostasis, is well established. In addition, cartilage and subchondral bone are increasingly considered as an osteochondral unit, rather than as 2 separate structures. Knee osteoarthritis, along with insufficiency fracture, is one of the main indications for the treatment of painful BMLs. Nowadays, there is a growing interest in this field, and new approaches are being developed. Our technique can be defined as a surgical procedure aimed directly at pathology within the subchondral bone and is named "osteo-core plasty." It consists of 2 parts: The first is decompression of bone marrow to decrease intraosseous pressure, and the second is administration of bone marrow aspirate concentrate for better healing potential and bone autograft to deliver supportive tissue. It should be noted that the cause of BMLs must be known before this kind of treatment is performed.
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Affiliation(s)
- Dawid Szwedowski
- Address correspondence to Dawid Szwedowski, M.D., Orthopaedic Arthroscopic Surgery International (OASI) Bioresearch Foundation Gobbi NPO, Milan, Italy.
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16
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Wu Z, Wang B, Tang J, Bai B, Weng S, Xie Z, Shen Z, Yan D, Chen L, Zhang J, Yang L. Degradation of subchondral bone collagen in the weight-bearing area of femoral head is associated with osteoarthritis and osteonecrosis. J Orthop Surg Res 2020; 15:526. [PMID: 33176818 PMCID: PMC7659206 DOI: 10.1186/s13018-020-02065-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 11/02/2020] [Indexed: 01/15/2023] Open
Abstract
Background The aim of the study was to evaluate the change of subchondral bone collagen and trabecular bone in the weight-bearing area of femoral head from patients with osteoarthritis (OA) or osteonecrosis of femoral head (ONFH), and discuss the effect of collagen degradation on OA and ONFH. Methods Femoral heads from patients with femoral neck fracture (FNF) were collected as control group. All collected samples were divided into OA group (N = 10), ONFH group (N = 10), and FNF group (N = 10). Differences of subchondral bone collagen were compared through scanning electron microscope (SEM) observation, immunohistochemistry staining, and Masson’s trichrome staining. Alteration of subchondral bone was displayed through hematoxylin and eosin (H&E) staining and gross morphology. Results SEM results showed that collagen fibers in OA and ONFH group appeared to be thinner, rougher, sparser, and more wizened. Immunohistochemistry and Masson’s trichrome staining results demonstrated that the content of collagen fibers in the OA and ONFH group was obviously less than the FNF group. H&E staining results showed that trabecular bone in OA and ONFH group appeared to be thinner and ruptured. Gross morphology results showed that the degeneration and destruction of cartilage and subchondral bone in OA and ONFH group were severer than FNF group. The characteristics mentioned above in ONFH group were more apparent than OA group. Conclusions This study revealed that degradation of collagen fibers from subchondral bone in the weight-bearing area of femoral head was associated with OA and ONFH, which may help to find new therapeutic strategies of the diseases.
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Affiliation(s)
- Zongyi Wu
- Department of Orthopaedics Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No.109, Xueyuan West Road, Lucheng District, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Bingzhang Wang
- Department of Orthopaedics Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No.109, Xueyuan West Road, Lucheng District, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Jiahao Tang
- Department of Orthopaedics Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No.109, Xueyuan West Road, Lucheng District, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Bingli Bai
- Department of Orthopaedics Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No.109, Xueyuan West Road, Lucheng District, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Sheji Weng
- Department of Orthopaedics Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No.109, Xueyuan West Road, Lucheng District, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Zhongjie Xie
- Department of Orthopaedics Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No.109, Xueyuan West Road, Lucheng District, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Zijian Shen
- Department of Orthopaedics Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No.109, Xueyuan West Road, Lucheng District, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Deyi Yan
- Department of Orthopaedics Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No.109, Xueyuan West Road, Lucheng District, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Liang Chen
- Department of Orthopaedics Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No.109, Xueyuan West Road, Lucheng District, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Jingdong Zhang
- Department of Orthopaedics Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No.109, Xueyuan West Road, Lucheng District, Wenzhou, 325000, Zhejiang, People's Republic of China.
| | - Lei Yang
- Department of Orthopaedics Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No.109, Xueyuan West Road, Lucheng District, Wenzhou, 325000, Zhejiang, People's Republic of China.
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17
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Chen L, Zheng JJY, Li G, Yuan J, Ebert JR, Li H, Papadimitriou J, Wang Q, Wood D, Jones CW, Zheng M. Pathogenesis and clinical management of obesity-related knee osteoarthritis: Impact of mechanical loading. J Orthop Translat 2020; 24:66-75. [PMID: 32695606 PMCID: PMC7349942 DOI: 10.1016/j.jot.2020.05.001] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 04/28/2020] [Accepted: 05/02/2020] [Indexed: 12/16/2022] Open
Abstract
Obesity-related osteoarthritis (OA) is a complex, multifactorial condition that can cause significant impact on patients' quality of life. Whilst chronic inflammation, adipocytokines and metabolic factors are considered to be important pathogenic factors in obesity related OA, there has been limited investigation into the biomechanical impact of obesity on OA development. This review aims to demonstrate that mechanical factors are the major pathological cause of obesity-related OA. The effect of obesity on pathological changes to the osteochondral unit and surrounding connective tissues in OA is summarized, as well as the impact of obesity-related excessive and abnormal joint loading, concomitant joint malalignment and muscle weakness. An integrated therapeutic strategy based on this multi-factorial presentation is presented, to assist in the management of obesity related OA. THE TRANSLATIONAL POTENTIAL OF THIS ARTICLE Despite the high prevalence of obesity-related OA, there is no specific guideline available for obesity-related OA management. In this review, we demonstrated the pathological changes of obesity-related OA and summarized the impact of biomechanical factors by proposing a hypothetical model of obesity-related OA change. Therapeutic strategies based on adjusting abnormal mechanical effects are presented to assist in the management of obesity-related OA.
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Affiliation(s)
- Lianzhi Chen
- Centre for Orthopaedic Research, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | | | - Guangyi Li
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Jun Yuan
- Centre for Orthopaedic Research, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
- Perron Institute for Neurological and Translational Science, Perth, Western Australia, Australia
| | - Jay R. Ebert
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Western Australia, Australia
| | - Hengyuan Li
- Department of Orthopedics, Second Affiliated Hospital of Zhejiang University, School of Medicine, Zhejiang, China
| | - John Papadimitriou
- Centre for Orthopaedic Research, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
- Pathwest Laboratories, Perth, Western Australia, Australia
| | - Qingwen Wang
- Department of Rheumatism and Immunology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - David Wood
- Centre for Orthopaedic Research, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Christopher W. Jones
- Fiona Stanley Hospital Group, Perth, Western Australia, Australia
- Curtin University Medical School, Perth, Western Australia, Australia
| | - Minghao Zheng
- Centre for Orthopaedic Research, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
- Perron Institute for Neurological and Translational Science, Perth, Western Australia, Australia
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18
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Focal Chondral and Subchondral Bone Lesions of the Knee: Current Evidence for the Use of Biologic Treatment. OPER TECHN SPORT MED 2020. [DOI: 10.1016/j.otsm.2019.150716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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19
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Mukherjee S, Nazemi M, Jonkers I, Geris L. Use of Computational Modeling to Study Joint Degeneration: A Review. Front Bioeng Biotechnol 2020; 8:93. [PMID: 32185167 PMCID: PMC7058554 DOI: 10.3389/fbioe.2020.00093] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 01/31/2020] [Indexed: 12/13/2022] Open
Abstract
Osteoarthritis (OA), a degenerative joint disease, is the most common chronic condition of the joints, which cannot be prevented effectively. Computational modeling of joint degradation allows to estimate the patient-specific progression of OA, which can aid clinicians to estimate the most suitable time window for surgical intervention in osteoarthritic patients. This paper gives an overview of the different approaches used to model different aspects of joint degeneration, thereby focusing mostly on the knee joint. The paper starts by discussing how OA affects the different components of the joint and how these are accounted for in the models. Subsequently, it discusses the different modeling approaches that can be used to answer questions related to OA etiology, progression and treatment. These models are ordered based on their underlying assumptions and technologies: musculoskeletal models, Finite Element models, (gene) regulatory models, multiscale models and data-driven models (artificial intelligence/machine learning). Finally, it is concluded that in the future, efforts should be made to integrate the different modeling techniques into a more robust computational framework that should not only be efficient to predict OA progression but also easily allow a patient’s individualized risk assessment as screening tool for use in clinical practice.
