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Mahmood F, Clarke J, Riches P. Is the mechanical function of meniscal tissue altered in osteoarthritic knees? Knee 2023; 44:194-200. [PMID: 37672911 DOI: 10.1016/j.knee.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/27/2023] [Accepted: 08/11/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Deteriorating meniscal function is thought to play a role in knee osteoarthritis. Meniscal proteoglycans maintain mechanical stiffness of the tissue through electrostatic effects. This study aimed to investigate whether the mechanical properties of macroscopically intact meniscus are preserved in osteoarthritis. METHODS Discs of lateral meniscal tissue two millimetres thick and of five millimetres diameter from osteoarthritic knees and from healthy donors were placed within a confined compression chamber, mounted in a materials testing machine and bathed in isotonic 0.14M PBS, hypotonic deionised water or hypertonic 3M PBS. Following equilibrium, a 10% ramp compressive strain was applied followed by a 7200 second hold. Resultant stress relaxation curves were fitted to a nonlinear poroviscoelastic model with strain dependent permeability using finite element modelling to determine mechanical parameters. All samples were assayed for proteoglycan content. Comparison of results was undertaken using multivariate ANOVA. RESULTS Thirty samples from osteoarthritic knees and 18 samples from healthy donors were tested. No significant differences in mechanical parameters or proteoglycan content was observed between groups. In both groups Young's modulus (E) was significantly greater, and zero-strain permeability significantly reduced, in samples tested in deionised water compared to samples tested in 0.14M or 3M PBS (all p < 0.05). CONCLUSION Mechanical parameters of intact lateral meniscus in osteoarthritic knees are similar to those found in healthy knees. Proteoglycan concentration and their electrostatic contribution to mechanical stiffness of the meniscus is maintained in menisci derived from osteoarthritic knees. Whilst macroscopic tears in the meniscal ultrastructure may contribute to osteoarthritis, intact meniscal tissue maintains its function.
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Affiliation(s)
- Fahd Mahmood
- Department of Orthopaedics, Golden Jubilee National Hospital, Agamemnon Street, Clydebank G81 4DY, United Kingdom.
| | - Jon Clarke
- Department of Orthopaedics, Golden Jubilee National Hospital, Agamemnon Street, Clydebank G81 4DY, United Kingdom
| | - Philip Riches
- Department of Biomedical Engineering, Wolfson Centre, University of Strathclyde, 16 Richmond Street, Glasgow G1 1XQ, United Kingdom
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2
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Hiranaka T, Furumatsu T, Miyazawa S, Kintaka K, Higashihara N, Tamura M, Zhang X, Xue H, Ozaki T. Increased cleft width during knee flexion is useful for the diagnosis of medial meniscus posterior root tears. Knee Surg Sports Traumatol Arthrosc 2022; 30:3726-3732. [PMID: 35508552 DOI: 10.1007/s00167-022-06983-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 04/11/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE This study aimed to evaluate changes in the cleft width, defined as the distance between the lateral edge of the medial tibial plateau and that of the medial meniscus (MM) posterior root, using open magnetic resonance imaging (MRI) in patients with MM posterior root tear (MMPRT). METHODS This study included 25 patients (20 women and 5 men; mean age: 65.2 years) who were diagnosed with MMPRT and underwent pullout repair. Upon coronal imaging, the cleft width was evaluated at the 10° and 90° flexed knee positions. The difference in the cleft width (defined as the cleft width at 90° minus the cleft width at 10°) was also calculated. Upon sagittal imaging, the MM posterior extrusion (MMPE) at 90° was also evaluated. Separate univariate linear regression models were used to determine the association between the time from injury to MRI and radiographic measurements. RESULTS The mean cleft width at 10° and 90° was 4.9 ± 2.6 mm and 7.4 ± 3.7 mm, respectively; the mean difference in cleft width was 2.5 ± 1.5 mm, and the mean MMPE at 90° was 3.7 ± 1.3 mm. There was a significant difference in cleft width at 10° and 90° (p < 0.001). The time from injury to MRI was significantly associated with the cleft width at 10° (R = 0.42; p = 0.023), cleft width at 90° (R = 0.59; p = 0.002), the difference in the cleft width (R = 0.62; p = 0.008), and MMPE at 90° (R = 0.53; p = 0.008). CONCLUSION This study demonstrates that the cleft width is significantly larger during knee flexion than during knee extension. Increased cleft width during knee flexion ("graben" sign) may help diagnose MMPRT, especially in cases where the cleft sign is unclear during knee extension. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Takaaki Hiranaka
- Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan.,Department of Orthopaedic Surgery, Ako Central Hospital, 52-6 Sohmon-cho, Ako, Hyogo, 678-0241, Japan
| | - Takayuki Furumatsu
- Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan.
| | - Shinichi Miyazawa
- Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan
| | - Keisuke Kintaka
- Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan
| | - Naohiro Higashihara
- Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan
| | - Masanori Tamura
- Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan
| | - Ximing Zhang
- Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan
| | - Haowei Xue
- Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan
| | - Toshifumi Ozaki
- Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan
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3
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Narez GE, Brown G, Herrick A, Ek RJ, Dejardin L, Wei F, Haut RC, Haut Donahue TL. Evaluating the Efficacy of Combined P188 Treatment and Surgical Intervention in Preventing Post-Traumatic Osteoarthritis Following a Traumatic Knee Injury. J Biomech Eng 2022; 144:1120716. [PMID: 34751734 DOI: 10.1115/1.4052564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Indexed: 11/08/2022]
Abstract
Previous studies have shown that reconstructive surgery alone following injury to the anterior cruciate ligament (ACL) does not prevent the development of post-traumatic osteoarthritis (PTOA). Poloxamer 188 (P188) has been shown to prevent cell death following trauma in both articular cartilage and meniscal tissue. This study aims to test the efficacy of single or multiple administrations of P188 in conjunction with reconstructive surgery to help prevent or delay the onset of the disease. Thirty skeletally mature rabbits underwent closed-joint trauma that resulted in ACL rupture and meniscal damage and were randomly assigned to one of four treatment groups with varying doses of P188. ACL reconstruction was then performed using an autograft from the semitendinosus tendon. Animals were euthanized 1-month following trauma, meniscal tissue was assessed for changes in morphology, mechanical properties, and proteoglycan content. Femurs and tibias were scanned using microcomputed tomography to determine changes in bone quality, architecture, and osteophyte formation. The medial meniscus experienced more damage and a decrease in the instantaneous modulus regardless of treatment group, while P188 treatment tended to limit degenerative changes in the lateral meniscus. Both lateral and medial menisci had documented decreases in the equilibrium modulus and inconsistent changes in proteoglycan content. Minimal changes were documented in the tibias and femurs, with the only significant change being the formation of osteophytes in both bones regardless of treatment group. The data suggest that P188 was able to limit some degenerative changes in the meniscus associated with PTOA and may warrant future studies.
