Micro-anatomical response of cartilage-on-bone to compression: mechanisms of deformation within and beyond the directly loaded matrix

Characterization of intra-tissue strain fields in articular cartilage explants during post-loading recovery using high frequency ultrasound

This study aims to demonstrate the potential of ultrasound elastography as a research tool for non-destructive imaging of intra-tissue strain fields and tissue quality assessment in cartilage explants. Osteochondral plugs from bovine patellae were loaded up to 10, 40, or 70 N using a hemi-spherical indenter. The load was kept constant for 15 min, after which samples were unloaded and ultrasound imaging of strain recovery over time was performed in the indented area for 1 h. Tissue strains were determined using speckle tracking and accumulated to LaGrangian strains in the indentation direction. For all samples, strain maps showed a heterogeneous strain field, with the highest values in the superficial cartilage under the indenter tip at the bottom of the indent and decreasing values in the deeper cartilage. Strains were higher at higher load levels and tissue recovery over time was faster after indentation at 10 N than at 40 N and 70 N. At lower compression levels most displacement occurred near the surface with little deformation in the deep layers, while at higher levels strains increased more evenly in all cartilage zones. Ultrasound elastography is a promising method for high resolution imaging of intra-tissue strain fields and evaluation of cartilage quality in tissue explants in a laboratory setting. In the future, it may become a clinical diagnostic tool used to identify the extent of cartilage damage around visible defects.

Mineral Crystal Thickness in Calcified Cartilage and Subchondral Bone in Healthy and Osteoarthritic Human Knees

Osteoarthritis (OA) is the most common joint disease, where articular cartilage degradation is often accompanied with sclerosis of the subchondral bone. However, the association between OA and tissue mineralization at the nanostructural level is currently not understood. In particular, it is technically challenging to study calcified cartilage, where relevant but poorly understood pathological processes such as tidemark multiplication and advancement occur. Here, we used state-of-the-art microfocus small-angle X-ray scattering with a 5-μm spatial resolution to determine the size and organization of the mineral crystals at the nanostructural level in human subchondral bone and calcified cartilage. Specimens with a wide spectrum of OA severities were acquired from both medial and lateral compartments of medial compartment knee OA patients (n = 15) and cadaver knees (n = 10). Opposing the common notion, we found that calcified cartilage has thicker and more mutually aligned mineral crystals than adjoining bone. In addition, we, for the first time, identified a well-defined layer of calcified cartilage associated with pathological tidemark multiplication, containing 0.32 nm thicker crystals compared to the rest of calcified cartilage. Finally, we found 0.2 nm thicker mineral crystals in both tissues of the lateral compartment in OA compared with healthy knees, indicating a loading-related disease process because the lateral compartment is typically less loaded in medial compartment knee OA. In summary, we report novel changes in mineral crystal thickness during OA. Our data suggest that unloading in the knee might be involved with the growth of mineral crystals, which is especially evident in the calcified cartilage. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).

Repopulation of decellularised articular cartilage by laser-based matrix engraving

BACKGROUND

In spite of advances in the treatment of cartilage defects using cell and scaffold-based therapeutic strategies, the long-term outcome is still not satisfying since clinical scores decline years after treatment. Scaffold materials currently used in clinical settings have shown limitations in providing suitable biomechanical properties and an authentic and protective environment for regenerative cells. To tackle this problem, we developed a scaffold material based on decellularised human articular cartilage.

METHODS

Human articular cartilage matrix was engraved using a CO₂ laser and treated for decellularisation and glycosaminoglycan removal. Characterisation of the resulting scaffold was performed via mechanical testing, DNA and GAG quantification and in vitro cultivation with adipose-derived stromal cells (ASC). Cell vitality, adhesion and chondrogenic differentiation were assessed. An ectopic, unloaded mouse model was used for the assessment of the in vivo performance of the scaffold in combination with ASC and human as well as bovine chondrocytes. The novel scaffold was compared to a commercial collagen type I/III scaffold.