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Affiliation(s)
- Satanik Mukherjee
- Prometheus, Division of Skeletal Tissue Engineering, KU Leuven, Leuven, Belgium.,Biomechanics Section, KU Leuven, Leuven, Belgium
| | - Majid Nazemi
- GIGA in silico Medicine, University of Liège, Liège, Belgium
| | - Ilse Jonkers
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Liesbet Geris
- Prometheus, Division of Skeletal Tissue Engineering, KU Leuven, Leuven, Belgium.,Biomechanics Section, KU Leuven, Leuven, Belgium.,GIGA in silico Medicine, University of Liège, Liège, Belgium
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20
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Messina OD, Vidal Wilman M, Vidal Neira LF. Nutrition, osteoarthritis and cartilage metabolism. Aging Clin Exp Res 2019; 31:807-813. [PMID: 30982220 DOI: 10.1007/s40520-019-01191-w] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 04/02/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Osteoarthritis (OA) is a degenerative joint disease and a leading cause of adult disability. There is no cure for OA and there is no effective treatment to stop its progression. Current pharmacologic treatments such as analgesics and non-steroidal anti-inflammatory drugs may improve the pain and offer some relief but they do not affect the progression of the disease. The chronic intake of these drugs may result in severe adverse events. The aim of this review is to revise the effects of nutrition on cartilage metabolism and OA progression. METHODS A systematic literature search was performed including those related to macro- and micro-nutrients' actions on cartilage and OA outcome. We selected peer-reviewed articles reporting the results of human clinical trials. RESULTS Glucosamine and chondroitin sulfate have shown to delay OA knee progression in several clinical trials. The effectiveness of some products considered nutraceuticals has been widely reviewed in the literature. This article presents a general description of the effectiveness and mechanism of action of nutrients, vitamins, antioxidants and other natural components considered as part of the normal diet. Many in vitro studies indicate the efficacy of specific nutrients in cartilage metabolism and its involvement in OA. However, rigorous clinical studies needed to evaluate the efficacy of these compounds in humans are still missing. The influence of nutrients and diet on the metabolism of cartilage and OA could represent a long-term coadjuvant alternative in the management of patients with OA. Effects of diet modifications on lipid and cholesterol profiles, adequate vitamin levels and weight reduction in obese patients could influence the course of the disease. CONCLUSION This review demonstrates that nutrition can improve the symptoms of OA. Glucosamine and chondroitin sulfate have shown robustly to delay the progression of knee OA in several well-designed studies, however more controlled clinical trials are needed to conclude that nutritional changes slow down the progression of the disease.
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Affiliation(s)
- Osvaldo Daniel Messina
- Rheumatology IRO Medical Center and Hospital C Argerich, Member of the Board of Governance, International Osteoporosis Foundation (IOF), Buenos Aires, Argentina
| | - Maritza Vidal Wilman
- Centro de Diagnóstico de Osteoporosis y Enfermedades Reumáticas (CEDOR), Lima, Peru.
| | - Luis F Vidal Neira
- Centro de Diagnóstico de Osteoporosis y Enfermedades Reumáticas (CEDOR), Lima, Peru
- Member of International Osteoporosis Foundation, Latin America (IOF-LATAM), Lima, Peru
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21
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Kosik-Kozioł A, Costantini M, Mróz A, Idaszek J, Heljak M, Jaroszewicz J, Kijeńska E, Szöke K, Frerker N, Barbetta A, Brinchmann JE, Święszkowski W. 3D bioprinted hydrogel model incorporating β-tricalcium phosphate for calcified cartilage tissue engineering. Biofabrication 2019; 11:035016. [PMID: 30943457 DOI: 10.1088/1758-5090/ab15cb] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
One promising strategy to reconstruct osteochondral defects relies on 3D bioprinted three-zonal structures comprised of hyaline cartilage, calcified cartilage, and subchondral bone. So far, several studies have pursued the regeneration of either hyaline cartilage or bone in vitro while-despite its key role in the osteochondral region-only few of them have targeted the calcified layer. In this work, we present a 3D biomimetic hydrogel scaffold containing β-tricalcium phosphate (TCP) for engineering calcified cartilage through a co-axial needle system implemented in extrusion-based bioprinting process. After a thorough bioink optimization, we showed that 0.5% w/v TCP is the optimal concentration forming stable scaffolds with high shape fidelity and endowed with biological properties relevant for the development of calcified cartilage. In particular, we investigate the effect induced by ceramic nano-particles over the differentiation capacity of bioprinted bone marrow-derived human mesenchymal stem cells in hydrogel scaffolds cultured up to 21 d in chondrogenic media. To confirm the potential of the presented approach to generate a functional in vitro model of calcified cartilage tissue, we evaluated quantitatively gene expression of relevant chondrogenic (COL1, COL2, COL10A1, ACAN) and osteogenic (ALPL, BGLAP) gene markers by means of RT-qPCR and qualitatively by means of fluorescence immunocytochemistry.
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Affiliation(s)
- Alicja Kosik-Kozioł
- Warsaw University of Technology, Faculty of Materials Science and Engineering, 02-507 Warsaw, Poland
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22
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Lee JH, Luo X, Ren X, Tan TC, Smith RAA, Swaminathan K, Sekar S, Bhakoo K, Nurcombe V, Hui JH, Cool SM. A Heparan Sulfate Device for the Regeneration of Osteochondral Defects. Tissue Eng Part A 2018; 25:352-363. [PMID: 30351222 DOI: 10.1089/ten.tea.2018.0171] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
IMPACT STATEMENT Repairing damaged joint cartilage remains a significant challenge. Treatment involving microfracture, tissue grafting, or cell therapy provides some benefit, but seldom regenerates lost articular cartilage. Providing a point-of-care solution that is cell and tissue free has the potential to transform orthopedic treatment for such cases. Glycosaminoglycans such as heparan sulfate (HS) are well suited for this purpose because they provide a matrix that enhances the prochondrogenic activities of growth factors normally found at sites of articular damage. In this study, we show the potential of a novel HS device, which is free of exogenous cells or growth factors, in regenerating osteochondral defects.
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Affiliation(s)
- Jonathan H Lee
- 1 NUS Graduate School for Integrative Sciences and Engineering, National University of Singapore, Centre for Life Sciences (CeLS), Singapore.,2 Glycotherapeutics Group, Institute of Medical Biology, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Xiaoman Luo
- 2 Glycotherapeutics Group, Institute of Medical Biology, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Xiafei Ren
- 3 Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Tuan Chun Tan
- 2 Glycotherapeutics Group, Institute of Medical Biology, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Raymond A A Smith
- 2 Glycotherapeutics Group, Institute of Medical Biology, Agency for Science, Technology and Research (A*STAR), Singapore
| | | | - Sakthivel Sekar
- 5 Translational Molecular Imaging Group, Singapore Bioimaging Consortium, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Kishore Bhakoo
- 5 Translational Molecular Imaging Group, Singapore Bioimaging Consortium, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Victor Nurcombe
- 2 Glycotherapeutics Group, Institute of Medical Biology, Agency for Science, Technology and Research (A*STAR), Singapore.,6 Lee Kong Chian School of Medicine, Nanyang Technological University-Imperial College, Singapore
| | - James H Hui
- 3 Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Simon M Cool
- 2 Glycotherapeutics Group, Institute of Medical Biology, Agency for Science, Technology and Research (A*STAR), Singapore.,3 Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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23
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Saltzman BM, Riboh JC. Subchondral Bone and the Osteochondral Unit: Basic Science and Clinical Implications in Sports Medicine. Sports Health 2018; 10:412-418. [PMID: 29932862 PMCID: PMC6116098 DOI: 10.1177/1941738118782453] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Context: Articular cartilage injuries and early osteoarthritis are among the most common
conditions seen by sports medicine physicians. Nonetheless, treatment options for
articular degeneration are limited once the osteoarthritic cascade has started. Intense
research is focused on the use of biologics, cartilage regeneration, and transplantation
to help maintain and improve cartilage health. An underappreciated component of joint
health is the subchondral bone. Evidence Acquisition: A comprehensive, nonsystematic review of the published literature was completed via a
PubMed/MEDLINE search of the keywords “subchondral” AND “bone” from database inception
through December 1, 2016. Study Design: Clinical review. Level of Evidence: Level 4. Methods: Articles collected via the database search were assessed for the association of bone
marrow lesions and osteoarthritis, cartilage regeneration, and ligamentous and meniscal
injury; the clinical disorder known as painful bone marrow edema syndrome; and the
subchondral bone as a target for medical and surgical intervention. Results: A complex interplay exists between the articular cartilage of the knee and its
underlying subchondral bone. The role of subchondral bone in the knee is intimately
related to the outcomes from cartilage restoration procedures, ligamentous injury,
meniscal pathology, and osteoarthritis. However, subchondral bone is often neglected
when it should be viewed as a critical element of the osteochondral unit and a key
player in joint health. Conclusion: Continued explorations into the intricacies of subchondral bone marrow abnormalities
and implications for the advent of procedures such as subchondroplasty will inform
further research efforts on how interventions aimed at the subchondral bone may provide
durable options for knee joint preservation.
