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Watanabe M, Campbell TM, Reilly K, Uhthoff HK, Laneuville O, Trudel G. Bone replaces unloaded articular cartilage during knee immobilization. A longitudinal study in the rat. Bone 2021; 142:115694. [PMID: 33069921 DOI: 10.1016/j.bone.2020.115694] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/22/2020] [Accepted: 10/12/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Joint immobility results in deleterious changes such as capsule shortening, bone loss and articular cartilage damage. Immobilization of rat knees in flexion for 32 weeks resulted in the distinctive feature of well-established replacement of articular cartilage by bone. Determining the time of onset of bone replacement is critical for the prevention of this likely irreversible complication of joint immobilization. OBJECTIVES To determine the onset and progression of bone replacement in the anterior tibial articular cartilage following knee immobilization in flexion. METHODS One hundred forty-nine adult male Sprague-Dawley rats were used. The experimental groups had one knee immobilized at 135°of flexion for durations of 2, 4, 8, 16 or 32 weeks and were compared to age-matched controls. The knees were evaluated histologically for the presence and cross-sectional area of bone within the articular cartilage of the tibia. Distance between the anterior aspect of the tibia and intact articular cartilage and cross-sectional bone area of the tibial epiphysis were also measured. RESULT Bone replacement in the articular cartilage was observed in 14%, 75%, 95%, 100% and 100% of knees after 2, 4, 8, 16 and 32 weeks of immobilization, respectively. No bone replacement was seen in the control knees. The mean area of bone replacement increased from 0.004 ± 0.007 mm2 after 2 weeks to 0.041 ± 0.036 mm2; 0.085 ± 0.077 mm2; 0.092 ± 0.056 mm2 and 0.107 ± 0.051 mm2 after 4, 8, 16 and 32 weeks of immobilization, respectively, (p < 0.001) largely restricted to the anterior tibial articular cartilage. Mean distance to intact articular cartilage increased from 0.89 ± 0.69 mm at 2 weeks to 1.10 ± 0.35 mm; 1.65 ± 0.77 mm; 1.48 ± 0.63 mm; and 1.78 ± 0.58 mm after 4, 8, 16 and 32 weeks of immobilization, respectively (p = 0.001). Epiphyseal bone cross-sectional area was significantly reduced following 4, 8, and 16 weeks of immobilization compare to controls (all 3 p < 0.05). CONCLUSION Knee immobilization in flexion resulted in bone replacement in the anterior tibial articular cartilage that began after 2 weeks and was prevalent after 4 weeks of immobilization. The bone replacement progressed in an anterior-to-posterior direction and stopped at the area of contact between tibia and femur. These findings stress the importance of mobility to maintain joint health.
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Affiliation(s)
- Masanori Watanabe
- Bone and Joint Research Laboratory, Division of Physical and Rehabilitation Medicine, Department of Medicine, Ottawa Hospital Research Institute, 505 Smyth Road, Ottawa, ON K1H 8M5, Canada; Faculty of Rehabilitation Science, Nagoya Gakuin University, 3-1-17 Taiho, Atsuta-ku, Nagoya, Aichi 456-0062, Japan.
| | - T Mark Campbell
- Bone and Joint Research Laboratory, Division of Physical and Rehabilitation Medicine, Department of Medicine, Ottawa Hospital Research Institute, 505 Smyth Road, Ottawa, ON K1H 8M5, Canada; Department of Physical Medicine and Rehabilitation, Elisabeth Bruyère Hospital, 43 Bruyere St. Room, 240D, Ottawa, ON K1N 5C8, Canada; Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5, Canada.
| | - Katherine Reilly
- Bone and Joint Research Laboratory, Division of Physical and Rehabilitation Medicine, Department of Medicine, Ottawa Hospital Research Institute, 505 Smyth Road, Ottawa, ON K1H 8M5, Canada.
| | - Hans K Uhthoff
- Bone and Joint Research Laboratory, Division of Physical and Rehabilitation Medicine, Department of Medicine, Ottawa Hospital Research Institute, 505 Smyth Road, Ottawa, ON K1H 8M5, Canada
| | - Odette Laneuville
- Bone and Joint Research Laboratory, Division of Physical and Rehabilitation Medicine, Department of Medicine, Ottawa Hospital Research Institute, 505 Smyth Road, Ottawa, ON K1H 8M5, Canada; Department of Biology, University of Ottawa, 30 Marie Curie Private, Ottawa, ON K1N6N5, Canada.
| | - Guy Trudel
- Bone and Joint Research Laboratory, Division of Physical and Rehabilitation Medicine, Department of Medicine, Ottawa Hospital Research Institute, 505 Smyth Road, Ottawa, ON K1H 8M5, Canada; Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5, Canada.