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Affiliation(s)
- Gerardo E Narez
- Department of Biomedical Engineering, University of Massachusetts Amherst, Amherst, MA 01003
| | - Gabriel Brown
- Department of Biomedical Engineering, University of Massachusetts Amherst, Amherst, MA 01003
| | - Ashley Herrick
- Department of Biomedical Engineering, University of Massachusetts Amherst, Amherst, MA 01003
| | - Ryan J Ek
- Department of Biomedical Engineering, University of Massachusetts Amherst, Amherst, MA 01003
| | - Loic Dejardin
- Department of Small Animal Clinical Sciences, Michigan State University, East Lansing, MI 48824
| | - Feng Wei
- Orthopaedic Biomechanics Laboratories, College of Osteopathic Medicine, Michigan State University, East Lansing, MI 48824
| | - Roger C Haut
- Orthopaedic Biomechanics Laboratories, College of Osteopathic Medicine, Michigan State University, East Lansing, MI 48824; Department of Mechanical Engineering, Michigan State University, East Lansing, MI 48824
| | - Tammy L Haut Donahue
- Department of Biomedical Engineering, University of Massachusetts Amherst, Amherst, MA 01003; S631 Life Sciences Laboratory, University of Massachusetts, 240 Thatcher Road, Amherst, MA 01003
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4
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Haut Donahue TL, Narez GE, Powers M, Dejardin LM, Wei F, Haut RC. A Morphological Study of the Meniscus, Cartilage and Subchondral Bone Following Closed-Joint Traumatic Impact to the Knee. Front Bioeng Biotechnol 2022; 10:835730. [PMID: 35387294 PMCID: PMC8977861 DOI: 10.3389/fbioe.2022.835730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/22/2022] [Indexed: 11/13/2022] Open
Abstract
Post-traumatic osteoarthritis (PTOA) is a debilitating disease that is a result of a breakdown of knee joint tissues following traumatic impact. The interplay of how these tissues influence each other has received little attention because of complex interactions. This study was designed to correlate the degeneration of the menisci, cartilage and subchondral bone following an acute traumatic event that resulted in anterior cruciate ligament (ACL) and medial meniscus tears. We used a well-defined impact injury animal model that ruptures the ACL and tears the menisci. Subsequently, the knee joints underwent ACL reconstruction and morphological analyses were performed on the menisci, cartilage and subchondral bone at 1-, 3- and 6-months following injury. The results showed that the morphological scores of the medial and lateral menisci worsened with time, as did the tibial plateau and femoral condyle articular cartilage scores. The medial meniscus was significantly correlated to the medial tibial subchondral bone at 1 month (p = 0.01), and to the medial tibial cartilage at 3 months (p = 0.04). There was only one significant correlation in the lateral hemijoint, i.e., the lateral tibial cartilage to the lateral tibial subchondral bone at 6 months (p = 0.05). These data may suggest that, following trauma, the observed medial meniscal damage should be treated acutely by means other than a full or partial meniscectomy, since that procedure may have been the primary cause of degenerative changes in the underlying cartilage and subchondral bone. In addition to potentially treating meniscal damage differently, improvements could be made in optimizing treatment of acute knee trauma.
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Affiliation(s)
- T. L. Haut Donahue
- Department of Biomedical Engineering, University of Memphis, Memphis, TN, United States
- *Correspondence: T. L. Haut Donahue,
| | - G. E. Narez
- Department of Biomedical Engineering, University of Massachusetts Amherst, Amherst, MA, United States
| | - M. Powers
- Department of Biomedical Engineering, University of Massachusetts Amherst, Amherst, MA, United States
| | - L. M. Dejardin
- Department of Small Animal Clinical Sciences, Michigan State University, East Lansing, MI, United States
| | - F. Wei
- Orthopaedic Biomechanics Laboratories, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, United States
| | - R. C. Haut
- Orthopaedic Biomechanics Laboratories, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, United States
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5
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Post-traumatic Osteoarthritis in Rabbits Following Traumatic Injury and Surgical Reconstruction of the Knee. Ann Biomed Eng 2022; 50:169-182. [PMID: 35028785 DOI: 10.1007/s10439-022-02903-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 01/01/2022] [Indexed: 01/13/2023]
Abstract
Post-traumatic osteoarthritis (PTOA) of the knee is often attributed to anterior cruciate ligament (ACL) and meniscus injury. The development of PTOA, however, does not seem to depend on whether or not the damaged ACL is reconstructed. There has been a need to develop animal models to study the mechanisms of PTOA following reconstruction of a traumatized knee. Eighteen rabbits underwent closed-joint trauma to produce ACL rupture and meniscus damage. Then, for the first time, the traumatized knee was surgically repaired in this animal model. Upon euthanasia at 1-, 3- or 6-month post-trauma, joint stability, cartilage morphology and mechanical properties, as well as histology of the cartilage and subchondral bone were evaluated. Trauma-induced knee injury involved 72% mid-substance ACL rupture, 28% partial ACL tear and 56% concurrent medial meniscal damage. ACL reconstruction effectively restored joint stability by reducing joint laxity to a level similar to that in the contralateral intact knee. Compared to their contralateral controls, reconstructed limbs showed osteoarthritic changes to the cartilage and subchondral bone as early as 1-month post-trauma. The degeneration progressed over time up to 6-month. Overall, the medial compartments had more tissue damage than their corresponding lateral counterparts. Damage patterns to the ACL, the frequency of observed concurrent meniscal injury, and reductions in cartilage integrity and health were consistent with clinical observations of human patients who undergo ACL injury and reconstruction. Thus, we believe the combined closed-joint injury and surgical repair lapine model of PTOA, being first-ever and clinically relevant, shows promise to evaluate well-targeted therapeutics and other interventions for this chronic disease.