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Affiliation(s)
- Bryan M Saltzman
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois
| | - Jonathan C Riboh
- Department of Orthopedic Surgery, Section of Sports Medicine, Duke University, Durham, North Carolina
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24
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Lu J, Zhang H, Cai D, Zeng C, Lai P, Shao Y, Fang H, Li D, Ouyang J, Zhao C, Xie D, Huang B, Yang J, Jiang Y, Bai X. Positive-Feedback Regulation of Subchondral H-Type Vessel Formation by Chondrocyte Promotes Osteoarthritis Development in Mice. J Bone Miner Res 2018; 33:909-920. [PMID: 29329496 DOI: 10.1002/jbmr.3388] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Revised: 01/02/2018] [Accepted: 01/03/2018] [Indexed: 01/01/2023]
Abstract
Vascular-invasion-mediated interactions between activated articular chondrocytes and subchondral bone are essential for osteoarthritis (OA) development. Here, we determined the role of nutrient sensing mechanistic target of rapamycin complex 1 (mTORC1) signaling in the crosstalk across the bone cartilage interface and its regulatory mechanisms. Then mice with chondrocyte-specific mTORC1 activation (Tsc1 CKO and Tsc1 CKOER ) or inhibition (Raptor CKOER ) and their littermate controls were subjected to OA induced by destabilization of the medial meniscus (DMM) or not. DMM or Tsc1 CKO mice were treated with bevacizumab, a vascular endothelial growth factor (VEGF)-A antibody that blocks angiogenesis. Articular cartilage degeneration was evaluated using the Osteoarthritis Research Society International score. Immunostaining and Western blotting were conducted to detect H-type vessels and protein levels in mice. Primary chondrocytes from mutant mice and ADTC5 cells were treated with interleukin-1β to investigate the role of chondrocyte mTORC1 in VEGF-A secretion and in vitro vascular formation. Clearly, H-type vessels were increased in subchondral bone in DMM-induced OA and aged mice. Cartilage mTORC1 activation stimulated VEGF-A production in articular chondrocyte and H-type vessel formation in subchondral bone. Chondrocyte mTORC1 promoted OA partially through formation of VEGF-A-stimulated subchondral H-type vessels. In particular, vascular-derived nutrients activated chondrocyte mTORC1, and stimulated chondrocyte activation and production of VEGF, resulting in further angiogenesis in subchondral bone. Thus a positive-feedback regulation of H-type vessel formation in subchondral bone by articular chondrocyte nutrient-sensing mTORC1 signaling is essential for the pathogenesis and progression of OA. © 2018 American Society for Bone and Mineral Research.
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Affiliation(s)
- Jiansen Lu
- Department of Orthopedics, Academy of Orthopedics, Guangdong Province, Orthopedic Hospital of Guangdong Province, The Third Affiliated Hospital of Southern Medical University.,State Key Laboratory of Organ Failure Research, Department of Cell Biology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Haiyan Zhang
- Department of Orthopedics, Academy of Orthopedics, Guangdong Province, Orthopedic Hospital of Guangdong Province, The Third Affiliated Hospital of Southern Medical University
| | - Daozhang Cai
- Department of Orthopedics, Academy of Orthopedics, Guangdong Province, Orthopedic Hospital of Guangdong Province, The Third Affiliated Hospital of Southern Medical University
| | - Chun Zeng
- Department of Orthopedics, Academy of Orthopedics, Guangdong Province, Orthopedic Hospital of Guangdong Province, The Third Affiliated Hospital of Southern Medical University
| | - Pinglin Lai
- Department of Orthopedics, Academy of Orthopedics, Guangdong Province, Orthopedic Hospital of Guangdong Province, The Third Affiliated Hospital of Southern Medical University
| | - Yan Shao
- Department of Orthopedics, Academy of Orthopedics, Guangdong Province, Orthopedic Hospital of Guangdong Province, The Third Affiliated Hospital of Southern Medical University.,State Key Laboratory of Organ Failure Research, Department of Cell Biology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Hang Fang
- Department of Orthopedics, Academy of Orthopedics, Guangdong Province, Orthopedic Hospital of Guangdong Province, The Third Affiliated Hospital of Southern Medical University
| | - Delong Li
- Department of Orthopedics, Academy of Orthopedics, Guangdong Province, Orthopedic Hospital of Guangdong Province, The Third Affiliated Hospital of Southern Medical University.,State Key Laboratory of Organ Failure Research, Department of Cell Biology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Jiayao Ouyang
- Department of Orthopedics, Academy of Orthopedics, Guangdong Province, Orthopedic Hospital of Guangdong Province, The Third Affiliated Hospital of Southern Medical University.,State Key Laboratory of Organ Failure Research, Department of Cell Biology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Chang Zhao
- Department of Orthopedics, Academy of Orthopedics, Guangdong Province, Orthopedic Hospital of Guangdong Province, The Third Affiliated Hospital of Southern Medical University
| | - Denghui Xie
- Department of Orthopedics, Academy of Orthopedics, Guangdong Province, Orthopedic Hospital of Guangdong Province, The Third Affiliated Hospital of Southern Medical University
| | - Bin Huang
- Department of Orthopedics, Academy of Orthopedics, Guangdong Province, Orthopedic Hospital of Guangdong Province, The Third Affiliated Hospital of Southern Medical University
| | - Jian Yang
- Department of Biomedical Engineering, Materials Research Institutes, The Huck Institutes of The Life Sciences, The Pennsylvania State University, University Park, PA, USA
| | - Yu Jiang
- Department of Pharmacology and Chemical Biology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Xiaochun Bai
- Department of Orthopedics, Academy of Orthopedics, Guangdong Province, Orthopedic Hospital of Guangdong Province, The Third Affiliated Hospital of Southern Medical University.,State Key Laboratory of Organ Failure Research, Department of Cell Biology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
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25
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Pirosa A, Gottardi R, Alexander PG, Tuan RS. Engineering in-vitro stem cell-based vascularized bone models for drug screening and predictive toxicology. Stem Cell Res Ther 2018; 9:112. [PMID: 29678192 PMCID: PMC5910611 DOI: 10.1186/s13287-018-0847-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The production of veritable in-vitro models of bone tissue is essential to understand the biology of bone and its surrounding environment, to analyze the pathogenesis of bone diseases (e.g., osteoporosis, osteoarthritis, osteomyelitis, etc.), to develop effective therapeutic drug screening, and to test potential therapeutic strategies. Dysregulated interactions between vasculature and bone cells are often related to the aforementioned pathologies, underscoring the need for a bone model that contains engineered vasculature. Due to ethical restraints and limited prediction power of animal models, human stem cell-based tissue engineering has gained increasing relevance as a candidate approach to overcome the limitations of animals and to serve as preclinical models for drug testing. Since bone is a highly vascularized tissue, the concomitant development of vasculature and mineralized matrix requires a synergistic interaction between osteogenic and endothelial precursors. A number of experimental approaches have been used to achieve this goal, such as the combination of angiogenic factors and three-dimensional scaffolds, prevascularization strategies, and coculture systems. In this review, we present an overview of the current models and approaches to generate in-vitro stem cell-based vascularized bone, with emphasis on the main challenges of vasculature engineering. These challenges are related to the choice of biomaterials, scaffold fabrication techniques, and cells, as well as the type of culturing conditions required, and specifically the application of dynamic culture systems using bioreactors.
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Affiliation(s)
- Alessandro Pirosa
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 450 Technology Drive, Pittsburgh, PA 15219 USA
| | - Riccardo Gottardi
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 450 Technology Drive, Pittsburgh, PA 15219 USA
- Ri.MED Foundation, Via Bandiera 11, Palermo, 90133 Italy
| | - Peter G. Alexander
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 450 Technology Drive, Pittsburgh, PA 15219 USA
| | - Rocky S. Tuan
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 450 Technology Drive, Pittsburgh, PA 15219 USA
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26
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Injectable nanohydroxyapatite-chitosan-gelatin micro-scaffolds induce regeneration of knee subchondral bone lesions. Sci Rep 2017; 7:16709. [PMID: 29196647 PMCID: PMC5711958 DOI: 10.1038/s41598-017-17025-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 11/21/2017] [Indexed: 02/06/2023] Open
Abstract
Subchondral bone has been identified as an attractive target for KOA. To determine whether a minimally invasive micro-scaffolds could be used to induce regeneration of knee subchondral bone lesions, and to examine the protective effect of subchondral bone regeneration on upper cartilage, a ready-to-use injectable treatment with nanohydroxyapatite-chitosan-gelatin micro-scaffolds (HaCGMs) is proposed. Human-infrapatellar-fat-pad-derived adipose stem cells (IPFP-ASCs) were used as a cellular model to examine the osteo-inductivity and biocompatibility of HaCGMs, which were feasibly obtained with potency for multi-potential differentiations. Furthermore, a subchondral bone lesion model was developed to mimic the necrotic region removing performed by surgeons before sequestrectomy. HaCGMs were injected into the model to induce regeneration of subchondral bone. HaCGMs exhibited desirable swelling ratios, porosity, stiffness, and bioactivity and allowed cellular infiltration. Eight weeks after treatment, assessment via X-ray imaging, micro-CT imaging, and histological analysis revealed that rabbits treated with HaCGMs had better subchondral bone regeneration than those not treated. Interestingly, rabbits in the HaCGM treatment group also exhibited improved reservation of upper cartilage compared to those in other groups, as shown by safranin O-fast green staining. Present study provides an in-depth demonstration of injectable HaCGM-based regenerative therapy, which may provide an attractive alternative strategy for treating KOA.
