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Jacob B, Jüllig M, Middleditch M, Payne L, Broom N, Sarojini V, Thambyah A. Protein Levels and Microstructural Changes in Localized Regions of Early Cartilage Degeneration Compared with Adjacent Intact Cartilage. Cartilage 2021; 12:192-210. [PMID: 30486653 PMCID: PMC7970373 DOI: 10.1177/1947603518809401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE It was hypothesized that the respective protein profiles of bovine cartilage from sites of localized mild to moderate (GI to GII) degeneration versus adjacent sites of intact tissue would vary in accordance with the tissue microstructural changes associated with a pre-osteoarthritic state. METHODS A total of 15 bovine patellae were obtained for this study. Paired samples of tissue were collected from the lateral region of each patella. If the patella contained a site of degeneration, a paired tissue set involved taking one sample each from the degenerated site and the intact tissue adjacent to it. Sufficient tissue was collected to facilitate 2 arms of investigation: microstructural imaging and proteome analysis. The microstructural analysis used a bespoke tissue preparation technique imaged with differential interference contrast optical microscopy to assess fibrillar scale destructuring and underlying bone spicule formation. An iTRAQ-based proteome analysis was performed using liquid chromatography-tandem mass spectrometry to identify the differential levels of proteins across the intact and degenerated cartilage and further, the results were validated with multiple reaction monitoring assay. RESULTS In the healthy cartilage pairs, there was no significant variation in protein profiles between 2 adjacent sample sites. In pairs of tissue that contained a sample of GI/GII tissue, there were both significant microstructural changes as well as the difference in abundance levels of 24 proteins. CONCLUSIONS From the known functions of the 24 proteins, found to be strongly aligned with the specific microstructural changes observed, a unique "proteins ensemble" involved in the initiation and progression of early cartilage degeneration is proposed.
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Affiliation(s)
- Bincy Jacob
- School of Biological Sciences, The
University of Auckland, Auckland, New Zealand
| | - Mia Jüllig
- School of Biological Sciences, The
University of Auckland, Auckland, New Zealand
| | - Martin Middleditch
- School of Biological Sciences, The
University of Auckland, Auckland, New Zealand
| | - Leo Payne
- School of Biological Sciences, The
University of Auckland, Auckland, New Zealand
| | - Neil Broom
- Department of Chemical and Materials
Engineering, Experimental Tissue Mechanics Laboratory, University of Auckland,
Auckland, New Zealand
| | | | - Ashvin Thambyah
- Department of Chemical and Materials
Engineering, Experimental Tissue Mechanics Laboratory, University of Auckland,
Auckland, New Zealand,Ashvin Thambyah, Department of Chemical and
Materials Engineering, Experimental Tissue Mechanics Laboratory, University of
Auckland, 20 Symonds Street, Auckland, 1010, New Zealand.
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Damen AHA, Nickien M, Ito K, van Donkelaar CC. The performance of resurfacing implants for focal cartilage defects depends on the degenerative condition of the opposing cartilage. Clin Biomech (Bristol, Avon) 2020; 79:105052. [PMID: 32591239 DOI: 10.1016/j.clinbiomech.2020.105052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 04/08/2020] [Accepted: 05/15/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Non-degradable resurfacing implants are being developed for treatment of focal cartilage defects. Performance of these implants has been investigated opposing intact cartilage. This study investigates whether implants would perform equally well when the opposing cartilage is fibrillated. METHODS Human osteochondral strips (~2x1x1 cm) with a smooth (n = 9) or fibrillated (n = 17) cartilage surface were obtained from human tibial plateaus excised during total knee arthroscopy. A custom-made pin-on-plate sliding indenter was used to apply simultaneous compression (0.75-3 MPa) and movement (4 mm/s over 6 mm). Either metal implants, polycarbonate-urethane or healthy porcine osteochondral plugs with a diameter of 6 mm were used as indenter. FINDINGS Cartilage roughness of the osteochondral strips was significantly higher for the fibrillated than the smooth group prior to sliding-indentation. Roughness of the indenters was not significantly altered by sliding indentation using either smooth or fibrillated cartilage. For all but one sample, sliding of smooth cartilage against any of the indenter surfaces did not cause damage. However, samples with fibrillated cartilage showed varied responses from seemingly unaffected to severe tissue wear as quantified by analysis of Indian ink staining and histology. INTERPRETATION This study demonstrates that the opposing cartilage quality is relevant for the clinical success of implanting an artificial implant in a focal cartilage defect. Therefore it is essential to test the efficacy of newly developed implants against arthritic joint surfaces, and care should be taken when interpreting in vivo studies in which implants are inserted in healthy joints.