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6
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Narez GE, Brown G, Herrick A, Ek RJ, Dejardin L, Wei F, Haut RC, Haut Donahue TL. Assessment of changes in the meniscus and subchondral bone in a novel closed-joint impact and surgical reconstruction lapine model. J Biomech 2021; 126:110630. [PMID: 34303894 DOI: 10.1016/j.jbiomech.2021.110630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 05/17/2021] [Accepted: 07/05/2021] [Indexed: 11/25/2022]
Abstract
Despite reconstruction surgery to repair a torn anterior cruciate ligament (ACL), patients often still show signs of post-traumatic osteoarthritis (PTOA) years following the procedure. The goal of this study was to document changes in the meniscus and subchondral bone due to closed-joint impact and surgical reconstruction in a lapine model. Animals received insult to the joint followed by surgical reconstruction of the ACL and partial meniscectomy. Following euthanasia of the animals at 1, 3, and 6-months post-impact, meniscal tissue was assessed for changes in morphology, mechanical properties and proteoglycan content. Femurs and tibias were scanned via micro-computed tomography to determine changes in bone quality, morphometry, and formation of osteophytes. Both the lateral and medial menisci showed severe degradation and tearing at all-time points, with higher degree of degeneration being observed at 6-months. Decreases in both the instantaneous and equilibrium modulus were documented in both menisci. Minimal changes were found in bone quality and morphometry, with most change documented in the tibia. Bones from the reconstructed limbs showed large volumes of osteophyte formations, with an increase in volume over time. The initial changes that were representative of PTOA may have been limited to the meniscus, but at later time points consistent changes due to the disease were seen in both tissues. This study, which builds on a previous study by this laboratory, suggests that the addition of surgical reconstruction of the ACL to our model was not sufficient to prevent the development of PTOA.
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Affiliation(s)
- Gerardo E Narez
- Department of Biomedical Engineering, University of Massachusetts Amherst, Amherst, MA, USA
| | - Gabriel Brown
- Department of Biomedical Engineering, University of Massachusetts Amherst, Amherst, MA, USA
| | - Ashley Herrick
- Department of Biomedical Engineering, University of Massachusetts Amherst, Amherst, MA, USA
| | - Ryan J Ek
- Department of Biomedical Engineering, University of Massachusetts Amherst, Amherst, MA, USA
| | - Loic Dejardin
- Department of Small Animal Clinical Sciences, Michigan State University, East Lansing, MI, USA
| | - Feng Wei
- Orthopaedic Biomechanics Laboratories, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA
| | - Roger C Haut
- Orthopaedic Biomechanics Laboratories, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA; Department of Mechanical Engineering, Michigan State University, East Lansing, MI, USA
| | - Tammy L Haut Donahue
- Department of Biomedical Engineering, University of Massachusetts Amherst, Amherst, MA, USA.
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7
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Fedje-Johnston W, Johnson CP, Tóth F, Carlson CS, Ellingson AM, Albersheim M, Lewis J, Bechtold J, Ellermann J, Rendahl A, Tompkins M. A pilot study to assess the healing of meniscal tears in young adult goats. Sci Rep 2021; 11:14181. [PMID: 34244551 PMCID: PMC8270994 DOI: 10.1038/s41598-021-93405-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 06/18/2021] [Indexed: 11/09/2022] Open
Abstract
Meniscal tears are a common orthopedic injury, yet their healing is difficult to assess post-operatively. This impedes clinical decisions as the healing status of the meniscus cannot be accurately determined non-invasively. Thus, the objectives of this study were to explore the utility of a goat model and to use quantitative magnetic resonance imaging (MRI) techniques, histology, and biomechanical testing to assess the healing status of surgically induced meniscal tears. Adiabatic T1ρ, T2, and T2* relaxation times were quantified for both operated and control menisci ex vivo. Histology was used to assign healing status, assess compositional elements, and associate healing status with compositional elements. Biomechanical testing determined the failure load of healing lesions. Adiabatic T1ρ, T2, and T2* were able to quantitatively identify different healing states. Histology showed evidence of diminished proteoglycans and increased vascularity in both healed and non-healed menisci with surgically induced tears. Biomechanical results revealed that increased healing (as assessed histologically and on MRI) was associated with greater failure load. Our findings indicate increased healing is associated with greater meniscal strength and decreased signal differences (relative to contralateral controls) on MRI. This indicates that quantitative MRI may be a viable method to assess meniscal tears post-operatively.
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Affiliation(s)
- William Fedje-Johnston
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA.,Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, MN, USA
| | - Casey P Johnson
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, MN, USA.,Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Ferenc Tóth
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, MN, USA
| | - Cathy S Carlson
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, MN, USA
| | - Arin M Ellingson
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA.,Divisions of Physical Therapy and Rehabilitation Science, Department of Rehabilitation Science, University of Minnesota, Minneapolis, MN, USA
| | - Melissa Albersheim
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Jack Lewis
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Joan Bechtold
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Jutta Ellermann
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Aaron Rendahl
- Department of Veterinary and Biomedical Sciences, University of Minnesota, St. Paul, MN, USA
| | - Marc Tompkins
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA. .,Tria Orthopedic Center, Bloomington, MN, USA.