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Tsai LC, Cooper E, Hetzendorfer K, Warren G, Chang YH, Willett N. Effects of treadmill running and limb immobilization on knee cartilage degeneration and locomotor joint kinematics in rats following knee meniscal transection. Osteoarthritis Cartilage 2019; 27:1851-1859. [PMID: 31437580 PMCID: PMC7576441 DOI: 10.1016/j.joca.2019.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 07/25/2019] [Accepted: 08/07/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This study examined the effects of reduced and elevated weight bearing on post-traumatic osteoarthritis (PTOA) development, locomotor joint kinematics, and degree of voluntary activity in rats following medial meniscal transection (MMT). DESIGN Twenty-one adult rats were subjected to MMT surgery of the left hindlimb and then assigned to one of three groups: (1) regular (i.e., no intervention), (2) hindlimb immobilization, or (3) treadmill running. Sham surgery was performed in four additional rats. Voluntary wheel run time/distance was measured, and 3D hindlimb kinematics were quantified during treadmill locomotion using biplanar radiography. Rats were euthanized 8 weeks after MMT or sham surgery, and the microstructure of the tibial cartilage and subchondral bone was quantified using contrast enhanced micro-CT. RESULTS All three MMT groups showed signs of PTOA (full-thickness lesions and/or increased cartilage volume) compared to the sham group, however the regular and treadmill-running groups had greater osteophyte formation than the immobilization group. For the immobilization group, increased volume was only observed in the anterior region of the cartilage. The treadmill-running group demonstrated a greater knee varus angle at mid-stance than the sham group, while the immobilization group demonstrated greater reduction in voluntary running than all the other groups at 2 weeks post-surgery. CONCLUSIONS Elevated weight-bearing via treadmill running at a slow/moderate speed did not accelerate PTOA in MMT rats when compared to regular weight-bearing. Reduced weight-bearing via immobilization may attenuate overall PTOA but still resulted in regional cartilage degeneration. Overall, there were minimal differences in hindlimb kinematics and voluntary running between MMT and sham rats.
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Affiliation(s)
- L.-C. Tsai
- Georgia State University, Atlanta, GA, USA,Address correspondence and reprint requests to: L.-C. Tsai, Department of Physical Therapy, Georgia State University, Atlanta, GA, USA. Tel: 404-413-1246. (L.-C. Tsai)
| | - E.S. Cooper
- Emory University, Atlanta, GA, USA,Georgia Institute of Technology, Atlanta, GA, USA
| | | | - G.L. Warren
- Georgia State University, Atlanta, GA, USA,Georgia Institute of Technology, Atlanta, GA, USA
| | - Y.-H. Chang
- Georgia Institute of Technology, Atlanta, GA, USA
| | - N.J. Willett
- Emory University, Atlanta, GA, USA,Georgia Institute of Technology, Atlanta, GA, USA,Atlanta VA Medical Center, Atlanta, GA, USA
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Vera MC, Abdala V, Aráoz E, Ponssa ML. Movement and joints: effects of overuse on anuran knee tissues. PeerJ 2018; 6:e5546. [PMID: 30186699 PMCID: PMC6120441 DOI: 10.7717/peerj.5546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 08/07/2018] [Indexed: 11/22/2022] Open
Abstract
Movement plays a main role in the correct development of joint tissues. In tetrapods, changes in normal movements produce alterations of such tissues during the ontogeny and in adult stages. The knee-joint is ideal for observing the influence of movement disorders, due to biomechanical properties of its components, which are involved in load transmission. We analyze the reaction of knee tissues under extreme exercise in juveniles and adults of five species of anurans with different locomotor modes. We use anurans as the case study because they undergo great mechanical stress during locomotion. We predicted that (a) knee tissues subjected to overuse will suffer a structural disorganization process; (b) adults will experience deeper morphological changes than juveniles; and (c) morphological changes will be higher in jumpers compared to walkers. To address these questions, we stimulated specimens on a treadmill belt during 2 months. We performed histological analyses of the knee of both treated and control specimens. As we expected, overuse caused structural changes in knee tissues. These alterations were gradual and higher in adults, and similar between jumpers and walkers species. This study represents a first approach to the understanding of the dynamics of anuran knee tissues during the ontogeny, and in relation to locomotion. Interestingly, the alterations found were similar to those observed in anurans subjected to reduced mobility and also to those described in joint diseases (i.e., osteoarthritis and tendinosis) in mammals, suggesting that among tetrapods, changes in movement generate similar responses in the tissues involved.