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27
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Roberts BC, Solomon LB, Mercer G, Reynolds KJ, Thewlis D, Perilli E. Joint loading and proximal tibia subchondral trabecular bone microarchitecture differ with walking gait patterns in end-stage knee osteoarthritis. Osteoarthritis Cartilage 2017. [PMID: 28642164 DOI: 10.1016/j.joca.2017.06.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To (1) stratify patient subgroups according to their distinct walking gait patterns in end-stage knee osteoarthritis (OA); (2) compare measures of joint loading and proximal tibia subchondral trabecular bone (STB) microarchitecture among these gait subgroups. DESIGN Twenty-five knee OA patients undergoing total knee arthroplasty (TKA) had pre-operative gait analysis. Following surgery, excised tibial plateaus were micro-CT-scanned and STB microarchitecture analysed in four tibial condylar regions of interest. Peak knee moments were input to k-means cluster analysis, to identify subgroups with homogeneous gait patterns. Joint loading and STB microarchitecture parameters were compared among gait subgroups (Kruskal-Wallis, Bonferroni-corrected Mann-Whitney U tests). RESULTS Three gait subgroups were revealed: biphasics (n = 7), flexors (n = 9), counter-rotators (n = 9). Peak knee adduction moment (KAM) and KAM impulse were significantly higher (P < 0.05) in biphasics than in flexors and counter-rotators (KAM = -0.65, -0.40 and -0.21 Nm/kg, respectively), suggesting a higher medial-to-lateral tibiofemoral load ratio in biphasics. Interestingly, STB medial-to-lateral bone volume fraction (BV/TV) ratio was also significantly higher (more than double) in biphasics and flexors than in counter-rotators (2.24, 2.00 and 1.00, respectively), whereas in biphasics it was only 10% higher than in flexors and not significantly so. CONCLUSIONS Within the confines of the limited sample size, data suggests that different mechanisms between the biphasic and flexor gait subroups may generate comparable loads upon the tibial plateau and corresponding bony responses, despite significantly lower KAM indices in flexors. Hence, in flexor gait OA patients, conservative treatments designed to reduce KAM, may not be appropriate. Understanding joint loading among walking gait patterns and relationships to bone microarchitecture may aid at identifying/improving management of persons at risk for developing knee OA.
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Affiliation(s)
- B C Roberts
- The Medical Device Research Institute, College of Science and Engineering, Flinders University, Adelaide, South Australia, Australia
| | - L B Solomon
- Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, South Australia, Australia; Centre for Orthopaedic and Trauma Research, The University of Adelaide, Adelaide, South Australia, Australia
| | - G Mercer
- Department of Orthopaedic Surgery, Repatriation General Hospital, Daws Park, South Australia, Australia
| | - K J Reynolds
- The Medical Device Research Institute, College of Science and Engineering, Flinders University, Adelaide, South Australia, Australia
| | - D Thewlis
- Centre for Orthopaedic and Trauma Research, The University of Adelaide, Adelaide, South Australia, Australia; Alliance for Research in Exercise, Nutrition and Activity, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - E Perilli
- The Medical Device Research Institute, College of Science and Engineering, Flinders University, Adelaide, South Australia, Australia.
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28
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Wang CY, Peng YJ, Hsu YJ, Lee HS, Chang YC, Chang CS, Chiang SW, Hsu YC, Lin MH, Huang GS. Cartilage MRI T2 ∗ relaxation time and perfusion changes of the knee in a 5/6 nephrectomy rat model of chronic kidney disease. Osteoarthritis Cartilage 2017; 25:976-985. [PMID: 28011101 DOI: 10.1016/j.joca.2016.12.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 11/28/2016] [Accepted: 12/14/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Chronic kidney disease (CKD) is characterized by metabolic disturbances in calcium and phosphorus homeostasis as kidney function declines. Alterations in blood perfusion in bone resulting from arteriosclerosis of bone vessels may relate to the progression of CKD. Herein, change in dynamic contrast enhanced (DCE) MRI parameters (A: amplitude, kel: elimination constant, and kep: permeability rate constant) and MRI T2∗ relaxation time of the knee cartilage were measured in a rodent nephrectomy model in order to (1) examine the relationship of peripheral blood perfusion to CKD and (2) demonstrate the feasibility of using DCE-MRI parameters and MRI T2∗ as imaging biomarkers to monitor disease progression. DESIGN Two groups of male Sprague-Dawley rats received either (1) no intervention or (2) 5/6 nephrectomy. RESULTS We found that the CKD group (compared with the control group) had lower A and kel values and similar kep value in the lateral and medial articular cartilages beginning at 12 weeks (P < 0.05); statistically significantly higher T2∗ values in the lateral and medial articular cartilages beginning at 18 weeks (P < 0.05); statistically significantly decreased inner luminal diameter of the popliteal artery, and altered structure of the lateral and medial articular cartilages (P < 0.05). CONCLUSION Perfusion deficiency and CKD may be related. DCE parameters and MRI T2∗ could serve as imaging biomarkers of cartilage degeneration in CKD progression.
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Affiliation(s)
- C-Y Wang
- Department and Graduate Institute of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan; Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Y-J Peng
- Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Y-J Hsu
- Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - H-S Lee
- Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Y-C Chang
- Department of Mathematics, Tamkang University, New Taipei City, Taiwan
| | - C-S Chang
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - S-W Chiang
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan; Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Y-C Hsu
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - M-H Lin
- Institute of Biomedical Sciences, Academic Sinica, Taipei, Taiwan
| | - G-S Huang
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
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29
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Early loss of subchondral bone following microfracture is counteracted by bone marrow aspirate in a translational model of osteochondral repair. Sci Rep 2017; 7:45189. [PMID: 28345610 PMCID: PMC5366926 DOI: 10.1038/srep45189] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 02/20/2017] [Indexed: 12/18/2022] Open
Abstract
Microfracture of cartilage defects may induce alterations of the subchondral bone in the mid- and long-term, yet very little is known about their onset. Possibly, these changes may be avoided by an enhanced microfracture technique with additional application of bone marrow aspirate. In this study, full-thickness chondral defects in the knee joints of minipigs were either treated with (1) debridement down to the subchondral bone plate alone, (2) debridement with microfracture, or (3) microfracture with additional application of bone marrow aspirate. At 4 weeks after microfracture, the loss of subchondral bone below the defects largely exceeded the original microfracture holes. Of note, a significant increase of osteoclast density was identified in defects treated with microfracture alone compared with debridement only. Both changes were significantly counteracted by the adjunct treatment with bone marrow. Debridement and microfracture without or with bone marrow were equivalent regarding the early cartilage repair. These data suggest that microfracture induced a substantial early resorption of the subchondral bone and also highlight the potential value of bone marrow aspirate as an adjunct to counteract these alterations. Clinical studies are warranted to further elucidate early events of osteochondral repair and the effect of enhanced microfracture techniques.
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30
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Subchondral screw abutment: does it harm the joint cartilage? An in vivo study on sheep tibiae. INTERNATIONAL ORTHOPAEDICS 2017; 41:1607-1615. [DOI: 10.1007/s00264-017-3404-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Accepted: 01/09/2017] [Indexed: 11/26/2022]
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31
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Effects of fast walking on tibiofemoral bone water content in middle-aged adults. Clin Biomech (Bristol, Avon) 2016; 37:65-69. [PMID: 27356281 DOI: 10.1016/j.clinbiomech.2016.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 04/25/2016] [Accepted: 06/19/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Although it is believed that genu varum increases loading on the medial knee during locomotion, the acute effect of increased loading on bone stress has not been determined. This study aimed to examine the effects of locomotion and lower extremity alignment on bone water content in middle-aged adults without knee osteoarthritis. METHODS Five males and 5 females participated. Lower extremity alignment was defined as the angle between the midpoint of the anterior mid-thigh and the midpoint of the patellar tendon using the center of the patella as the fulcrum. A chemical-shift-encoded water-fat magnetic resonance imaging protocol was used to assess bone water content before and after a 30-minute fast walking session. Bone stress response was determined by quantifying water content within the weight-bearing regions of the medial and lateral compartments of the tibiofemoral joint. Paired t-tests were used to compare bone water content before and after fast walking. Pearson correlation coefficients were used to determine the associations between lower extremity alignment and changes in water content post-walking. FINDINGS The paired t-tests revealed no changes in water content after fast walking within medial and lateral femur/tibia (P>0.05). Pearson correlation analyses revealed a significant moderate correlation between increased bone water content of the medial femur and increased varus alignment (R=0.688, P=0.028). INTERPRETATION Although there was no significant change in bone water content following locomotion, knee varus was associated with signs of bone stress in the medial femur.