FINDINGS

Crossed line engravings of the matrix allowed for a most regular and ubiquitous distribution of cells and chemical as well as enzymatic matrix treatment was performed to increase cell adhesion. The biomechanical characteristics of this novel scaffold that we term CartiScaff were found to be superior to those of commercially available materials. Neo-tissue was integrated excellently into the scaffold matrix and new collagen fibres were guided by the laser incisions towards a vertical alignment, a typical feature of native cartilage important for nutrition and biomechanics. In an ectopic, unloaded in vivo model, chondrocytes and mesenchymal stromal cells differentiated within the incisions despite the lack of growth factors and load, indicating a strong chondrogenic microenvironment within the scaffold incisions. Cells, most noticeably bone marrow-derived cells, were able to repopulate the empty chondrocyte lacunae inside the scaffold matrix.

INTERPRETATION

Due to the better load-bearing, its chondrogenic effect and the ability to guide matrix-deposition, CartiScaff is a promising biomaterial to accelerate rehabilitation and to improve long term clinical success of cartilage defect treatment.

FUNDING

Austrian Research Promotion Agency FFG ("CartiScaff" #842455), Lorenz Böhler Fonds (16/13), City of Vienna Competence Team Project Signaltissue (MA23, #18-08).

Repopulation of decellularised articular cartilage by laser-based matrix engraving

Background

In spite of advances in the treatment of cartilage defects using cell and scaffold-based therapeutic strategies, the long-term outcome is still not satisfying since clinical scores decline years after treatment. Scaffold materials currently used in clinical settings have shown limitations in providing suitable biomechanical properties and an authentic and protective environment for regenerative cells. To tackle this problem, we developed a scaffold material based on decellularised human articular cartilage.

Methods

Human articular cartilage matrix was engraved using a CO₂ laser and treated for decellularisation and glycosaminoglycan removal. Characterisation of the resulting scaffold was performed via mechanical testing, DNA and GAG quantification and in vitro cultivation with adipose-derived stromal cells (ASC). Cell vitality, adhesion and chondrogenic differentiation were assessed. An ectopic, unloaded mouse model was used for the assessment of the in vivo performance of the scaffold in combination with ASC and human as well as bovine chondrocytes. The novel scaffold was compared to a commercial collagen type I/III scaffold.

Findings

Crossed line engravings of the matrix allowed for a most regular and ubiquitous distribution of cells and chemical as well as enzymatic matrix treatment was performed to increase cell adhesion. The biomechanical characteristics of this novel scaffold that we term CartiScaff were found to be superior to those of commercially available materials. Neo-tissue was integrated excellently into the scaffold matrix and new collagen fibres were guided by the laser incisions towards a vertical alignment, a typical feature of native cartilage important for nutrition and biomechanics. In an ectopic, unloaded in vivo model, chondrocytes and mesenchymal stromal cells differentiated within the incisions despite the lack of growth factors and load, indicating a strong chondrogenic microenvironment within the scaffold incisions. Cells, most noticeably bone marrow-derived cells, were able to repopulate the empty chondrocyte lacunae inside the scaffold matrix.

Interpretation

Due to the better load-bearing, its chondrogenic effect and the ability to guide matrix-deposition, CartiScaff is a promising biomaterial to accelerate rehabilitation and to improve long term clinical success of cartilage defect treatment.

Funding

Austrian Research Promotion Agency FFG (“CartiScaff” #842455), Lorenz Böhler Fonds (16/13), City of Vienna Competence Team Project Signaltissue (MA23, #18-08)

The mechanical significance of the zonally differentiated collagen network of articular cartilage in relation to tissue swelling

BACKGROUND

We hypothesise that the Benninghoff arcade fibril structure motif of cartilage is able to predict the swelling response of cartilage.