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Affiliation(s)
- Miriam Corina Vera
- Unidad Ejecutora Lillo (UEL), CONICET-Fundación Miguel Lillo, San Miguel de Tucumán, Argentina
| | - Virginia Abdala
- Instituto de Biodiversidad Neotropical (IBN), UNT-CONICET, San Miguel de Tucumán, Argentina
| | - Ezequiel Aráoz
- Instituto de Ecología Regional, Universidad Nacional de Tucumán, Yerba Buena, Tucumán, Argentina
| | - María Laura Ponssa
- Unidad Ejecutora Lillo (UEL), CONICET-Fundación Miguel Lillo, San Miguel de Tucumán, Argentina
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Lin Y, Li T, Xiong Y, Li J, Fu W. [Research progress of rehabilitation after autologous chondrocyte implantation on knee]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2018; 32:758-763. [PMID: 29905057 PMCID: PMC8414014 DOI: 10.7507/1002-1892.201801034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 04/30/2018] [Indexed: 02/05/2023]
Abstract
Objective To summarize the research progress of rehabilitation after autologous chondrocyte implantation (ACI). Methods The literature related to basic science and clinical practice about rehabilitation after ACI in recent years was searched, selected, and analyzed. Results Based on the included literature, the progress of the graft maturation consists of proliferation phase (0-6 weeks), transition phase (6-12 weeks), remodeling phase (12-26 weeks), and maturation phase (26 weeks-2 years). To achieve early protection, stimulate the maturation, and promote the graft-bone integrity, rehabilitation protocol ought to be based on the biomechanical properties at different phases. Weight-bearing program, range of motion (ROM), and options or facilities of exercise are importance when considering a rehabilitation program. Conclusion It has been proved that the patients need a program with an increasingly progressive weight-bearing and ROM in principles of rehabilitation after ACI. Specific facilities can be taken at a certain phase. Evidences extracted in the present work are rather low and the high-quality and controlled trials still need to improve the rehabilitation protocol.
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Affiliation(s)
- Yipeng Lin
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China
| | - Tao Li
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China
| | - Yan Xiong
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China
| | - Jian Li
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China
| | - Weili Fu
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041,
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Mutsuzaki H, Nakajima H, Sakane M. Extension of knee immobilization delays recovery of histological damages in the anterior cruciate ligament insertion and articular cartilage in rabbits. J Phys Ther Sci 2018; 30:140-144. [PMID: 29410585 PMCID: PMC5788794 DOI: 10.1589/jpts.30.140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 10/24/2017] [Indexed: 12/15/2022] Open
Abstract
[Purpose] To investigate the influence of knee immobilization period on recovery of
histological damages in the anterior cruciate ligament (ACL) insertion and articular
cartilage in rabbits. This knowledge is important for determining the appropriate
rehabilitation approach for patients with ligament injuries, fracture, disuse atrophy, and
degenerative joint disease. [Materials and Methods] Forty-eight male Japanese white
rabbits were divided equally into the remobilization and control groups. The
remobilization group had the right knee surgically immobilized, and was divided equally
into four subgroups according to the duration of immobilization (1, 2, 4 and 8 weeks).
After the immobilization was removed, the rabbits moved freely for 8 weeks. The control
group underwent sham operation and followed the same time course as the remobilization
group. The chondrocyte apoptosis rate and chondrocyte proliferation rate in the ACL
insertion and articular cartilage were analyzed after remobilization. [Results] In the ACL
insertion, the remobilization group had a higher chondrocyte apoptosis rate than the
control group after 8 weeks of immobilization, and a lower chondrocyte proliferation rate
than the control group after 4 and 8 weeks of immobilization. In the articular cartilage,
the remobilization group had a lower chondrocyte proliferation rate than the control group
after 8 weeks of immobilization. After 8 weeks of remobilization, the ACL insertion and
articular cartilage are not completely recovered after 4 and 8 weeks of immobilization,
respectively. [Conclusion] Our results suggest that 8 weeks of remobilization will result
in recovery of the ACL insertion after 2 weeks of knee immobilization, and recovery of the
articular cartilage after 4 weeks of knee immobilization. If 8 weeks of immobilization
occurs, a remobilization duration of more than 8 weeks may be necessary.
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Affiliation(s)
- Hirotaka Mutsuzaki
- Department of Orthopaedic Surgery, Ibaraki Prefectural University of Health Sciences: 4669-2 Ami, Inashiki-gun, Ibaraki 300-0394, Japan
| | | | - Masataka Sakane
- Department of Orthopaedic Surgery, Tsukuba Gakuen Hospital, Japan
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