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8
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Narez GE, Wei F, Dejardin L, Haut RC, Haut Donahue TL. A single dose of P188 prevents cell death in meniscal explants following impact injury. J Mech Behav Biomed Mater 2021; 117:104406. [PMID: 33621866 DOI: 10.1016/j.jmbbm.2021.104406] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 10/06/2020] [Accepted: 02/12/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To determine the efficacy of single and multiple administrations of Poloxamer 188 (P188) in saving meniscal cells following an injurious impact. METHODS Meniscal explants were harvested from both the lateral and medial menisci of Flemish Giant rabbits. After a 24-h incubation period, explants were subjected to 50% impact strain to simulate traumatic joint injury, and the explants were then placed in media with or without supplemented P188. Temporal administrations of P188 over a 14-day period were given based on one of 6 different treatments regimes. Over the 14-day period, explants were cyclically loaded to 10% strain at 1 Hz for 1 h per day, five days a week. Cell viability was assessed on day 14, with the remainder of the tissue being fixed to determine cell apoptosis levels and proteoglycan changes via histology. RESULTS The injurious impact proved to produce significant levels of cell death in meniscal explants. The ability of P188 to prevent cell death was not affected by the number of P188 doses (single versus multiple). P188 treatment proved to maintain cell viability levels comparable to those from unimpacted explants. There were no significant changes in cell apoptosis or proteoglycan coverage in the tissues over a 14-day period for any group, all treatment groups were statistically similar to the unimpacted explants. CONCLUSION A single dose of P188 following impact is all that is necessary to inhibit cell death in the meniscus following a traumatic impact. Thus, orthopaedic surgeons may choose to administer P188 in addition to treating any other acute damage due to a traumatic load to the knee, such as anterior cruciate ligament rupture, although more in depth in vivo studies are necessary.
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Affiliation(s)
- Gerardo E Narez
- Department of Biomedical Engineering, University of Massachusetts, Amherst, MA, USA
| | - Feng Wei
- Orthopaedic Biomechanics Laboratories, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA
| | - Loic Dejardin
- Department of Small Animal Clinical Sciences, Michigan State University, East Lansing, MI, USA
| | - Roger C Haut
- Orthopaedic Biomechanics Laboratories, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA
| | - Tammy L Haut Donahue
- Department of Biomedical Engineering, University of Massachusetts, Amherst, MA, USA.
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9
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Narez GE, Fischenich KM, Donahue TLH. Experimental animal models of post-traumatic osteoarthritis of the knee. Orthop Rev (Pavia) 2020; 12:8448. [PMID: 32922696 PMCID: PMC7461640 DOI: 10.4081/or.2020.8448] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 02/09/2020] [Indexed: 12/28/2022] Open
Abstract
Due to the complex and dynamic nature of osteoarthritis (OA) and post-traumatic osteoarthritis (PTOA), animal models have been used to investigate the progression and pathogenesis of the disease. Researchers have used different experimental models to study OA and PTOA. With an emphasis on the knee joint, this review will compare and contrast the existing body of knowledge from anterior cruciate ligament transection models, meniscectomy models, combination models, as well as impact models in large animals to see how tissues respond to these different approaches to induce experimental OA and PTOA. The tissues discussed will include articular cartilage and the meniscus, with a focus on morphological, mechanical and histological assessments. The goal of this review is to demonstrate the progressive nature of OA by indicating the strong correlation between progressive tissue degeneration, change of mechanical properties, and loss of biochemical integrity and to highlight key differences between the most commonly used experimental animal models.
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Affiliation(s)
- Gerardo E Narez
- Department of Biomedical Engineering, University of Massachusetts, Amherst, MA
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10
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Mahmood MF, Clarke MJ, Riches DP. Proteoglycans exert a significant effect on human meniscal stiffness through ionic effects. Clin Biomech (Bristol, Avon) 2020; 77:105028. [PMID: 32422472 DOI: 10.1016/j.clinbiomech.2020.105028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 04/27/2020] [Accepted: 04/30/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Proteoglycans contribute to mechanical stiffness in articular cartilage, aiding load transmission. The magnitude of the ionic contribution of proteoglycans to the stiffness of human meniscal tissue has not been established. METHODS Thirty-six discs of human meniscal tissue were placed within a custom confined compression chamber and bathed in three solutions of increasing ionic concentration. Following a 0.3 N preload, at equilibrium, a 10% ramp compressive strain was followed by a 7200 s hold phase. A nonlinear poroviscoelastic model with strain dependent permeability was fitted to resultant stress relaxation curves. All samples were assayed for proteoglycan content. Model parameters were analysed using multivariate analysis of variance whilst proteoglycan content was compared using a univariate analysis of variance model. FINDINGS A significant difference (p < .05) was observed in the value of the Young's modulus (E) between samples tested in deionised water compared to those tested in solutions of high ionic concentration. No differences were observed in the zero-strain permeability or the exponential strain dependent stiffening coefficient. Proteoglycan content was not found to differ with solution; but was found to be significantly increased in the middle meniscal region of both menisci. INTERPRETATION Proteoglycans make a significant ionic contribution to mechanical stiffness of the meniscus, increasing it by 58% in the physiological condition. It is therefore critical that meniscal regeneration strategies attempt to recreate the function of proteoglycans to ensure normal meniscal function.