METHODS

A total of ten healthy adult bovine patellae were used for this study, yielding 20 paired full depth cartilage samples (half with surface layer intact and half with surface layer removed). Following excision from the bone, samples were allowed to equilibrate first in physiological saline for 2 h, and then in distilled water for another 2 h to maximise the swelling response. Images were captured using a stereomicroscope to measure strain and the fully-swollen samples were fixed in 10% formalin to retain shape for microscopic and ultrastructural imaging.

FINDINGS

We expected all swelling samples with an intact 'strain-limiting' surface layer to curl upwards, instead only 70% of them did. For samples without a surface layer, we expected the swelling to be evenly distributed and to remain relatively uncurled; but in 40% of the samples there was a downward curvature (i.e. opposite to that of the previous group). Micro-to-ultrastructural imaging, to determine fibrillar structure and organisation, revealed the deep zone cartilage was an additional counter layer limiting swelling strain, and was the likely cause of the unexpected swelling responses.

INTERPRETATION

Our expectations that the surface layer alone will influence the swelling response, was based on the assumptions of the Benninghoff arcade model. This study highlights the additional importance of sub-micron scale fibrillar interconnectivity and the role of the deep zone.

Alteration of structural and mechanical properties of the temporomandibular joint disc following elastase digestion

The temporomandibular joint disc is a fibrocartilaginous structure, composed of collagen fibers, elastin fibers, and proteoglycans. Despite the crucial role of elastin fibers in load‐bearing properties of connective tissues, its contribution in temporomandibular joint disc biomechanics has been disregarded. This study attempts to characterize the structural–functional contribution of elastin in the temporomandibular joint disc. Using elastase, we selectively perturbed the elastin fiber network in porcine temporomandibular joint discs and investigated the structural, compositional, and mechanical regional changes through: (a) analysis of collagen and elastin fibers by immunolabeling and transmission electron microscopy; (b) quantitative analysis of collagen tortuosity, cell shape, and disc volume; (c) biochemical quantification of collagen, glycosaminoglycan and elastin content; and (d) cyclic compression test. Following elastase treatment, microscopic examination revealed fragmentation of elastin fibers across the temporomandibular joint disc, with a more pronounced effect in the intermediate regions. Also, biochemical analyses of the intermediate regions showed significant depletion of elastin (50%), and substantial decrease in collagen (20%) and glycosaminoglycan (49%) content, likely due to non‐specific activity of elastase. Degradation of elastin fibers affected the homeostatic configuration of the disc, reflected in its significant volume enlargement accompanied by remarkable reduction of collagen tortuosity and cell elongation. Mechanically, elastase treatment nearly doubled the maximal energy dissipation across the intermediate regions while the instantaneous modulus was not significantly affected. We conclude that elastin fibers contribute to the restoration and maintenance of the disc resting shape and actively interact with collagen fibers to provide mechanical resilience to the temporomandibular joint disc.

Polarized reflectance from articular cartilage depends upon superficial zone collagen network microstructure

Polarized reflectance from articular cartilage involves light scattering dependent on surface features, sub-surface optical properties, and collagen birefringence. To understand how surface roughness, zonal collagen microstructure, and chondrocyte organization contribute to polarized reflectance signals, experiments were conducted on bovine cartilage explants and osteochondral cores to compare polarized reflectance texture with split lines and relate these signals to cartilage zonal features and chondrocyte distribution. Texture parameter sensitivity to articular surface damage was determined from polarized reflectance maps and optimized to detect surface damage. Results indicate that polarized reflectance texture predominantly derives from the superficial zone collagen network, while the parameter average value also depends on surface roughness and total cartilage thickness.