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Affiliation(s)
- A H A Damen
- Orthopaedic Biomechanics, Dept. of Biomedical Engineering, Eindhoven University of Technology, the Netherlands
| | - M Nickien
- Orthopaedic Biomechanics, Dept. of Biomedical Engineering, Eindhoven University of Technology, the Netherlands
| | - K Ito
- Orthopaedic Biomechanics, Dept. of Biomedical Engineering, Eindhoven University of Technology, the Netherlands
| | - C C van Donkelaar
- Orthopaedic Biomechanics, Dept. of Biomedical Engineering, Eindhoven University of Technology, the Netherlands.
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Workman J, Thambyah A, Broom N. The influence of early degenerative changes on the vulnerability of articular cartilage to impact-induced injury. Clin Biomech (Bristol, Avon) 2017; 43:40-49. [PMID: 28199881 DOI: 10.1016/j.clinbiomech.2017.01.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 11/01/2016] [Accepted: 01/03/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Recently, the structural changes in a bovine model of early degeneration were validated by our research group to be analogous to that in early human osteoarthritis. The hypothesis of this study was that the structural changes associated with increasing levels of degeneration would lead to higher levels of tissue damage in response to impact induced injury. METHODS A total of forty bovine patellae were obtained for this study. Cartilage-on-bone samples were extracted from the distal lateral quarter, a region known to be affected by varying levels of degeneration. A single impact drop test was applied to these samples delivering 2.3J of energy. A dynamic load cell and image capture at 2000fps allowed for the calculation of the reaction stress and coefficient of restitution. The extent of tissue damage was examined from the micro to ultrastructural levels using differential interference contrast optical microscopy and scanning electron microscopy respectively. FINDINGS The impact mechanical properties of mildly degenerate articular cartilage were not significantly different but showed a significantly larger amount of structural damage. From comparing the mechanical and structural response of intact and mildly degenerate cartilage, to tissue showing increased macro-scale tissue degeneration, the significance of the surface layer and fibrillar scale transverse interconnectivity in effectively attenuating impact loads is demonstrated in this study. INTERPRETATION This study shows that even though articular cartilage can appear visibly normal under macroscopic observation, the micro-scale structural changes associated with very early stage osteoarthritis can have a significant effect on its vulnerability to impact damage.
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Affiliation(s)
- Joshua Workman
- University of Auckland, 2-6 Park Ave, Grafton, Auckland 1023, New Zealand
| | - Ashvin Thambyah
- University of Auckland, 2-6 Park Ave, Grafton, Auckland 1023, New Zealand.
| | - Neil Broom
- University of Auckland, 2-6 Park Ave, Grafton, Auckland 1023, New Zealand
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Hargrave-Thomas EJ, Thambyah A, McGlashan SR, Broom ND. The bovine patella as a model of early osteoarthritis. J Anat 2013; 223:651-64. [PMID: 24111904 DOI: 10.1111/joa.12115] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2013] [Indexed: 12/12/2022] Open
Abstract
The bovine patella model has been used extensively for studying important structure-function aspects of articular cartilage, including its degeneration. However, the degeneration seen in this model has, to our knowledge, never been adequately compared with human osteoarthritis (OA). In this study, bovine patellae displaying normal to severely degenerate states were compared with human tissue displaying intact cartilage to severe OA. Comparisons of normal and OA features were made with histological scoring, morphometric measurements, and qualitative observations. Differential interference contrast microscopy was used to image early OA changes in the articular cartilage matrix and to investigate whether this method provided comparable quality of visualisation of key structural features with standard histology. The intact bovine cartilage was found to be similar to healthy human cartilage and the degenerate bovine cartilage resembled the human OA tissues with regard to structural disruption, cellularity changes, and staining loss. The extent of degeneration in the bovine tissues matched the mild to moderate range of human OA tissues; however, no bovine samples exhibited late-stage OA. Additionally, in both bovine and human tissues, cartilage degeneration was accompanied by calcified cartilage thickening, tidemark duplication, and the advancement of the cement line by protrusions of bony spicules into the calcified cartilage. This comparison of degeneration in the bovine and human tissues suggests a common pathway for the progression of OA and thus the bovine patella is proposed to be an appropriate model for investigating the structural changes associated with early OA.
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Affiliation(s)
- E J Hargrave-Thomas
- Experimental Tissue Mechanics Laboratory, Department of Chemical and Materials Engineering, University of Auckland, Auckland, New Zealand
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A review of the combination of experimental measurements and fibril-reinforced modeling for investigation of articular cartilage and chondrocyte response to loading. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2013; 2013:326150. [PMID: 23653665 PMCID: PMC3638701 DOI: 10.1155/2013/326150] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 01/11/2013] [Accepted: 02/23/2013] [Indexed: 11/17/2022]
Abstract
The function of articular cartilage depends on its structure and composition, sensitively impaired in disease (e.g. osteoarthritis, OA). Responses of chondrocytes to tissue loading are modulated by the structure. Altered cell responses as an effect of OA may regulate cartilage mechanotransduction and cell biosynthesis. To be able to evaluate cell responses and factors affecting the onset and progression of OA, local tissue and cell stresses and strains in cartilage need to be characterized. This is extremely challenging with the presently available experimental techniques and therefore computational modeling is required. Modern models of articular cartilage are inhomogeneous and anisotropic, and they include many aspects of the real tissue structure and composition. In this paper, we provide an overview of the computational applications that have been developed for modeling the mechanics of articular cartilage at the tissue and cellular level. We concentrate on the use of fibril-reinforced models of cartilage. Furthermore, we introduce practical considerations for modeling applications, including also experimental tests that can be combined with the modeling approach. At the end, we discuss the prospects for patient-specific models when aiming to use finite element modeling analysis and evaluation of articular cartilage function, cellular responses, failure points, OA progression, and rehabilitation.