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Beddoes CM, Whitehouse MR, Briscoe WH, Su B. Hydrogels as a Replacement Material for Damaged Articular Hyaline Cartilage. MATERIALS (BASEL, SWITZERLAND) 2016; 9:E443. [PMID: 28773566 PMCID: PMC5456752 DOI: 10.3390/ma9060443] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 05/24/2016] [Accepted: 05/30/2016] [Indexed: 12/12/2022]
Abstract
Hyaline cartilage is a strong durable material that lubricates joint movement. Due to its avascular structure, cartilage has a poor self-healing ability, thus, a challenge in joint recovery. When severely damaged, cartilage may need to be replaced. However, currently we are unable to replicate the hyaline cartilage, and as such, alternative materials with considerably different properties are used. This results in undesirable side effects, including inadequate lubrication, wear debris, wear of the opposing articular cartilage, and weakening of the surrounding tissue. With the number of surgeries for cartilage repair increasing, a need for materials that can better mimic cartilage, and support the surrounding material in its typical function, is becoming evident. Here, we present a brief overview of the structure and properties of the hyaline cartilage and the current methods for cartilage repair. We then highlight some of the alternative materials under development as potential methods of repair; this is followed by an overview of the development of tough hydrogels. In particular, double network (DN) hydrogels are a promising replacement material, with continually improving physical properties. These hydrogels are coming closer to replicating the strength and toughness of the hyaline cartilage, while offering excellent lubrication. We conclude by highlighting several different methods of integrating replacement materials with the native joint to ensure stability and optimal behaviour.
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Affiliation(s)
- Charlotte M Beddoes
- School of Oral and Dental Sciences, University of Bristol, Lower Maudlin Street, Bristol BS1 2LY, UK.
| | - Michael R Whitehouse
- Musculoskeletal Research Unit, University of Bristol, Level 1 Learning and Research Building, Bristol BS10 5NB, UK.
| | - Wuge H Briscoe
- School of Chemistry, University of Bristol, Cantock's Close, Bristol BS8 1TS, UK.
| | - Bo Su
- School of Oral and Dental Sciences, University of Bristol, Lower Maudlin Street, Bristol BS1 2LY, UK.
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Abstract
The subchondral zone plays an important role in both the structural and biochemical maintenance of articular cartilage. Knowledge of the structure, function, and pathophysiology of the normal subchondral bone/articular surface interface is essential for an understanding of the pathogenesis of many of the disease entities that we will review in this chapter.
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Hamilton JL, Nagao M, Levine BR, Chen D, Olsen BR, Im HJ. Targeting VEGF and Its Receptors for the Treatment of Osteoarthritis and Associated Pain. J Bone Miner Res 2016; 31:911-24. [PMID: 27163679 PMCID: PMC4863467 DOI: 10.1002/jbmr.2828] [Citation(s) in RCA: 172] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 02/26/2016] [Accepted: 03/04/2016] [Indexed: 01/15/2023]
Abstract
Increased vascular endothelial growth factor (VEGF) levels are associated with osteoarthritis (OA) progression. Indeed, VEGF appears to be involved in OA-specific pathologies including cartilage degeneration, osteophyte formation, subchondral bone cysts and sclerosis, synovitis, and pain. Moreover, a wide range of studies suggest that inhibition of VEGF signaling reduces OA progression. This review highlights both the potential significance of VEGF in OA pathology and pain, as well as potential benefits of inhibition of VEGF and its receptors as an OA treatment. With the emergence of the clinical use of anti-VEGF therapy outside of OA, both as high-dose systemic treatments and low-dose local treatments, these particular therapies are now more widely understood. Currently, there is no established disease-modifying drug available for patients with OA, which warrants continued study of the inhibition of VEGF signaling in OA, as stand-alone or adjuvant therapy. © 2016 American Society for Bone and Mineral Research.
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Affiliation(s)
- John L. Hamilton
- Department of Biochemistry, Rush University Medical Center, Chicago, IL 60612, USA
| | - Masashi Nagao
- Department of Developmental Biology, Harvard School of Dental Medicine, Boston, MA, 02115, USA
| | - Brett R. Levine
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612, USA
| | - Di Chen
- Department of Biochemistry, Rush University Medical Center, Chicago, IL 60612, USA
| | - Bjorn R. Olsen
- Department of Developmental Biology, Harvard School of Dental Medicine, Boston, MA, 02115, USA
| | - Hee-Jeong Im
- Department of Biochemistry, Rush University Medical Center, Chicago, IL 60612, USA
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612, USA
- Internal Medicine Section of Rheumatology, Rush University Medical Center, Chicago, IL 60612, USA
- Department of Bioengineering, University of Illinois, Chicago, IL, 60612, USA
- Jesse Brown Veterans Affairs, Chicago, IL 60612, USA
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Muttigi MS, Han I, Park HK, Park H, Lee SH. Matrilin-3 Role in Cartilage Development and Osteoarthritis. Int J Mol Sci 2016; 17:ijms17040590. [PMID: 27104523 PMCID: PMC4849044 DOI: 10.3390/ijms17040590] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 04/10/2016] [Accepted: 04/13/2016] [Indexed: 11/16/2022] Open
Abstract
The extracellular matrix (ECM) of cartilage performs essential functions in differentiation and chondroprogenitor cell maintenance during development and regeneration. Here, we discuss the vital role of matrilin-3, an ECM protein involved in cartilage development and potential osteoarthritis pathomechanisms. As an adaptor protein, matrilin-3 binds to collagen IX to form a filamentous network around cells. Matrilin-3 is an essential component during cartilage development and ossification. In addition, it interacts directly or indirectly with transforming growth factor β (TGF-β), and bone morphogenetic protein 2 (BMP2) eventually regulates chondrocyte proliferation and hypertrophic differentiation. Interestingly, matrilin-3 increases interleukin receptor antagonists (IL-Ra) in chondrocytes, suggesting its role in the suppression of IL-1β-mediated inflammatory action. Matrilin-3 downregulates the expression of matrix-degrading enzymes, such as a disintegrin metalloproteinase with thrombospondin motifs 4 (ADAMTS4) and ADAMTS5, matrix metalloproteinase 13 (MMP13), and collagen X, a hypertrophy marker during development and inflammatory conditions. Matrilin-3 essentially enhances collagen II and aggrecan expression, which are required to maintain the tensile strength and elasticity of cartilage, respectively. Interestingly, despite these attributes, matrilin-3 induces osteoarthritis-associated markers in chondrocytes in a concentration-dependent manner. Existing data provide insights into the critical role of matrilin-3 in inflammation, matrix degradation, and matrix formation in cartilage development and osteoarthritis.
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Affiliation(s)
- Manjunatha S Muttigi
- School of Integrative Engineering, Chung-Ang University, Seoul 06911, Korea.
- Department of Biomedical Science, CHA University, Seongnam-Si 13488, Korea.
| | - Inbo Han
- Department of Neurosurgery, CHA Bundang Medical Center, CHA University, Seongnam-si 13496, Korea.
| | - Hun-Kuk Park
- Department of Biomedical Engineering, Collage of Medicine, Kyung Hee University, Seoul 02447, Korea.
| | - Hansoo Park
- School of Integrative Engineering, Chung-Ang University, Seoul 06911, Korea.
| | - Soo-Hong Lee
- Department of Biomedical Science, CHA University, Seongnam-Si 13488, Korea.
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Guillén-García P, Rodríguez-Iñigo E, Guillén-Vicente I, Guillén-Vicente M, Fernández-Jaén T, Concejero V, Val D, Maestro A, Abelow S, López-Alcorocho JM. Viability of Pathologic Cartilage Fragments as a Source for Autologous Chondrocyte Cultures. Cartilage 2016; 7:149-56. [PMID: 27047637 PMCID: PMC4797241 DOI: 10.1177/1947603515621998] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE To study if a culture of chondrocytes can be obtained from pathologic hyaline cartilage (PHC) fragments. DESIGN Twenty-five men and 9 women with osteochondritis dissecans (OCD) in 11 cases, arthrosis in 13 patients, and trauma in the remaining 10 cases were included. The PHC fragments and a small sample of the next healthy cartilage were extracted by arthroscopy. According to the appearance, the PHC samples were divided into fixed (3 cases), flapped (6 patients), or loose bodies (25 cases), depending on the attachment degree of the cartilage to the subchondral bone. Approximately half of each pathologic sample and the whole healthy one were digested to isolate the cells trying to establish the cell culture. RESULTS We were able to establish a cell culture in 7 out of 34 (20.6%) PHC samples (positive samples), whereas in the remaining 27 (79.4%) no cell growth was observed (negative samples). Most of the negative samples were loose bodies (P = 0.005) taken from patients with OCD or arthrosis (P = 0.001) with an evolution time of more than 1 year (P < 0.001). The best binary logistic regression model (P < 0.001) showed that the only factor affecting the establishment of cell culture was the evolution time (P = 0.044). CONCLUSION It is possible to culture chondrocytes from osteochondral fragments if they are traumatic, within a year of injury and not from fragments due to arthrosis or OCD.