Effect of crosslinking in cartilage-like collagen microstructures

The mechanical performance of biological tissues is underpinned by a complex and finely balanced structure. Central to this is collagen, the most abundant protein in our bodies, which plays a dominant role in the functioning of tissues, and also in disease. Based on the collagen meshwork of articular cartilage, we have developed a bottom-up spring-node model of collagen and examined the effect of fibril connectivity, implemented by crosslinking, on mechanical behaviour. Although changing individual crosslink stiffness within an order of magnitude had no significant effect on modelling predictions, the density of crosslinks in a meshwork had a substantial impact on its behaviour. Highly crosslinked meshworks maintained a 'normal' configuration under loading, with stronger resistance to deformation and improved recovery relative to sparsely crosslinked meshwork. Stress on individual fibrils, however, was higher in highly crosslinked meshworks. Meshworks with low numbers of crosslinks reconfigured to disease-like states upon deformation and recovery. The importance of collagen interconnectivity may provide insight into the role of ultrastructure and its mechanics in the initiation, and early stages, of diseases such as osteoarthritis.

The Impact of Collagen Fibril Polarity on Second Harmonic Generation Microscopy

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

Cartilage Strain Distributions Are Different Under the Same Load in the Central and Peripheral Tibial Plateau Regions

There is increasing evidence that the regional spatial variations in the biological and mechanical properties of articular cartilage are an important consideration in the pathogenesis of knee osteoarthritis (OA) following kinematic changes at the knee due to joint destabilizing events (such as an anterior cruciate ligament (ACL) injury). Thus, given the sensitivity of chondrocytes to the mechanical environment, understanding the internal mechanical strains in knee articular cartilage under macroscopic loads is an important element in understanding knee OA. The purpose of this study was to test the hypothesis that cartilage from the central and peripheral regions of the tibial plateau has different internal strain distributions under the same applied load. The internal matrix strain distribution for each specimen was measured on osteochondral blocks from the tibial plateau of mature ovine stifle joints. Each specimen was loaded cyclically for 20 min, after which the specimen was cryofixed in its deformed position and freeze fractured. The internal matrix was viewed in a scanning electron microscope (SEM) and internal strains were measured by quantifying the deformation of the collagen fiber network. The peak surface tensile strain, maximum principal strain, and maximum shear strain were compared between the regions. The results demonstrated significantly different internal mechanical strain distributions between the central and peripheral regions of tibial plateau articular cartilage under both the same applied load and same applied nominal strain. These differences in the above strain measures were due to differences in the deformation patterns of the collagen network between the central and peripheral regions. Taken together with previous studies demonstrating differences in the biochemical response of chondrocytes from the central and peripheral regions of the tibial plateau to mechanical load, the differences in collagen network deformation observed in this study help to provide a fundamental basis for understanding the association between altered knee joint kinematics and premature knee OA.

An overview of multiphase cartilage mechanical modelling and its role in understanding function and pathology

There is a long history of mathematical and computational modelling with the objective of understanding the mechanisms governing cartilage׳s remarkable mechanical performance. Nonetheless, despite sophisticated modelling development, simulations of cartilage have consistently lagged behind structural knowledge and thus the relationship between structure and function in cartilage is not fully understood. However, in the most recent generation of studies, there is an emerging confluence between our structural knowledge and the structure represented in cartilage modelling. This raises the prospect of further refinement in our understanding of cartilage function and also the initiation of an engineering-level understanding for how structural degradation and ageing relates to cartilage dysfunction and pathology, as well as informing the potential design of prospective interventions. Aimed at researchers entering the field of cartilage modelling, we thus review the basic principles of cartilage models, discussing the underlying physics and assumptions in relatively simple settings, whilst presenting the derivation of relatively parsimonious multiphase cartilage models consistent with our discussions. We proceed to consider modern developments that start aligning the structure captured in the models with observed complexities. This emphasises the challenges associated with constitutive relations, boundary conditions, parameter estimation and validation in cartilage modelling programmes. Consequently, we further detail how both experimental interrogations and modelling developments can be utilised to investigate and reduce such difficulties before summarising how cartilage modelling initiatives may improve our understanding of cartilage ageing, pathology and intervention.