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Affiliation(s)
- Mr Fahd Mahmood
- Department of Biomedical Engineering, Wolfson Centre, University of Strathclyde, 16 Richmond Street, Glasgow G1 1XQ, UK; Department of Orthopaedics, Golden Jubilee National Hospital, Agamemnon Street, Clydebank G81 4DY, UK.
| | - Mr Jon Clarke
- Department of Orthopaedics, Golden Jubilee National Hospital, Agamemnon Street, Clydebank G81 4DY, UK
| | - Dr Philip Riches
- Department of Biomedical Engineering, Wolfson Centre, University of Strathclyde, 16 Richmond Street, Glasgow G1 1XQ, UK
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11
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Constitutive modeling of menisci tissue: a critical review of analytical and numerical approaches. Biomech Model Mechanobiol 2020; 19:1979-1996. [PMID: 32572727 DOI: 10.1007/s10237-020-01352-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 05/28/2020] [Indexed: 02/07/2023]
Abstract
Menisci are fibrocartilaginous disks consisting of soft tissue with a complex biomechanical structure. They are critical determinants of the kinematics as well as the stability of the knee joint. Several studies have been carried out to formulate tissue mechanical behavior, leading to the development of a wide spectrum of constitutive laws. In addition to developing analytical tools, extensive numerical studies have been conducted on menisci modeling. This study reviews the developments of the most widely used continuum models of the meniscus mechanical properties in conjunction with emerging analytical and numerical models used to study the meniscus. The review presents relevant approaches and assumptions used to develop the models and includes discussions regarding strengths, weaknesses, and discrepancies involved in the presented models. The study presents a comprehensive coverage of relevant publications included in Compendex, EMBASE, MEDLINE, PubMed, ScienceDirect, Springer, and Scopus databases. This review aims at opening novel avenues for improving menisci modeling within the framework of constitutive modeling through highlighting the needs for further research directed toward determining key factors in gaining insight into the biomechanics of menisci which is crucial for the elaborate design of meniscal replacements.
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12
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Early degeneration of the meniscus revealed by microbiomechanical alteration in a rabbit anterior cruciate ligament transection model. J Orthop Translat 2020; 21:146-152. [PMID: 32309140 PMCID: PMC7152828 DOI: 10.1016/j.jot.2019.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 05/21/2019] [Accepted: 06/03/2019] [Indexed: 02/07/2023] Open
Abstract
Background The microbiomechanical properties of the meniscus influence the cell response to the surrounding biomechanical environment and are beneficial to understand meniscus repairing and healing. To date, however, this information remains ambiguous. This study aims to characterise the microbiomechanical properties of the meniscus after degeneration in a rabbit anterior cruciate ligament transection (ACLT) model and to analyse the corresponding histology at the macroscale and chemical composition. Methods Twenty New Zealand white rabbits were used. Menisci were collected from the knee joints 4 and 8 weeks after the ACLT and from those of the corresponding control groups. The central portions of both medial and lateral menisci were investigated using atomic force microscopy, histological study, and an energy-dispersive spectrometer. The evaluation was conducted regionally within the inner, middle, and outer sites from the top layer (facing the femoral surface) to the bottom layer (facing the tibial surface) in both the lateral and medial menisci to obtain the site-dependent properties. Results At 4 weeks after surgery, the dynamic elastic modulus at the microlevel increased significantly at both the top and bottom layers compared with the intact meniscus (P = 0.021). At 8 weeks after surgery, the stiffening occurred in all regions (P = 0.030). The medial meniscus showed greater change than the lateral meniscus. All these microbiomechanical alterations occurred before the histological findings at the macroscale. Conclusion The microbiomechanical properties in the meniscus changed significantly after ACLT and were site dependent. Their alterations occurred before the histological changes of degeneration were observed. The Translational Potential of this Article The results of our study indicated that degeneration promoted meniscus stiffening. Thus, they provide a better understanding of the disease process affecting the meniscus. Our results might be beneficial to understand how mechanical forces distribute throughout the healthy and pathologic joint. They indicate the possibility of early diagnosis using a minimally invasive arthroscopic tool, as well as they might guide treatment to the healthy and pathologic meniscus and joint.
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Chen M, Guo W, Gao S, Hao C, Shen S, Zhang Z, Wang Z, Li X, Jing X, Zhang X, Yuan Z, Wang M, Zhang Y, Peng J, Wang A, Wang Y, Sui X, Liu S, Guo Q. Biomechanical Stimulus Based Strategies for Meniscus Tissue Engineering and Regeneration. TISSUE ENGINEERING PART B-REVIEWS 2018; 24:392-402. [PMID: 29897012 DOI: 10.1089/ten.teb.2017.0508] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Meniscus injuries are very common in the knee joint. Treating a damaged meniscus continues to be a scientific challenge in sport medicine because of its poor self-healing potential and few clinical therapeutic options. Tissue engineering strategies are very promising solutions for repairing and regenerating a damaged meniscus. Meniscus is exposed to a complex biomechanical microenvironment, and it plays a crucial role in meniscal development, growth, and repairing. Over the past decades, increasing attention has been focused on the use of biomechanical stimulus to enhance biomechanical properties of the engineered meniscus. Further understanding the influence of mechanical stimulation on cell proliferation and differentiation, metabolism, relevant gene expression, and pro/anti-inflammatory responses may be beneficial to enhance meniscal repair and regeneration. On the one hand, this review describes some basic information about meniscus; on the other hand, we sum up the various biomechanical stimulus based strategies applied in meniscus tissue engineering and how these factors affect meniscal regeneration. We hope this review will provide researchers with inspiration on tissue engineering strategies for meniscus regeneration in the future.