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Affiliation(s)
- Pedro Guillén-García
- Research Unit, CLÍNICA CEMTRO, Madrid, Spain,Sports Traumatology Department, Faculty of Medicine, Catholic University of Murcia, Murcia, Spain
| | | | | | | | - Tomás Fernández-Jaén
- Research Unit, CLÍNICA CEMTRO, Madrid, Spain,Sports Traumatology Department, Faculty of Medicine, Catholic University of Murcia, Murcia, Spain
| | | | - Daniel Val
- Pathology Department, Hospital Carlos III, Madrid, Spain
| | - Antonio Maestro
- Department of Orthopedics and Trauma Surgery, FREMAP, Gijon, Spain
| | | | - Juan Manuel López-Alcorocho
- Research Unit, CLÍNICA CEMTRO, Madrid, Spain,Juan Manuel López-Alcorocho, CLINICA CEMTRO, C/ Ventisquero de la Condesa, 42, 28035 Madrid, Spain.
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Xie L, Tintani F, Wang X, Li F, Zhen G, Qiu T, Wan M, Crane J, Chen Q, Cao X. Systemic neutralization of TGF-β attenuates osteoarthritis. Ann N Y Acad Sci 2016; 1376:53-64. [PMID: 26837060 DOI: 10.1111/nyas.13000] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Osteoarthritis (OA) is a major source of pain and disability worldwide with no effective medical therapy due to poor understanding of its pathogenesis. Transforming growth factor β (TGF-β) has been reported to play a role in subchondral bone pathology and articular cartilage degeneration during the progression of OA. In this study, we demonstrated that systemic use of a TGF-β-neutralizing antibody (1D11) attenuates OA progression by targeting subchondral bone pathological features in rodent OA models. Systemic administration of 1D11 preserves the subchondral bone microarchitecture, preventing articular cartilage degeneration by inhibition of excessive TGF-β activity, in both subchondral bone and the circulation. Moreover, the aberrant increases in the numbers of blood vessels, nestin(+) mesenchymal stromal/stem cells, and osterix(+) osteoblast progenitors were normalized by 1D11 systemic injection. Thus, systemic neutralization of excessive TGF-β ligands effectively prevented OA progression in animal models, with promising clinical implications for OA treatment.
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Affiliation(s)
- Liang Xie
- Department of Orthopaedic Surgery, Institute for Cell Engineering, Johns Hopkins University, Baltimore, Maryland.,State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Francis Tintani
- Department of Orthopaedic Surgery, Institute for Cell Engineering, Johns Hopkins University, Baltimore, Maryland
| | - Xiao Wang
- Department of Orthopaedic Surgery, Institute for Cell Engineering, Johns Hopkins University, Baltimore, Maryland
| | - Fengfeng Li
- Department of Orthopaedic Surgery, Institute for Cell Engineering, Johns Hopkins University, Baltimore, Maryland
| | - Gehua Zhen
- Department of Orthopaedic Surgery, Institute for Cell Engineering, Johns Hopkins University, Baltimore, Maryland
| | - Tao Qiu
- Department of Orthopaedic Surgery, Institute for Cell Engineering, Johns Hopkins University, Baltimore, Maryland
| | - Mei Wan
- Department of Orthopaedic Surgery, Institute for Cell Engineering, Johns Hopkins University, Baltimore, Maryland
| | - Janet Crane
- Department of Orthopaedic Surgery, Institute for Cell Engineering, Johns Hopkins University, Baltimore, Maryland
| | - Qianming Chen
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
| | - Xu Cao
- Department of Orthopaedic Surgery, Institute for Cell Engineering, Johns Hopkins University, Baltimore, Maryland.
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38
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Musculoskeletal imaging in preventive medicine. Wien Med Wochenschr 2016; 166:9-14. [PMID: 26819215 DOI: 10.1007/s10354-016-0431-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 01/05/2016] [Indexed: 10/22/2022]
Abstract
The aim is to review the modalities in musculoskeletal imaging with view on the prognostic impact for the patient's and for social outcome and with view on three major fields of preventive medicine: nutrition and metabolism, sports, and patient education. The added value provided by preventive imaging is (1) to monitor bone health and body composition with a broad spectrum of biomarkers, (2) to detect and quantify variants or abnormalities of nerves, muscles, tendons, bones, and joints with a risk of overuse, rupture, or fracture, and (3) to develop radiology reports from the widely used narrative format to structured text and multimedia datasets. The awareness problem is a term for describing the underreporting and the underdiagnosis of fragility fractures in osteoporosis.
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Tsai PH, Lee HS, Siow TY, Wang CY, Chang YC, Lin MH, Hsu YC, Lee CH, Chung HW, Huang GS. Abnormal perfusion in patellofemoral subchondral bone marrow in the rat anterior cruciate ligament transection model of post-traumatic osteoarthritis: a dynamic contrast-enhanced magnetic resonance imaging study. Osteoarthritis Cartilage 2016; 24:129-33. [PMID: 26241778 DOI: 10.1016/j.joca.2015.07.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 07/13/2015] [Accepted: 07/21/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Although anterior cruciate ligament (ACL) injury is a well-recognized risk factor for developing knee post-traumatic osteoarthritis (PTOA), the process in the patellofemoral (PF) joint after ACL injury is still under-researched. Our aim was to investigate the perfusion changes in PF subchondral bone marrow in the rat ACL transection (ACLX) model of PTOA using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). DESIGN Eighteen male Sprague Dawley rats were randomly separated into three groups (n = 6 each group): a normal control group and groups receiving ACLX and sham-surgery, respectively, in the right knee. Perfusion parameters in the patellar and femoral subchondral bone marrows of all rats were measured on DCE-MRI at 0, 4, 8, and 16 weeks after respective treatment. After the last MRI at week 16, the rats were sacrificed and their right knees were harvested for histologic examination. In addition, to observe the long-term histologic change in PF joints, 9 additional rats (n = 3 in each group) were included and sacrificed at week 32 for histologic examination. RESULTS In the ACLX group vs the sham and control groups, the perfusion parameters were significantly changed in both patellar and femoral subchondral bone marrows at week 16. Histologic examination revealed cartilage defects in ACLX rats at 32 weeks after surgery. CONCLUSIONS These data point to a possible functional relationship between subchondral bone marrow perfusion abnormalities and cartilage breakdown in PTOA. Moreover, the perfusion parameters derived from DCE-MRI can potentially serve as biomarkers of early OA.
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Affiliation(s)
- P-H Tsai
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC; Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC; Department of Medical Imaging and Translational Imaging Research Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan, ROC
| | - H-S Lee
- Department of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC; Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - T Y Siow
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Institute for Radiological Research, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC; Institute of Biomedical Sciences, Academic Sinica, Taipei, Taiwan, ROC
| | - C-Y Wang
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC; Department and Graduate Institute of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Y-C Chang
- Department of Mathematics, Tamkang University, Taipei, Taiwan, ROC
| | - M-H Lin
- Institute of Biomedical Sciences, Academic Sinica, Taipei, Taiwan, ROC
| | - Y-C Hsu
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - C-H Lee
- Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University and Hospital, Taipei, Taiwan, ROC
| | - H-W Chung
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan, ROC
| | - G-S Huang
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC; Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
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Bagi CM, Berryman E, Zakur DE, Wilkie D, Andresen CJ. Effect of antiresorptive and anabolic bone therapy on development of osteoarthritis in a posttraumatic rat model of OA. Arthritis Res Ther 2015; 17:315. [PMID: 26542671 PMCID: PMC4635572 DOI: 10.1186/s13075-015-0829-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 10/20/2015] [Indexed: 12/15/2022] Open
Abstract
Introduction Osteoarthritis (OA) is a leading cause of disability, but despite the high unmet clinical need and extensive research seeking dependable therapeutic interventions, no proven disease-modifying treatment for OA is currently available. Due to the close interaction and interplay between the articular cartilage and the subchondral bone plate, it has been hypothesized that antiresorptive drugs can also reduce cartilage degradation, inhibit excessive turnover of the subchondral bone plate, prevent osteophyte formation, and/or that bone anabolic drugs might also stimulate cartilage synthesis by chondrocytes and preserve cartilage integrity. The benefit of intensive zoledronate (Zol) and parathyroid hormone (PTH) therapy for bone and cartilage metabolism was evaluated in a rat model of OA. Methods Medial meniscectomy (MM) was used to induce OA in male Lewis rats. Therapy with Zol and human PTH was initiated immediately after surgery. A dynamic weight-bearing (DWB) system was deployed to evaluate the weight-bearing capacity of the front and hind legs. At the end of the 10-week study, the rats were euthanized and the cartilage pathology was evaluated by contrast (Hexabrix)-enhanced μCT imaging and traditional histology. Bone tissue was evaluated at the tibial metaphysis and epiphysis, including the subchondral bone. Histological techniques and dynamic histomorphometry were used to evaluate cartilage morphology and bone mineralization. Results The results of this study highlight the complex changes in bone metabolism in different bone compartments influenced by local factors, including inflammation, pain and mechanical loads. Surgery caused severe and extensive deterioration of the articular cartilage at the medial tibial plateau, as evidenced by contrast-enhanced μCT and histology. The study results showed the negative impact of MM surgery on the weight-bearing capacity of the operated limb, which was not corrected by treatment. Although both Zol and PTH improved subchondral bone mass and Zol reduced serum CTX-II level, both treatments failed to prevent or correct cartilage deterioration, osteophyte formation and mechanical incapacity. Conclusions The various methods utilized in this study showed that aggressive treatment with Zol and PTH did not have the capacity to prevent or correct the deterioration of the hyaline cartilage, thickening of the subchondral bone plate, osteophyte formation or the mechanical incapacity of the osteoarthritic knee.