How a radial focal incision influences the internal shear distribution in articular cartilage with respect to its zonally differentiated microanatomy

Articular surface fibrillation and the loss of both transverse interconnectivity and zonal differentiation are indicators of articular cartilage (AC) degeneration. However, exactly how these structural features affect the load-redistributing properties of cartilage is still poorly understood. This study investigated how a single radial incision made to varying depths with respect to the primary zones of AC influenced its deformation response to compression. Three depths of incision were applied to cartilage-on-bone tissue blocks: one not exceeding the transition zone; one into the mid-radial zone; and one down to the calcified cartilage. Also included were non-incised controls. All samples were compressed to a near-equilibrium strain using a flat-faced indenter that incorporated a central relief channel within which the incision could be positioned lengthwise along the channel axis. Employing fixation under load followed by decalcification, the structural responses of the cartilage-on-bone samples were investigated. The study provides an analysis of the micro-morphological response that is characteristic of a completely normal cartilage-on-bone system but which contains a defined degree of disruption induced by the focal radial incision. The resulting loss of transverse continuity of the cartilage with respect to its zonally differentiated structure is shown to lead to an altered pattern of internal matrix shear whose intensity varies with incision depth.

Localization of viscous behavior and shear energy dissipation in articular cartilage under dynamic shear loading

Though remarkably robust, articular cartilage becomes susceptible to damage at high loading rates, particularly under shear. While several studies have measured the local static and steady-state shear properties of cartilage, it is the local viscoelastic properties that determine the tissue's ability to withstand physiological loading regimens. However, measuring local viscoelastic properties requires overcoming technical challenges that include resolving strain fields in both space and time and accurately calculating their phase offsets. This study combined recently developed high-speed confocal imaging techniques with three approaches for analyzing time- and location-dependent mechanical data to measure the depth-dependent dynamic modulus and phase angles of articular cartilage. For sinusoidal shear at frequencies f = 0.01 to 1 Hz with no strain offset, the dynamic shear modulus |G*| and phase angle δ reached their minimum and maximum values (respectively) approximately 100 μm below the articular surface, resulting in a profound focusing of energy dissipation in this narrow band of tissue that increased with frequency. This region, known as the transitional zone, was previously thought to simply connect surface and deeper tissue regions. Within 250 μm of the articular surface, |G*| increased from 0.32 ± 0.08 to 0.42 ± 0.08 MPa across the five frequencies tested, while δ decreased from 12 deg ± 1 deg to 9.1 deg ± 0.5 deg. Deeper into the tissue, |G*| increased from 1.5 ± 0.4 MPa to 2.1 ± 0.6 MPa and δ decreased from 13 deg ± 1 deg to 5.5 deg ± 0.2 deg. Viscoelastic properties were also strain-dependent, with localized energy dissipation suppressed at higher shear strain offsets. These results suggest a critical role for the transitional zone in dissipating energy, representing a possible shift in our understanding of cartilage mechanical function. Further, they give insight into how focal degeneration and mechanical trauma could lead to sustained damage in this tissue.

A multi-scale structural study of the porcine anterior cruciate ligament tibial enthesis

Like the human anterior cruciate ligament (ACL), the porcine ACL also has a double bundle structure and several biomechanical studies using this model have been carried out to show the differential effect of these two bundles on macro-level knee joint function. It is hypothesised that if the different bundles of the porcine ACL are mechanically distinct in function, then a multi-scale anatomical characterisation of their individual enthesis will also reveal significant differences in structure between the bundles. Twenty-two porcine knee joints were cleared of their musculature to expose the intact ACL following which ligament-bone samples were obtained. The samples were fixed in formalin followed by decalcification with formic acid. Thin sections containing the ligament insertion into the tibia were then obtained by cryosectioning and analysed using differential interference contrast (DIC) optical microscopy and scanning electron microscopy (SEM). At the micro-level, the anteromedial (AM) bundle insertion at the tibia displayed a significant deep-rooted interdigitation into bone, while for the posterolateral (PL) bundle the fibre insertions were less distributed and more focal. Three sub-types of enthesis were identified in the ACL and related to (i) bundle type, (ii) positional aspect within the insertion, and (iii) specific bundle function. At the nano-level the fibrils of the AM bundle were significantly larger than those in the PL bundle. The modes by which the AM and PL fibrils merged with the bone matrix fibrils were significantly different. A biomechanical interpretation of the data suggests that the porcine ACL enthesis is a specialized, functionally graded structural continuum, adapted at the micro-to-nano scales to serve joint function at the macro level.