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Nickien M, Thambyah A, Broom N. How changes in fibril-level organization correlate with the macrolevel behavior of articular cartilage. WILEY INTERDISCIPLINARY REVIEWS-SYSTEMS BIOLOGY AND MEDICINE 2013; 5:495-509. [PMID: 23554314 DOI: 10.1002/wsbm.1220] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The primary structural components of articular cartilage are the zonally differentiated interconnected network of collagen fibrils and proteoglycans, the latter having the potential to bind large amounts of water. Both components exist in a coupled relationship that gives rise to its remarkable mechanical properties. The response of cartilage to compression is governed both by the degree to which the hydrated proteoglycans are constrained within this fibrillar network and the ease with which the matrix fluid can be displaced. The functional properties of cartilage are therefore closely linked to the integrity of the fibrillar network. Our current understanding of this network has been derived via studies conducted at the macro, micro, and ultrastructural levels. Of particular interest to joint researchers and clinicians are issues relating to how the network structure varies both directionally and with zonal depth, how its integrity is maintained via mechanisms of fibril interconnectivity, and how it is modified by ageing, degeneration, and trauma. Physical models have been developed to explore modes of interconnectivity. Combined micromechanical and structural studies confirm the critical role that this interconnectivity must play but detailed descriptions at the molecular level remain elusive. Current computationally based models of cartilage have in some cases implemented the fibrillar component, albeit simplistically, as a separate structure. Considering how important a role fibril network interconnectivity plays in actual tissue structure and mechanical behavior, and especially how it changes with degeneration, a major challenge facing joint tissue modellers is how to incorporate such a feature in their models.
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Affiliation(s)
- Mieke Nickien
- Experimental Tissue Mechanics Laboratory, Department of Chemical and Materials Engineering, University of Auckland, Auckland, New Zealand
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Raya JG, Melkus G, Adam-Neumair S, Dietrich O, Mützel E, Reiser MF, Putz R, Kirsch T, Jakob PM, Glaser C. Diffusion-tensor imaging of human articular cartilage specimens with early signs of cartilage damage. Radiology 2012; 266:831-41. [PMID: 23238155 DOI: 10.1148/radiol.12120954] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To assess the use of diffusion-tensor (DT) imaging of articular cartilage to detect and grade early cartilage damage in human specimens with early signs of cartilage damage. MATERIALS AND METHODS This study was approved by the institutional review board. Forty-three cartilage-on-bone samples drilled from 21 human patellae were examined with 17.6-T magnetic resonance (MR) imaging and a diffusion-weighted spin-echo sequence (spatial resolution, 50 × 100 × 800 μm). Subsequently, samples underwent histologic analysis with safranin O staining. Cartilage damage on safranin O histologic slides was quantified with Osteoarthritis Research Society International (OARSI) grades; grades ranged from 0 (healthy) to 6 (bone remodeling). Maps of longitudinal diffusivity (λ(l)), transverse diffusivity (λ(t)), mean diffusivity (MD), and fractional anisotropy (FA) were calculated. Cartilage was segmented, and region of interest (ROI) analysis was performed and compared with histologic findings. Significant differences in MR parameters between the OARSI groups were assessed with the Tukey test. The value of DT imaging in the diagnosis and grading of cartilage damage was assessed with logistic regression analysis. RESULTS Samples had OARSI grades of 0 (n = 14), 1 (n = 11), 2 (n = 12), 3 (n = 4), and 4 (n = 2). Samples with an OARSI grade greater than 0 had significantly increased λ(l), λ(t), and MD (7%-25% increase) in the superficial cartilage growing deeper into cartilage with increasing OARSI grade. Samples with an OARSI grade greater than 0 showed significantly decreased FA in the deep cartilage (-25% to -35% decrease), suggesting that changes in the collagen architecture may occur early in cartilage degradation. DTI showed excellent performance in the detection of cartilage damage (accuracy, 0.95; 41 of 43 samples) and good performance in the grading of cartilage damage (accuracy, 0.74; 32 of 43 samples). CONCLUSION DT imaging of articular cartilage can enable physicians to detect and grade early cartilage damage.
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Affiliation(s)
- José G Raya
- Department of Radiology, New York University Langone Medical Center, 660 First Ave, 4th Floor, New York, NY 10016, USA.