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Affiliation(s)
- Mingxue Chen
- 1 Institute of Orthopedics , Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Beijing, People's Republic of China .,2 Department of Orthopedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, 100035 Beijing, People's Republic of China
| | - Weimin Guo
- 1 Institute of Orthopedics , Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Beijing, People's Republic of China
| | - Shunag Gao
- 3 Center for Biomaterial and Tissue Engineering, Academy for Advanced Interdisciplinary Studies, Peking University , Beijing, People's Republic of China
| | - Chunxiang Hao
- 4 Institute of Anesthesiology , Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Shi Shen
- 1 Institute of Orthopedics , Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Beijing, People's Republic of China .,5 Department of Bone and Joint Surgery, The Affiliated Hospital of Southwest Medical University , Luzhou, People's Republic of China
| | - Zengzeng Zhang
- 1 Institute of Orthopedics , Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Beijing, People's Republic of China .,6 First Department of Orthopedics, First Affiliated Hospital of Jiamusi University , Jiamusi, People's Republic of China
| | - Zehao Wang
- 1 Institute of Orthopedics , Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Beijing, People's Republic of China
| | - Xu Li
- 1 Institute of Orthopedics , Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Beijing, People's Republic of China .,7 School of Medicine, Nankai University , Tianjin, People's Republic of China
| | - Xiaoguang Jing
- 1 Institute of Orthopedics , Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Beijing, People's Republic of China .,6 First Department of Orthopedics, First Affiliated Hospital of Jiamusi University , Jiamusi, People's Republic of China
| | - Xueliang Zhang
- 1 Institute of Orthopedics , Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Beijing, People's Republic of China .,8 Shanxi Traditional Chinese Hospital , Taiyuan, People's Republic of China
| | - Zhiguo Yuan
- 1 Institute of Orthopedics , Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Beijing, People's Republic of China
| | - Mingjie Wang
- 1 Institute of Orthopedics , Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Beijing, People's Republic of China
| | - Yu Zhang
- 1 Institute of Orthopedics , Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Beijing, People's Republic of China
| | - Jiang Peng
- 1 Institute of Orthopedics , Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Beijing, People's Republic of China
| | - Aiyuan Wang
- 1 Institute of Orthopedics , Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Beijing, People's Republic of China
| | - Yu Wang
- 1 Institute of Orthopedics , Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Beijing, People's Republic of China
| | - Xiang Sui
- 1 Institute of Orthopedics , Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Beijing, People's Republic of China
| | - Shuyun Liu
- 1 Institute of Orthopedics , Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Beijing, People's Republic of China
| | - Quanyi Guo
- 1 Institute of Orthopedics , Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Beijing, People's Republic of China
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Levillain A, Magoariec H, Boulocher C, Decambron A, Viateau V, Hoc T. Effects of a viscosupplementation therapy on rabbit menisci in an anterior cruciate ligament transection model of osteoarthritis. J Biomech 2017; 58:147-154. [PMID: 28554494 DOI: 10.1016/j.jbiomech.2017.04.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 04/14/2017] [Accepted: 04/30/2017] [Indexed: 12/26/2022]
Abstract
The aim of this study was to evaluate the morphological, microstructural, and mechanical effects of a viscosupplementation therapy on rabbit menisci at an early stage of osteoarthritis (OA). Anterior cruciate ligament transection (ACLT) was performed in twelve male New-Zealand White rabbits on the right knee joint. Six of these twelve rabbits received a mono intra-articular injection of high molecular weight hyaluronic acid (HA) two weeks after ACLT. Six additional healthy rabbits served as controls. Medial menisci were removed from all right knees (n=18) six weeks after ACLT and were graded macroscopically. Indentation-relaxation tests were performed in the anterior and posterior regions of the menisci. Collagen fiber organization and glycosaminoglycan (GAG) content were assessed by biphotonic confocal microscopy and histology, respectively. Viscosupplementation significantly (p=0.002) improved the surface integrity of the medial menisci compared to the operated non-treated group. Moreover, the injection seems to have an effect on the GAG distribution in the anterior region of the menisci. However, the viscoelastic properties of both operated groups were similar and significantly lower than those of the healthy group, which was explained by their modified collagen fiber organization. They displayed disruption of the tie fibers due to structural alterations of the superficial layers from which they emanate, leading to modifications in the deep zone. To conclude, the viscosupplementation therapy prevents macroscopic lesions of the menisci, but it fails to restore their collagen fiber organization and their viscoelastic properties. This finding supports the role of this treatment in improving the lubrication over the knee.
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Affiliation(s)
- A Levillain
- LTDS, UMR CNRS 5513, Université de Lyon, Ecole centrale de Lyon, 36 av Guy de Collongue, 69134 Ecully Cedex, France
| | - H Magoariec
- LTDS, UMR CNRS 5513, Université de Lyon, Ecole centrale de Lyon, 36 av Guy de Collongue, 69134 Ecully Cedex, France
| | - C Boulocher
- Research unit ICE, UPSP 2011.03.101, Université de Lyon, veterinary campus of VetAgro Sup, 69 280 Marcy l'Etoile, France
| | - A Decambron
- B2OA, UMR 7052, ENVA, 7 Avenue du Général de Gaulle, 94700 Maisons-Alfort, France
| | - V Viateau
- B2OA, UMR 7052, ENVA, 7 Avenue du Général de Gaulle, 94700 Maisons-Alfort, France
| | - T Hoc
- LTDS, UMR CNRS 5513, Université de Lyon, Ecole centrale de Lyon, 36 av Guy de Collongue, 69134 Ecully Cedex, France.