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Affiliation(s)
- Cedo M Bagi
- Global Science and Technology, Pfizer Global Research and Development, Pfizer Inc., 100 Eastern Point Road, Groton, CT, 06340, USA.
| | - Edwin Berryman
- Comparative Medicine, Global Science and Technology, Pfizer Global Research and Development, Pfizer Inc., 100 Eastern Point Road, Groton, CT, 06340, USA.
| | - David E Zakur
- Comparative Medicine, Global Science and Technology, Pfizer Global Research and Development, Pfizer Inc., 100 Eastern Point Road, Groton, CT, 06340, USA. david.zakur.@pfizer.com
| | - Dean Wilkie
- Investigative Pathology, Drug Safety Research and Development, Pfizer Inc., 100 Eastern Point Road, Groton, CT, 06340, USA.
| | - Catharine J Andresen
- Comparative Medicine, Global Science and Technology, Pfizer Global Research and Development, Pfizer Inc., 100 Eastern Point Road, Groton, CT, 06340, USA.
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Orth P, Madry H. Advancement of the Subchondral Bone Plate in Translational Models of Osteochondral Repair: Implications for Tissue Engineering Approaches. TISSUE ENGINEERING PART B-REVIEWS 2015; 21:504-20. [PMID: 26066580 DOI: 10.1089/ten.teb.2015.0122] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Subchondral bone plate advancement is of increasing relevance for translational models of osteochondral repair in tissue engineering (TE). Especially for therapeutic TE approaches, a basic scientific knowledge of its chronological sequence, possible etiopathogenesis, and clinical implications are indispensable. This review summarizes the knowledge on this topic gained from a total of 31 translational investigations, including 1009 small and large animals. Experimental data indicate that the advancement of the subchondral bone plate frequently occurs during the spontaneous repair of osteochondral defects and following established articular cartilage repair approaches for chondral lesions such as marrow stimulation and TE-based strategies such as autologous chondrocyte implantation. Importantly, this subchondral bone reaction proceeds in a defined chronological and spatial pattern, reflecting both endochondral ossification and intramembranous bone formation. Subchondral bone plate advancement arises earlier in small animals and defects, but is more pronounced at the long term in large animals. Possible etiopathologies comprise a disturbed subchondral bone/articular cartilage crosstalk and altered biomechanical conditions or neovascularization. Of note, no significant correlation was found so far between subchondral bone plate advancement and articular cartilage repair. This evidence from translational animal models adverts to an increasing awareness of this previously underestimated pathology. Future research will shed more light on the advancement of the subchondral bone plate in TE models of cartilage repair.
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Affiliation(s)
- Patrick Orth
- 1 Center of Experimental Orthopedics, Saarland University , Homburg, Germany .,2 Department of Orthopedic Surgery, Saarland University Medical Center , Homburg, Germany
| | - Henning Madry
- 1 Center of Experimental Orthopedics, Saarland University , Homburg, Germany .,2 Department of Orthopedic Surgery, Saarland University Medical Center , Homburg, Germany
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Stupina TA, Stepanov MA, Teplen'kii MP. Role of subchondral bone in the restoration of articular cartilage. Bull Exp Biol Med 2015; 158:820-3. [PMID: 25894785 DOI: 10.1007/s10517-015-2870-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Indexed: 10/23/2022]
Abstract
The role of subchondral bone in the restoration of the articular cartilage was determined in experiments on mongrel dogs subjected to gonarthrosis modeling followed by subchondral zone tunneling and introduction of bone marrow suspension into the canal. Light microscopy, computer histomorphometry, and electron probe microanalysis showed that stimulation of functional activity of chondrocytes was achieved via correction of homeostasis of the cartilage and subchondral bone and improvement of tissue trophic. Restoration of the microarchitecture of the subchondral bone and improving its vascularization after tunneling with the introduction of bone marrow suspension into the drill holes enhances chondrocyte metabolism and recovers their functionality.
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Affiliation(s)
- T A Stupina
- G. A. Ilizarov Russian Research Center for Restorative Traumatology and Orthopaedics, Ministry of Health of the Russian Federation, Kurgan, Russia,
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Li G, Yin J, Gao J, Cheng TS, Pavlos NJ, Zhang C, Zheng MH. Subchondral bone in osteoarthritis: insight into risk factors and microstructural changes. Arthritis Res Ther 2014; 15:223. [PMID: 24321104 PMCID: PMC4061721 DOI: 10.1186/ar4405] [Citation(s) in RCA: 491] [Impact Index Per Article: 49.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 12/02/2013] [Indexed: 12/11/2022] Open
Abstract
Osteoarthritis (OA) is a major cause of disability in the adult population. As a
progressive degenerative joint disorder, OA is characterized by cartilage damage,
changes in the subchondral bone, osteophyte formation, muscle weakness, and
inflammation of the synovium tissue and tendon. Although OA has long been viewed as a
primary disorder of articular cartilage, subchondral bone is attracting increasing
attention. It is commonly reported to play a vital role in the pathogenesis of OA.
Subchondral bone sclerosis, together with progressive cartilage degradation, is
widely considered as a hallmark of OA. Despite the increase in bone volume fraction,
subchondral bone is hypomineralized, due to abnormal bone remodeling. Some
histopathological changes in the subchondral bone have also been detected, including
microdamage, bone marrow edema-like lesions and bone cysts. This review summarizes
basic features of the osteochondral junction, which comprises subchondral bone and
articular cartilage. Importantly, we discuss risk factors influencing subchondral
bone integrity. We also focus on the microarchitectural and histopathological changes
of subchondral bone in OA, and provide an overview of their potential contribution to
the progression of OA. A hypothetical model for the pathogenesis of OA is
proposed.
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Bouvard B, Abed E, Yéléhé-Okouma M, Bianchi A, Mainard D, Netter P, Jouzeau JY, Lajeunesse D, Reboul P. Hypoxia and vitamin D differently contribute to leptin and dickkopf-related protein 2 production in human osteoarthritic subchondral bone osteoblasts. Arthritis Res Ther 2014; 16:459. [PMID: 25312721 PMCID: PMC4302570 DOI: 10.1186/s13075-014-0459-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 09/18/2014] [Indexed: 12/17/2022] Open
Abstract
Introduction Bone remodelling and increased subchondral densification are important in osteoarthritis (OA). Modifications of bone vascularization parameters, which lead to ischemic episodes associated with hypoxic conditions, have been suspected in OA. Among several factors potentially involved, leptin and dickkopf-related protein 2 (DKK2) are good candidates because they are upregulated in OA osteoblasts (Obs). Therefore, in the present study, we investigated the hypothesis that hypoxia may drive the expression of leptin and DKK2 in OA Obs. Methods Obs from the sclerotic portion of OA tibial plateaus were cultured under either 20% or 2% oxygen tension in the presence or not of 50 nM 1,25-dihydroxyvitamin D3 (VitD3). The expression of leptin, osteocalcin, DKK2, hypoxia-inducible factor 1α (Hif-1α) and Hif-2α was measured by real-time polymerase chain reaction and leptin production was measured by enzyme-linked immunosorbent assay (ELISA). The expression of Hif-1α, Hif-2α, leptin and DKK2 was reduced using silencing RNAs (siRNAs). The signalling pathway of hypoxia-induced leptin was investigated by Western blot analysis and with mitogen-activated protein kinase (MAPK) inhibitors. Results The expression of leptin and DKK2 in Obs was stimulated 7-fold and 1.8-fold, respectively (P <0.05) under hypoxia. Interestingly, whereas VitD3 stimulated leptin and DKK2 expression 2- and 4.2-fold, respectively, under normoxia, it stimulated their expression by 28- and 6.2-fold, respectively, under hypoxia (P <0.05). The hypoxia-induced leptin production was confirmed by ELISA, particularly in the presence of VitD3 (P <0.02). Compared to Obs incubated in the presence of scramble siRNAs, siHif-2α inhibited VitD3-stimulated leptin mRNA and protein levels by 70% (P =0.004) and 60% (P <0.02), respectively, whereas it failed to significantly alter the expression of DKK2. siHif-1α has no effect on these genes. Immunoblot analysis showed that VitD3 greatly stabilized Hif-2α under hypoxic conditions. The increase in leptin expression under hypoxia was also regulated, by p38 MAPK (P <0.03) and phosphoinositide 3-kinase (P <0.05). We found that the expression of leptin and DKK2 were not related to each other under hypoxia. Conclusions Hypoxic conditions via Hif-2 regulation trigger Obs to produce leptin, particularly under VitD3 stimulation, whereas DKK2 is regulated mainly by VitD3 rather than hypoxia.