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Ganguly K, McRury ID, Goodwin PM, Morgan RE, Augé WK. Targeted In Situ Biosynthetic Transcriptional Activation in Native Surface-Level Human Articular Chondrocytes during Lesion Stabilization. Cartilage 2012; 3:141-55. [PMID: 26069627 PMCID: PMC4297128 DOI: 10.1177/1947603511426881] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Safe articular cartilage lesion stabilization is an important early surgical intervention advance toward mitigating articular cartilage disease burden. While short-term chondrocyte viability and chondrosupportive matrix modification have been demonstrated within tissue contiguous to targeted removal of damaged articular cartilage, longer term tissue responses require evaluation to further clarify treatment efficacy. The purpose of this study was to examine surface chondrocyte responses within contiguous tissue after lesion stabilization. METHODS Nonablation radiofrequency lesion stabilization of human cartilage explants obtained during knee replacement was performed for surface fibrillation. Time-dependent chondrocyte viability, nuclear morphology and cell distribution, and temporal response kinetics of matrix and chaperone gene transcription indicative of differentiated chondrocyte function were evaluated in samples at intervals to 96 hours after treatment. RESULTS Subadjacent surface articular cartilage chondrocytes demonstrated continued viability for 96 hours after treatment, a lack of increased nuclear fragmentation or condensation, persistent nucleic acid production during incubation reflecting cellular assembly behavior, and transcriptional up-regulation of matrix and chaperone genes indicative of retained biosynthetic differentiated cell function. CONCLUSIONS The results of this study provide further evidence of treatment efficacy and suggest the possibility to manipulate or induce cellular function, thereby recruiting local chondrocytes to aid lesion recovery. Early surgical intervention may be viewed as a tissue rescue, allowing articular cartilage to continue displaying biological responses appropriate to its function rather than converting to a tissue ultimately governed by the degenerative material property responses of matrix failure. Early intervention may positively impact the late changes and reduce disease burden of damaged articular cartilage.
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Affiliation(s)
| | | | | | | | - Wayne K. Augé
- NuOrtho Surgical Inc., Fall River, MA, USA,Center for Orthopaedic and Sports Performance Research Inc., Santa Fe, NM, USA
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Fick JM, Espino DM. Articular cartilage surface failure: An investigation of the rupture rate and morphology in relation to tissue health and hydration. Proc Inst Mech Eng H 2012; 226:389-96. [DOI: 10.1177/0954411912439824] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study investigates the rupture rate and morphology of articular cartilage by altering the bathing environments of healthy and degenerate bovine cartilage. Soaking tissues in either distilled water or 1.5 M NaCl saline was performed in order to render the tissues into a swollen or dehydrated state, respectively. Creep compression was applied using an 8 mm flat-ended polished indenter that contained a central pore of 450 µm in diameter, providing a consistent region for rupture to occur across all 105 tested specimens. Rupture rates were determined by varying the nominal compressive stress and the loading time. Similar rupture rates were observed with the swollen healthy and degenerate specimens, loaded with either 6 or 7 MPa of nominal compressive stress over 11 and 13 min. The observed rupture rates for the dehydrated specimens loaded with 7 MPa over 60 and 90 s were 20% versus 40% and 20% versus 60% for healthy and degenerate tissues, respectively. At 8 MPa of nominal compressive stress over 60 and 90 s the observed rupture rates were 20% versus 60% and 40% versus 80% for healthy and degenerate tissues, respectively; with all dehydrated degenerate tissues exhibiting a greater tendency to rupture (Barnard’s exact test, p < 0.05). Rupture morphologies were only different in the swollen degenerate tissues ( p < 0.05). The mechanisms by which dehydration and swelling induce initial surface rupture of mildly degenerate articular cartilage differ. Dehydration increases the likelihood that the surface will rupture, however, swelling alters the observed rupture morphology.
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Affiliation(s)
- James M Fick
- Most Recent Affiliation: Department of Chemical and Materials Engineering, University of Auckland, New Zealand
| | - Daniel M Espino
- School of Mechanical Engineering, University of Birmingham, UK
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10
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Goyal N, Gupta M. Computerized Morphometric Analysis of Human Femoral Articular Cartilage. ISRN RHEUMATOLOGY 2012; 2012:360201. [PMID: 22619732 PMCID: PMC3348523 DOI: 10.5402/2012/360201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Accepted: 12/01/2011] [Indexed: 11/30/2022]
Abstract
Objective. Articular cartilage shows changes with age that are considered to be the most important factors in the development and progression of osteoarthritis. The studies on age changes in articular cartilage have been traditionally based on individual observations but this approach is limited by its subjectivity and bias, yielding considerable variability. So the present study was conducted to observe various age related changes in morphology of femoral articular cartilage using computerized morphometric analysis. Design. The articular cartilage specimens were divided into two groups according to age: group 1 (n = 16) below 40 years (16–40 years) and group 2 (n = 12) above 40 years (41–86 years) of age. 5 μm thick paraffin sections were stained with H&E and analyzed using Image Pro Express image analysis software for quantitative analysis of articular cartilage. Various parameters, that is, total thickness of the cartilage, area of lacunae in each zone, area of subchondral cavities, and number of chondrocytes per 10,000 μm2 area in each zone were measured. Results. Significant difference with age was found in the total thickness and area of lacunae in zone 3. Conclusions. Not much difference is observed in articular cartilage morphology with age. So ageing is not the only risk factor in development of osteoarthritis.