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15
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Steineman BD, LaPrade RF, Santangelo KS, Warner BT, Goodrich LR, Haut Donahue TL. Early Osteoarthritis After Untreated Anterior Meniscal Root Tears: An In Vivo Animal Study. Orthop J Sports Med 2017; 5:2325967117702452. [PMID: 28508006 PMCID: PMC5415046 DOI: 10.1177/2325967117702452] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Meniscal root tears cause menisci and their insertions to inadequately distribute loads and potentially leave underlying articular cartilage unprotected. Untreated meniscal root tears are becoming increasingly recognized to induce joint degradation; however, little information is known about anterior meniscal root tears and how they affect joint tissue. Purpose: To observe the early degenerative changes within the synovial fluid, menisci, tibial articular cartilage, and subchondral bone after arthroscopic creation of untreated anterior meniscal root tears. Study Design: Controlled laboratory study. Methods: Anterolateral meniscal root tears were created in 1 knee joint of 5 adult Flemish Giant rabbits, and anteromedial meniscal root tears were created in 4 additional rabbits. The contralateral limbs were used as nonoperated controls. The animals were euthanized at 8 weeks postoperatively; synovial fluid was aspirated, and tissue samples of menisci and tibial articular cartilage were collected and processed for multiple analyses to detect signs of early degeneration. Results: Significant changes were found within the synovial fluid, meniscal tissue, and tibial subchondral bone of the knees with anterior meniscal root tears when compared with controls. There were no significant changes identified in the tibial articular cartilage when comparing the tear groups with controls. Conclusion: This study demonstrated early degenerative changes within the synovial fluid, menisci, and tibial subchondral bone when leaving anterior meniscal root tears untreated for 8 weeks. The results suggest that meniscal tissue presents measurable, degenerative changes prior to changes within the articular cartilage after anterior meniscal root tears. Anterior destabilization of the meniscus arthroscopically may lead to measurable degenerative changes and be useful for future in vivo natural history and animal repair studies. Clinical Relevance: The present study is the first to investigate various tissue changes after anterior meniscal root tears of both the medial and lateral menisci. The results from this study suggest that degenerative changes occur within the synovial fluid, meniscus, and tibial subchondral bone prior to any measurable changes to the tibial articular cartilage. Further studies should expand on this study to evaluate how these components continue to progress when left untreated for long periods.
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Affiliation(s)
- Brett D Steineman
- School of Biomedical Engineering, Colorado State University, Fort Collins, Colorado, USA
| | - Robert F LaPrade
- The Steadman Clinic, Vail, Colorado, USA.,Steadman Philippon Research Institute, Vail, Colorado, USA
| | - Kelly S Santangelo
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado, USA.,Orthopedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Science, Colorado State University, Fort Collins, Colorado, USA
| | | | - Laurie R Goodrich
- Orthopedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Science, Colorado State University, Fort Collins, Colorado, USA
| | - Tammy L Haut Donahue
- School of Biomedical Engineering, Colorado State University, Fort Collins, Colorado, USA.,Department of Mechanical Engineering, Colorado State University, Fort Collins, Colorado, USA
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16
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Fischenich KM, Pauly HM, Button KD, Fajardo RS, DeCamp CE, Haut RC, Haut Donahue TL. A study of acute and chronic tissue changes in surgical and traumatically-induced experimental models of knee joint injury using magnetic resonance imaging and micro-computed tomography. Osteoarthritis Cartilage 2017; 25:561-569. [PMID: 27756698 PMCID: PMC5359039 DOI: 10.1016/j.joca.2016.10.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 09/27/2016] [Accepted: 10/09/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The objective of this study was to monitor the progression of joint damage in two animal models of knee joint trauma using two non-invasive, clinically available imaging modalities. METHODS A 3-T clinical magnet and micro-computed tomography (μCT) was used to document changes immediately following injury (acute) and post-injury (chronic) at time points of 4, 8, or 12 weeks. Joint damage was recorded at dissection and compared to the chronic magnetic resonance imaging (MRI) record. Fifteen Flemish Giant rabbits were subjected to a single tibiofemoral compressive impact (ACLF), and 18 underwent a combination of anterior cruciate ligament (ACL) and meniscal transection (mACLT). RESULTS All ACLF animals experienced ACL rupture, and 13 also experienced acute meniscal damage. All ACLF and mACLT animals showed meniscal and articular cartilage damages at dissection. Meniscal damage was documented as early as 4 weeks and worsened in 87% of the ACLF animals and 71% of the mACLT animals. Acute cartilage damage also developed further and increased in occurrence with time in both models. A progressive decrease in bone quantity and quality was documented in both models. The MRI data closely aligned with dissection notes suggesting this clinical tool may be a non-invasive method for documenting joint damage in lapine models of knee joint trauma. CONCLUSIONS The study investigates the acute to chronic progression of meniscal and cartilage damage at various time points, and chronic changes to the underlying bone in two models of posttraumatic osteoarthritis (PTOA), and highlights the dependency of the model on the location, type, and progression of damage over time.
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Affiliation(s)
| | - Hannah M. Pauly
- Department of Mechanical Engineering, Colorado State
University, Fort Collins, CO USA
| | - Keith D. Button
- Orthopaedic Biomechanics Laboratories, College of
Osteopathic Medicine, Michigan State University, East Lansing, MI USA
| | - Ryan S. Fajardo
- Department of Radiology, Michigan State University, East
Lansing, MI USA
| | - Charles E. DeCamp
- Small Animal Clinical Sciences, College of Veterinary
Medicine, Michigan State University, East Lansing, MI USA
| | - Roger C. Haut
- Orthopaedic Biomechanics Laboratories, College of
Osteopathic Medicine, Michigan State University, East Lansing, MI USA,Department of Radiology, Michigan State University, East
Lansing, MI USA
| | - Tammy L. Haut Donahue
- Department of Mechanical Engineering, Colorado State
University, Fort Collins, CO USA
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17
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Fischenich KM, Button KD, DeCamp C, Haut RC, Donahue TLH. Comparison of two models of post-traumatic osteoarthritis; temporal degradation of articular cartilage and menisci. J Orthop Res 2017; 35:486-495. [PMID: 27129040 DOI: 10.1002/jor.23275] [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: 02/02/2016] [Accepted: 04/22/2016] [Indexed: 02/04/2023]
Abstract
The objective of this study was to compare longitudinal results from two models of combined anterior cruciate ligament (ACL) and meniscal injury. A modified ACL transection (mACLT) model and a traumatic impact (ACLF) model were used to create an ACL rupture and acute meniscal damage in a Flemish Giant animal model. The animals were euthanized at time points of 4, 8, or 12 weeks. The menisci were assessed for equilibrium and instantaneous compressive modulus, as well as glycosaminoglycan (GAG) coverage. The articular cartilage was mechanically assessed for thickness, matrix modulus, fiber modulus, and permeability. Articular cartilage GAG coverage, fissuring, tidemark integrity, and subchondral bone thickness were measured. Both models resulted in damage indicative of osteoarthritis, including decreased meniscal mechanics and GAG coverage, increased permeability and fissuring of articular cartilage, and decreased GAG coverage. The mACLT model had an early and lasting effect on the menisci mechanics and GAG coverage, while cartilage damage was not significantly affected until 12 weeks. The ACLF model resulted in an earlier change of articular cartilage GAG coverage and fissuring in both the 8 and 12 week groups. The menisci were only significantly affected at the 12 week time point in the ACLF model. We concluded the progression of post traumatic osteoarthritis was dependent on injury modality: a point to be considered in future investigations. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:486-495, 2017.