Micromechanical response of articular cartilage to tensile load measured using nonlinear microscopy

Articular cartilage (AC) is a highly anisotropic biomaterial, and its complex mechanical properties have been a topic of intense investigation for over 60 years. Recent advances in the field of nonlinear optics allow the individual constituents of AC to be imaged in living tissue without the need for exogenous contrast agents. Combining mechanical testing with nonlinear microscopy provides a wealth of information about microscopic responses to load. This work investigates the inhomogeneous distribution of strain in loaded AC by tracking the movement and morphological changes of individual chondrocytes using point pattern matching and Bayesian modeling. This information can be used to inform models of mechanotransduction and pathogenesis, and is readily extendable to various other connective tissues.

Further insight into the depth-dependent microstructural response of cartilage to compression using a channel indentation technique

Stress relaxation and structural analysis were used to investigate the zonally differentiated microstructural response to compression of the integrated cartilage-on-bone tissue system. Fifteen cartilage-on-bone samples were divided into three equal groups and their stress relaxation responses obtained at three different levels of axial compressive strain defined as low (~20%), medium (~40%) and high (~60%). All tests were performed using a channel indenter which included a central relief space designed to capture the response of the matrix adjacent to the directly loaded regions. On completion of each stress relaxation test and while maintaining the imposed axial strain, the samples were formalin fixed, decalcified, and then sectioned for microstructural analysis. Chondron aspect ratios were used to determine the extent of relative strain at different zonal depths. The stress relaxation response of cartilage to all three defined levels of axial strain displayed an initial highly viscous response followed by a significant elastic response. Chondron aspect ratio measurements showed that at the lowest level of compression, axial deformation was confined to the superficial cartilage layer, while in the medium and high axial strain samples the deformation extended into the midzone. The cells in the deep zone remained undeformed for all compression levels.

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

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

An anatomic study of coronoid cartilage thickness with special reference to fractures

BACKGROUND

Current coronoid fracture classification systems are based on fragment size and configuration using plain radiographs and/or computed tomography (CT). During surgery, coronoid fracture fragments appear much larger than anticipated because cartilage is radiolucent and therefore not accounted for with preoperative imaging. The purpose of this imaging study was to quantify the articular cartilage thickness of the coronoid, with reference to coronoid fractures.

MATERIALS AND METHODS

Twenty-four cadaveric ulnae were dissected, imaged with CT, and analyzed by use of image analysis software. Thirteen identifiable landmarks were chosen on the coronoid, olecranon, and proximal radioulnar joint to measure articular cartilage thickness. Intraobserver reliability and interobserver reliability were determined.

RESULTS

Cartilage thickness was highest at the coronoid tip, with a mean of 3.0 mm (range, 1.7-4.6 mm). Cartilage thickness at the tip correlated inversely with age (P < .01) and correlated strongly with overall ulnar height and ulnar length (P < .05). All measurements had excellent intraobserver and interobserver reliability.

CONCLUSION

The thickness of cartilage on the coronoid tip is not inconsequential. The results of this study indicate that a 2-mm coronoid tip fracture on CT scan may actually appear to be a mean of 5 mm thick when viewed at the time of surgery. Clinically, this is important because it may alter the classification, the decision to treat, or the type of fixation used. Importantly, biomechanical cadaveric studies assessing coronoid injuries have incorporated cartilage thickness into coronoid size measurements when creating simulated fractures; therefore, it is critical that the conclusions of such biomechanical studies be scrutinized with regard to their clinical recommendations. Surgeons should be aware of these discrepancies.