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Affiliation(s)
- Neeru Goyal
- Department of Anatomy, Health Sciences Block, Christian Medical College, Ludhiana 141008, India
| | - Madhur Gupta
- Department of Anatomy, Swami Devi Dayal Hospital & Dental College & Hospital, Golpura 134118, India
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BROWN CAMERONPETER. ISSUES AND ADVANCES IN THE EARLY STAGE DIAGNOSIS OF OSTEOARTHRITIS. INTERNATIONAL JOURNAL OF NANOSCIENCE 2011. [DOI: 10.1142/s0219581x10006508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
With the progress of localized treatment procedures such as unicompartmental knee replacement, chondrocyte implantation and osteochondral grafting, it has become important to develop a means of assessing early stage cartilage and bone degradation. This review outlines the recent advances in arthroscopic tools, and discusses the major problems and issues faced in developing effective assessment methods. The central problem in joint tissue assessment is to discriminate degradation from the wide variation in normal tissue. This discrimination, however, is far from being realized by current methodologies, and is compounded by the difficulty in correlating structural features with pain and mobility in the joint. In response to these findings, an argument is provided for a new direction in quantitative tissue evaluation using an integrated chemical, structural, and functional approach, and the importance of structure–function–pain relationships.
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Affiliation(s)
- CAMERON PETER BROWN
- Facoltà di Scienze, Università di Roma II, Via Della Ricerca Scientifica 00133 Roma, Italy
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12
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Brown CP, Houle MA, Chen M, Price AJ, Légaré F, Gill HS. Damage initiation and progression in the cartilage surface probed by nonlinear optical microscopy. J Mech Behav Biomed Mater 2011; 5:62-70. [PMID: 22100080 DOI: 10.1016/j.jmbbm.2011.08.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 08/11/2011] [Accepted: 08/15/2011] [Indexed: 11/24/2022]
Abstract
With increasing interest in treating osteoarthritis at its earliest stages, it has become important to understand the mechanisms by which the disease progresses across a joint. Here, second harmonic generation (SHG) microscopy, coupled with a two-dimensional spring-mass network model, was used to image and investigate the collagen meshwork architecture at the cartilage surface surrounding osteoarthritic lesions. We found that minor weakening of the collagen meshwork leads to the bundling of fibrils at the surface under normal loading. This bundling appears to be an irreversible step in the degradation process, as the stress concentrations drive the progression of damage, forming larger bundles and cracks that eventually form lesions.
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Affiliation(s)
- C P Brown
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, United Kingdom.
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13
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Ganguly K, McRury ID, Goodwin PM, Morgan RE, Augé WK. Native Chondrocyte Viability during Cartilage Lesion Progression: Normal to Surface Fibrillation. Cartilage 2010; 1:306-11. [PMID: 26069561 PMCID: PMC4297056 DOI: 10.1177/1947603510373918] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Early surgical intervention for articular cartilage disease is desirable before full-thickness lesions develop. As early intervention treatments are designed, native chondrocyte viability at the treatment site before intervention becomes an important parameter to consider. The purpose of this study is to evaluate native chondrocyte viability in a series of specimens demonstrating the progression of articular cartilage lesions to determine if the chondrocyte viability profile changes during the evolution of articular cartilage disease to the level of surface fibrillation. DESIGN Osteochondral specimens demonstrating various degrees of articular cartilage damage were obtained from patients undergoing knee total joint replacement. Three groups were created within a patient harvest based on visual and tactile cues commonly encountered during surgical intervention: group 1, visually and tactilely intact surfaces; group 2, visually intact, tactilely soft surfaces; and group 3, surface fibrillation. Confocal laser microscopy was performed following live/dead cell viability staining. RESULTS Groups 1 to 3 demonstrated viable chondrocytes in all specimens, even within the fibrillated portions of articular cartilage, with little to no evidence of dead chondrocytes. Chondrocyte viability profile in articular cartilage does not appear to change as disease lesion progresses from normal to surface fibrillation. CONCLUSIONS Fibrillated partial-thickness articular cartilage lesions are a good therapeutic target for early intervention. These lesions retain a high profile of viable chondrocytes and are readily diagnosed by visual and tactile cues during surgery. Early intervention should be based on matrix failure rather than on more aggressive procedures that further corrupt the matrix and contribute to chondrocyte necrosis of contiguous untargeted cartilage.