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Ho KY, Hu HH, Colletti PM, Powers CM. Running-induced patellofemoral pain fluctuates with changes in patella water content. Eur J Sport Sci 2013; 14:628-34. [PMID: 24283889 DOI: 10.1080/17461391.2013.862872] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Although increased bone water content resulting from repetitive patellofemoral joint loading has been suggested to be a possible mechanism underlying patellofemoral pain (PFP), there is little data to support this mechanism. The purpose of the current study was to determine whether running results in increases in patella water content and pain and whether 48 hours of rest reduces patella water content and pain to pre-running levels. Ten female runners with a diagnosis of PFP (mean age 25.1 years) participated. Patella water content was quantified using a chemical-shift-encoded water-fat magnetic resonance imaging (MRI) protocol. The visual analog scale (VAS) was used to quantify subjects' pain levels. MRI and pain data were obtained prior to running, immediately following a 40-minute running session, and 48 hours post-running. Pain and patella water content were compared among the 3 time points using one-way ANOVA's with repeated measures. Immediately post-running, persons with PFP reported significant increases in pain and exhibited elevated patella water content. Pain and patella water content decreased to pre-running levels following 48 hours of rest. Our findings suggest that transient changes in patella water content associated with running may, in part, contribute to patellofemoral symptoms.
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Affiliation(s)
- Kai-Yu Ho
- a Department of Physical Therapy , University of Nevada , Las Vegas , Nevada , USA
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Ho KY, Keyak JH, Powers CM. Comparison of patella bone strain between females with and without patellofemoral pain: a finite element analysis study. J Biomech 2013; 47:230-6. [PMID: 24188973 DOI: 10.1016/j.jbiomech.2013.09.010] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2013] [Revised: 08/27/2013] [Accepted: 09/10/2013] [Indexed: 11/27/2022]
Abstract
Elevated bone principal strain (an indicator of potential bone injury) resulting from reduced cartilage thickness has been suggested to contribute to patellofemoral symptoms. However, research linking patella bone strain, articular cartilage thickness, and patellofemoral pain (PFP) remains limited. The primary purpose was to determine whether females with PFP exhibit elevated patella bone strain when compared to pain-free controls. A secondary objective was to determine the influence of patella cartilage thickness on patella bone strain. Ten females with PFP and 10 gender, age, and activity-matched pain-free controls participated. Patella bone strain fields were quantified utilizing subject-specific finite element (FE) models of the patellofemoral joint (PFJ). Input parameters for the FE model included (1) PFJ geometry, (2) elastic moduli of the patella bone, (3) weight-bearing PFJ kinematics, and (4) quadriceps muscle forces. Using quasi-static simulations, peak and average minimum principal strains as well as peak and average maximum principal strains were quantified. Cartilage thickness was quantified by computing the perpendicular distance between opposing voxels defining the cartilage edges on axial plane magnetic resonance images. Compared to the pain-free controls, individuals with PFP exhibited increased peak and average minimum and maximum principal strain magnitudes in the patella. Additionally, patella cartilage thickness was negatively associated with peak minimum principal patella strain and peak maximum principal patella strain. The elevated bone strain magnitudes resulting from reduced cartilage thickness may contribute to patellofemoral symptoms and bone injury in persons with PFP.
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Affiliation(s)
- Kai-Yu Ho
- Department of Physical Therapy, University of Nevada, Las Vegas, NV, USA
| | - Joyce H Keyak
- Department of Radiological Sciences, University of California, Irvine, CA, USA; Department of Mechanical and Aerospace Engineering, University of California, Irvine, CA, USA
| | - Christopher M Powers
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA.
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Interplay between cartilage and subchondral bone contributing to pathogenesis of osteoarthritis. Int J Mol Sci 2013; 14:19805-30. [PMID: 24084727 PMCID: PMC3821588 DOI: 10.3390/ijms141019805] [Citation(s) in RCA: 175] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 09/17/2013] [Accepted: 09/23/2013] [Indexed: 12/23/2022] Open
Abstract
Osteoarthritis (OA) is a common debilitating joint disorder, affecting large sections of the population with significant disability and impaired quality of life. During OA, functional units of joints comprising cartilage and subchondral bone undergo uncontrolled catabolic and anabolic remodeling processes to adapt to local biochemical and biological signals. Changes in cartilage and subchondral bone are not merely secondary manifestations of OA but are active components of the disease, contributing to its severity. Increased vascularization and formation of microcracks in joints during OA have suggested the facilitation of molecules from cartilage to bone and vice versa. Observations from recent studies support the view that both cartilage and subchondral bone can communicate with each other through regulation of signaling pathways for joint homeostasis under pathological conditions. In this review we have tried to summarize the current knowledge on the major signaling pathways that could control the cartilage-bone biochemical unit in joints and participate in intercellular communication between cartilage and subchondral bone during the process of OA. An understanding of molecular communication that regulates the functional behavior of chondrocytes and osteoblasts in both physiological and pathological conditions may lead to development of more effective strategies for treating OA patients.
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Kim BJ, Choi BH, Jin LH, Park SR, Min BH. Comparison between subchondral bone change and cartilage degeneration in collagenase- and DMM- induced osteoarthritis (OA) models in mice. Tissue Eng Regen Med 2013. [DOI: 10.1007/s13770-013-1080-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Zhang S, Chen L, Jiang Y, Cai Y, Xu G, Tong T, Zhang W, Wang L, Ji J, Shi P, Ouyang HW. Bi-layer collagen/microporous electrospun nanofiber scaffold improves the osteochondral regeneration. Acta Biomater 2013; 9:7236-47. [PMID: 23567945 DOI: 10.1016/j.actbio.2013.04.003] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Revised: 03/20/2013] [Accepted: 04/01/2013] [Indexed: 02/08/2023]
Abstract
An optimal scaffold is crucial for osteochondral regeneration. Collagen and electrospun nanofibers have been demonstrated to facilitate cartilage and bone regeneration, respectively. However, the effect of combining collagen and electrospun nanofibers on osteochondral regeneration has yet to be evaluated. Here, we report that the combination of collagen and electrospun poly-l-lactic acid nanofibers synergistically promotes osteochondral regeneration. We first fabricated bi-layer microporous scaffold with collagen and electrospun poly-l-lactic acid nanofibers (COL-nanofiber). Mesenchymal stem cells were cultured on the bi-layer scaffold and their adhesion, proliferation and differentiation were examined. Moreover, osteochondral defects were created in rabbits and implanted with COL-nanofiber scaffold. Cartilage and subchondral bone regeneration were evaluated at 6 and 12weeks after surgery. Compared with COL scaffold, cells on COL-nanofiber scaffold exhibited more robust osteogenic differentiation, indicated by higher expression levels of OCN and runx2 genes as well as the accumulation of calcium nodules. Furthermore, implantation of COL-nanofiber scaffold seeded with cells induced more rapid subchondral bone emergence, and better cartilage formation, which led to better functional repair of osteochondral defects as manifested by histological staining, biomechanical test and micro-computed tomography data. Our study underscores the potential of using the bi-layer microporous COL-nanofiber scaffold for the treatment of deep osteochondral defects.
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Abstract
Cartilage damage which characterizes osteoarthritis is accompanied with bone lesions. Joint integrity results from the balance in the physiological interactions between bone and cartilage. Several local factors regulate physiological remodeling of cartilage, the disequilibrium of these leading to a higher cartilage catabolism. Several cytokines secreted by bone cells can induce chondrocyte differentiation which suggests their role in the dialogue between both cells. Several animal models of osteoarthritis have been developed in order to assess the mechanism of cartilage loss and chondrocyte functions that encompassed surgical, chemical, or genetic approaches. Indeed, the animal models are helpful to investigate the cartilage changes in relation to changes in bone remodeling. Accumulative in vivo evidence show that increased bone resorption occurs at early stage of the development of osteoarthritis. Inhibition of bone resorbing molecules prevents cartilage damage, confirming the role of bone factors in the cross talk between both tissues. Among these numerous molecules, some participate to the imbalance in cartilage homeostasis and in the pathophysiology of osteoarthritis. These local factors are potential candidates for new drug targets.
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Affiliation(s)
- M Cohen-Solal
- INSERM U606, University Paris-Diderot Paris 7, Lariboisière Hospital, 2 rue Ambroise Paré, 75010, Paris, France.
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