Vulnerability of the superficial zone of immature articular cartilage to compressive injury

OBJECTIVE

The zonal composition and functioning of adult articular cartilage causes depth-dependent responses to compressive injury. In immature cartilage, shear and compressive moduli as well as collagen and sulfated glycosaminoglycan (sGAG) content also vary with depth. However, there is little understanding of the depth-dependent damage caused by injury. Since injury to immature knee joints most often causes articular cartilage lesions, this study was undertaken to characterize the zonal dependence of biomechanical, biochemical, and matrix-associated changes caused by compressive injury.

METHODS

Disks from the superficial and deeper zones of bovine calves were biomechanically characterized. Injury to the disks was achieved by applying a final strain of 50% compression at 100%/second, followed by biomechanical recharacterization. Tissue compaction upon injury as well as sGAG density, sGAG loss, and biosynthesis were measured. Collagen fiber orientation and matrix damage were assessed using histology, diffraction-enhanced x-ray imaging, and texture analysis.

RESULTS

Injured superficial zone disks showed surface disruption, tissue compaction by 20.3 ± 4.3% (mean ± SEM), and immediate biomechanical impairment that was revealed by a mean ± SEM decrease in dynamic stiffness to 7.1 ± 3.3% of the value before injury and equilibrium moduli that were below the level of detection. Tissue areas that appeared intact on histology showed clear textural alterations. Injured deeper zone disks showed collagen crimping but remained undamaged and biomechanically intact. Superficial zone disks did not lose sGAG immediately after injury, but lost 17.8 ± 1.4% of sGAG after 48 hours; deeper zone disks lost only 2.8 ± 0.3% of sGAG content. Biomechanical impairment was associated primarily with structural damage.

CONCLUSION

The soft superficial zone of immature cartilage is vulnerable to compressive injury, causing superficial matrix disruption, extensive compaction, and textural alteration, which results in immediate loss of biomechanical function. In conjunction with delayed superficial sGAG loss, these changes may predispose the articular surface to further softening and tissue damage, thus increasing the risk of development of secondary osteoarthritis.

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

OBJECTIVE

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

DESIGN

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

RESULTS

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

CONCLUSIONS

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

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

BACKGROUND

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

METHODS

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

FINDINGS

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

INTERPRETATION

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

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

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

On new bone formation in the pre-osteoarthritic joint

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.

Deep vertical collagen fibrils play a significant role in mechanics of articular cartilage

The primary orientation of collagen fibrils alters along the cartilage depth; being horizontal in the superficial zone, random in the transitional zone, and vertical in the deep zone. Commonly used confined and unconfined (when with no underlying bone) testing configurations cannot capture the mechanical role of deep vertical fibril network. To determine this role in cartilage mechanics, an axisymmetric nonlinear fibril-reinforced poroelastic model of tibial cartilage plateaus was developed accounting for depth-dependent properties and distinct fibril networks with physical material properties. Both creep and relaxation indentation models were analyzed which results were found equivalent in the transient period but diverged in post-transient periods. Vertical fibrils played a significant role at the transient period in dramatically increasing the stiffness of the tissue and in protecting the solid matrix against large distortions and strains at the subchondral junction. This role, however, disappeared both with time and at loading rates slower than those expected in physiological activities such as walking. The vertical fibrils demonstrated a chevron-type deformation pattern that was further accentuated with time in creep loading. Damages to deep vertical collagen fibril network or their firm anchorage to the bone, associated with bone bruises, for example, would weaken the transient stiffness and place the tissue at higher risk of failure particularly at the deep zone.

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

OBJECTIVE

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

METHOD

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

RESULTS

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

CONCLUSION

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