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Affiliation(s)
- Kumkum Ganguly
- B-Division, Los Alamos National Laboratory, Los Alamos, NM, USA
| | | | - Peter M. Goodwin
- Center for Integrated Nanotechnologies, Los Alamos National Laboratory, Los Alamos, NM, USA
| | | | - Wayne K. Augé
- NuOrtho Surgical, Inc., Fall River, MA, USA,Center for Orthopaedic and Sports Performance Research, Inc., Santa Fe, NM, USA,Wayne K. Augé II, MD, Center for Orthopaedic and Sports Performance Research, Inc., 936 Vista Jemez Court, Santa Fe, NM 87505, USA ;
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14
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Ganguly K, McRury ID, Goodwin PM, Morgan RE, Augé Ii WK. Histopomorphic evaluation of radiofrequency mediated débridement chondroplasty. Open Orthop J 2010; 4:211-20. [PMID: 20721322 PMCID: PMC2923343 DOI: 10.2174/1874325001004010211] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Revised: 05/21/2010] [Accepted: 05/27/2010] [Indexed: 11/22/2022] Open
Abstract
The use of radiofrequency devices has become widespread for surgical ablation procedures. When ablation devices have been deployed in treatment settings requiring tissue preservation like débridement chondroplasty, adoption has been limited due to the collateral damage caused by these devices in healthy tissue surrounding the treatment site. Ex vivo radiofrequency mediated débridement chondroplasty was performed on osteochondral specimens demonstrating surface fibrillation obtained from patients undergoing knee total joint replacement. Three radiofrequency systems designed to perform débridement chondroplasty were tested each demonstrating different energy delivery methods: monopolar ablation, bipolar ablation, and non-ablation energy. Treatment outcomes were compared with control specimens as to clinical endpoint and histopomorphic characteristics. Fibrillated cartilage was removed in all specimens; however, the residual tissue remaining at the treatment site displayed significantly different characteristics attributable to radiofrequency energy delivery method. Systems that delivered ablation-based energies caused tissue necrosis and collateral damage at the treatment site including corruption of cartilage Superficial and Transitional Zones; whereas, the non-ablation system created a smooth articular surface with Superficial Zone maintenance and without chondrocyte death or tissue necrosis. The mechanism of radiofrequency energy deposition upon tissues is particularly important in treatment settings requiring tissue preservation. Ablation-based device systems can cause a worsened state of articular cartilage from that of pre-treatment. Non-ablation energy can be successful in modifying/preconditioning tissue during débridement chondroplasty without causing collateral damage. Utilizing a non-ablation radiofrequency system provides the ability to perform successful débridement chondroplasty without causing additional articular cartilage tissue damage and may allow for other cartilage intervention success.
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Affiliation(s)
- Kumkum Ganguly
- B-Division, Los Alamos National Laboratory, Los Alamos, New Mexico, USA
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15
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Fick JM, Thambyah A, Broom ND. Articular cartilage compression: how microstructural response influences pore pressure in relation to matrix health. Connect Tissue Res 2010; 51:132-49. [PMID: 20001847 DOI: 10.3109/03008200903125229] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Our research investigated the influence of degeneration on both the pore-pressure development and microstructural response of cartilage during indentation with a flat-porous-indenter. Experiments were conducted to link the mechanical and structural responses of normal and degenerate articular cartilage. We found that from the instant of loading the degenerate matrix generated a higher peak hydrostatic excess pore pressure in a shorter period of time than the normal matrix. Following the attainment of this peak value the pore pressure in both tissue groups then gradually decayed toward zero over time, thus demonstrating a classical consolidation response. The microstructural analysis provided a unique insight into the influence of degeneration on the mechanisms of internal stress-sharing within the loaded matrix. Both disruption of the articular surface and general matrix destructuring results in an altered deformation field in both the directly loaded and nondirectly loaded regions. It is argued that the higher levels of matrix shear combined with less of the applied load being redirected into the wider cartilage continuum accounts for the elevated levels of peak hydrostatic pore pressure generated in the degenerate matrix.
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Affiliation(s)
- James M Fick
- Biomaterials Laboratory, Department of Chemical and Materials Engineering, University of Auckland, Auckland, New Zealand
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Anisotropic dynamic changes in the pore network structure, fluid diffusion and fluid flow in articular cartilage under compression. Biomaterials 2010; 31:3117-28. [PMID: 20144846 DOI: 10.1016/j.biomaterials.2010.01.102] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2009] [Accepted: 01/15/2010] [Indexed: 10/19/2022]
Abstract
A compression cell designed to fit inside an NMR spectrometer was used to investigate the in situ mechanical strain response, structural changes to the internal pore structure, and the diffusion and flow of interstitial water in full-thickness cartilage samples as it was deforming dynamically under a constant compressive load (pressure). We distinguish between the hydrostatic pressure acting on the interstitial fluid and the pore pressure acting on the cartilage fibril network. Our results show that properties related to the pore matrix microstructure such as diffusion and hydraulic conductivity are strongly influenced by the hydrostatic pressure in the interstitial fluid of the dynamically deforming cartilage which differ significantly from the properties measured under static i.e. equilibrium loading conditions (when the hydrostatic pressure has relaxed back to zero). The magnitude of the hydrostatic fluid pressure also appears to affect the way cartilage's pore matrix changes during deformation with implications for the diffusion and flow-driven fluid transport through the deforming pore matrix. We also show strong evidence for a highly anisotropic pore structure and deformational dynamics that allows cartilage to deform without significantly altering the axial porosity of the matrix even at very large strains. The insensitivity of the axial porosity to compressive strain may be playing a critical function in directing the flow of pressurized interstitial fluid in the compressed cartilage to the surface, to support the load, and provide a protective interfacial fluid film that 'weeps' out from the deforming tissue and thereby enhances the (elasto)hydrodynamic efficacy of sliding joints. Our results appear to show a close synergy between the structure of cartilage and both the hydrodynamic and boundary lubrication mechanisms.
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Mansfield J, Yu J, Attenburrow D, Moger J, Tirlapur U, Urban J, Cui Z, Winlove P. The elastin network: its relationship with collagen and cells in articular cartilage as visualized by multiphoton microscopy. J Anat 2009; 215:682-91. [PMID: 19796069 DOI: 10.1111/j.1469-7580.2009.01149.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
A combination of two-photon fluorescence (TPF), second harmonic generation (SHG) and coherent anti-Stokes Raman scattering (CARS) imaging has been used to investigate the elastin fibre network in healthy equine articular cartilage from the metacarpophalangeal joint. The elastin fibres were identified using their intrinsic two-photon fluorescence and immuno-staining was used to confirm the identity of these fibres. SHG was used to reveal the collagen matrix and the collagen fibre orientations were determined from their SHG polarization sensitivity, while CARS was used to clearly delineate the cell boundaries. Extensive elastin fibre networks were found in all the joint regions investigated. The elastin was found predominantly in the superficial zone (upper 50 microm) and was aligned parallel to the articular surface. Elastin was also detected in the pericellular matrix surrounding the superficial chondrocytes; however, individual fibres could not be resolved in this region. Variations in the density and organization of the fibres were observed in different regions on the joint surface.
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Affiliation(s)
- Jessica Mansfield
- Biophysics, School of Physics, University of Exeter, Exeter EX4 4QL, UK.
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18
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Brown CP, Bowden JC, Rintoul L, Meder R, Oloyede A, Crawford RW. Diffuse reflectance near infrared spectroscopy can distinguish normal from enzymatically digested cartilage. Phys Med Biol 2009; 54:5579-94. [DOI: 10.1088/0031-9155/54/18/015] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Thambyah A, Broom N. On new bone formation in the pre-osteoarthritic joint. Osteoarthritis Cartilage 2009; 17:456-63. [PMID: 18977155 DOI: 10.1016/j.joca.2008.09.005] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2008] [Accepted: 09/06/2008] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This study investigated the structural alterations in the osteochondral junction, traversing the intact-to-lesion regions, with the aim of elucidating the way in which the pre-osteoarthritic (pre-OA) state progresses to fully developed osteoarthritis (OA). METHOD Thirty bovine patellae showing varying degrees of degeneration, with lesions located in the distal-lateral quarter, were used for this study. Cartilage-on-bone blocks were cut along the lateral facet to include both the lesion site in the distal end and the intact site in the proximal end. The blocks were formalin-fixed, mildly decalcified and microtomed to obtain 30 microm - thick osteochondral slices. Using differential interference contrast optics, the tissue microstructure was captured at high resolution in its fully hydrated state. RESULTS There were structural changes in the osteochondral junction beneath the still-intact articular cartilage adjacent to the lesion site. The changes observed in traversing from the intact to the lesion site exhibited characteristics that were strikingly similar to those associated with primary bone formation. The evidence suggests that disruption of the cartilage continuum by a lesion has wider mechanobiological consequences at the osteochondral junction. CONCLUSION The progression of OA appears to involve new bone formation adjacent to lesion sites. We hypothesise that the new bone spicules that appear in regions beneath intact cartilage adjacent to lesion sites provide a snapshot of the elusive pre-OA state.
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Affiliation(s)
- A Thambyah
- Biomaterials Laboratory, Department of Chemical and Materials Engineering, University of Auckland, New Zealand
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20
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Thambyah A, Broom N. Micro-anatomical response of cartilage-on-bone to compression: mechanisms of deformation within and beyond the directly loaded matrix. J Anat 2007; 209:611-22. [PMID: 17062019 PMCID: PMC2100340 DOI: 10.1111/j.1469-7580.2006.00646.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The biomechanical function of articular cartilage relies crucially on its integration with both the subchondral bone and the wider continuum of cartilage beyond the directly loaded contact region. This study was aimed at visualizing, at the microanatomical level, the deformation response of cartilage including that of the non-directly loaded continuum. Cartilage-on-bone samples from bovine patellae were loaded in static compression until a near-equilibrium deformation was achieved, and then chemically fixed in this deformed state. Full-depth cartilage-bone sections, incorporating the indentation profile and beyond, were studied in their fully hydrated state using differential interference contrast microscopy. Morphometric measurements of the indented profile were used in combination with a force analysis of the tangential layer to investigate the extent to which the applied force is attenuated in moving away from the directly loaded region. This study provides microscopic evidence of a structure-related response in the transitional zone of the cartilage matrix. It is manifested as an intense chevron-type shear discontinuity arising from the constraints provided by both the strain-limiting articular surface and the osteochondral attachment. The discontinuity persists well into the non-directly loaded continuum of cartilage and is proposed as a force attenuation mechanism. The structural and biomechanical analyses presented in this study emphasize the important role of the complex microanatomy of cartilage, highlighting the interconnectivity and optimal recruitment of the load-bearing elements throughout the zonally differentiated cartilage depth.
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Affiliation(s)
- Ashvin Thambyah
- Biomaterials Laboratory, Department of Chemical and Materials Engineering, University of Auckland, New Zealand
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Brown CP, Oloyede A, Moody HR, Crawford RW. A novel approach to the development of benchmarking parameters for characterizing cartilage health. Connect Tissue Res 2007; 48:52-61. [PMID: 17364668 DOI: 10.1080/03008200601074778] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This article outlines the motivation and preliminary investigations into a novel method of characterizing cartilage health for potential in vivo application. Current in vivo indentation techniques, which primarily rely on stiffness measurements based on axial data, are unable to adequately distinguish between healthy and degraded tissue. The present in vitro study investigates the effects of controlled artificial degradation on the effective surface stretch, comparing the results with those obtained from the peripheral cartilage surrounding focal osteoarthritis. Results suggest that this technique is highly sensitive, showing a maximum range of 14% effective surface stretch in a normal joint compared with 42% for axial strain measurements. We further demonstrated that the technique can discriminate between degenerative changes and the intrinsic variations in cartilage properties across the normal joint. From these investigations we propose that the relationship between indentation and the in-plane strain field under the indenter can better distinguish degraded tissue than the currently used stiffness techniques.
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Affiliation(s)
- Cameron P Brown
- School of Engineering System, Faculty of Built Environment and Engineering, Queensland University of Technology, Brisbane, Australia
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Flachsmann R, Kistler M, Rentzios A, Broom ND. Influence of an initiating microsplit on the resistance to compression-induced rupture of the articular surface. Connect Tissue Res 2006; 47:77-84. [PMID: 16754513 DOI: 10.1080/03008200600584090] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Cartilage-on-bone samples from bovine patellae containing a defined stellar or linear initiating split in the articular surface were incrementally loaded in direct compression with intervening rehydration, until articular surface rupture occurred. All patellae were either normal or exhibited a mild level of surface fibrillation. In all cases the actual loading site was free of disruption. The average rupture stress of the healthy cartilage was significantly higher than that of the mildly degenerate cartilage, and in both tissue categories average rupture stresses were lower for the linear split morphology than for the stellar. We propose that this contrasting rupture behavior is explained by differences in both secondary lineal surface strains associated with the depth of compressive indentation and in the ability of the fibrillar network within the surface layer to re-arrange itself in the localized regions of stress concentration around the initiating split.
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Affiliation(s)
- R Flachsmann
- Biomaterials Research Laboratory, Department of Chemical and Materials Engineering, University of Auckland, New Zealand
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Flachsmann R, Kim W, Broom N. Vulnerability to rupture of the intact articular surface with respect to age and proximity to site of fibrillation: a dynamic and static-investigation. Connect Tissue Res 2005; 46:159-69. [PMID: 16147854 DOI: 10.1080/03008200500216470] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Bovine cartilage-on-bone samples taken from healthy mature patellae and from the intact regions of degenerate patellae were subjected to dynamic and static compressive loading. In-plane articular surface strain and rupture behavior were investigated and compared with previously published data obtained from immature bovine patellae. Both aging and proximity of the intact tested region to the fibrillated lesion increase the likelihood of articular surface rupture under both impact and static loading. Substantially higher levels of stress can be applied dynamically than statically without increasing the risk of articular surface rupture. Articular surface rupture is a result of lineal strains generated by the indentation profile, but any direct measurement of its in situ rupture strength is not possible. However, differences in both measured articular surface strains and rupture characteristics between the three categories of tissue suggest that there is a progressive reduction in the intrinsic strength of the intact surface layer of cartilage with both aging and proximity to site of fibrillation.
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Affiliation(s)
- René Flachsmann
- Biomaterials Laboratory, Department of Chemical and Materials Engineering, University of Auckland, New Zealand
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