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Affiliation(s)
- Kristine M Fischenich
- Department of Mechanical Engineering, Colorado State University, 1374 Campus Delivery, Fort Collins, 80523, Colorado.,School of Biomedical Engineering, Colorado State University, 1374 Campus Delivery, Fort Collins, 80523, Colorado
| | - Keith D Button
- Orthopaedic Biomechanics Laboratories, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan
| | - Charlie DeCamp
- Small Animal Clinical Sciences, College of Veterinary, Michigan State University, East Lansing, Michigan
| | - Roger C Haut
- Orthopaedic Biomechanics Laboratories, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan
| | - Tammy L Haut Donahue
- Department of Mechanical Engineering, Colorado State University, 1374 Campus Delivery, Fort Collins, 80523, Colorado.,School of Biomedical Engineering, Colorado State University, 1374 Campus Delivery, Fort Collins, 80523, Colorado
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18
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Levillain A, Magoariec H, Boulocher C, Decambron A, Viateau V, Hoc T. Viscoelastic properties of rabbit osteoarthritic menisci: A correlation with matrix alterations. J Mech Behav Biomed Mater 2016; 65:1-10. [PMID: 27543842 DOI: 10.1016/j.jmbbm.2016.08.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 07/23/2016] [Accepted: 08/05/2016] [Indexed: 01/11/2023]
Abstract
The aim of this study was to evaluate the effect of early osteoarthritis (OA) on the viscoelastic properties of rabbit menisci and to correlate the mechanical alterations with the microstructural changes. Anterior Cruciate Ligament Transection (ACLT) was performed in six male New-Zealand White rabbits on the right knee joint. Six healthy rabbits served as controls. Menisci were removed six weeks after ACLT and were graded macroscopically. Indentation-relaxation tests were performed in the anterior and posterior regions of the medial menisci. The collagen fibre organization and glycosaminoglycan (GAG) content were assessed by biphotonic confocal microscopy and histology, respectively. OA menisci displayed severe macroscopic lesions compared with healthy menisci (p=0.009). Moreover, the instantaneous and equilibrium moduli, which were 2.9±1.0MPa and 0.60±0.18MPa in the anterior region of healthy menisci, respectively, decreased significantly (p=0.03 and p=0.004, respectively) in OA menisci by 55% and 57%, respectively, indicating a global decrease in meniscal stiffness in this region. The equilibrium modulus alone decreased significantly (p=0.04) in the posterior region, going from 0.60±0.18MPa to 0.26±012MPa. This induced a loss of tissue elasticity. These mechanical changes were associated in the posterior region with a structural disruption of the superficial layers, from which the tie fibres emanate, and with a decrease in the GAG content in the anterior region. Consequently, the circumferential collagen fibres of the deep zone were dissociated and the collagen bundles were less compact. Our results demonstrate the strong meniscal modifications induced by ACLT at an early stage of OA and highlight the relationship between structural and chemical matrix alterations and mechanical properties.
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Affiliation(s)
- A Levillain
- LTDS, UMR CNRS 5513, Université de Lyon, Ecole centrale de Lyon, 36av Guy de Collongue, 69134 Ecully Cedex, France
| | - H Magoariec
- LTDS, UMR CNRS 5513, Université de Lyon, Ecole centrale de Lyon, 36av Guy de Collongue, 69134 Ecully Cedex, France
| | - C Boulocher
- Research unit ICE, UPSP 2011.03.101, Université de Lyon, veterinary campus of VetAgro Sup, 69 280 Marcy l'Etoile, France
| | - A Decambron
- B2OA, UMR 7052, ENVA, 7Avenue du Général de Gaulle, 94700 Maisons-Alfort, France
| | - V Viateau
- B2OA, UMR 7052, ENVA, 7Avenue du Général de Gaulle, 94700 Maisons-Alfort, France
| | - T Hoc
- LTDS, UMR CNRS 5513, Université de Lyon, Ecole centrale de Lyon, 36av Guy de Collongue, 69134 Ecully Cedex, France.
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19
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Osteoarthritis year in review 2015: mechanics. Osteoarthritis Cartilage 2016; 24:27-35. [PMID: 26707990 PMCID: PMC4693146 DOI: 10.1016/j.joca.2015.08.018] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 08/13/2015] [Accepted: 08/29/2015] [Indexed: 02/02/2023]
Abstract
Motivated by the conceptual framework of multi-scale biomechanics, this narrative review highlights recent major advances with a focus on gait and joint kinematics, then tissue-level mechanics, cell mechanics and mechanotransduction, matrix mechanics, and finally the nanoscale mechanics of matrix macromolecules. A literature review was conducted from January 2014 to April 2015 using PubMed to identify major developments in mechanics related to osteoarthritis (OA). Studies of knee adduction, flexion, rotation, and contact mechanics have extended our understanding of medial compartment loading. In turn, advances in measurement methodologies have shown how injuries to both the meniscus and ligaments, together, can alter joint kinematics. At the tissue scale, novel findings have emerged regarding the mechanics of the meniscus as well as cartilage superficial zone. Moving to the cell level, poroelastic and poro-viscoelastic mechanisms underlying chondrocyte deformation have been reported, along with the response to osmotic stress. Further developments have emerged on the role of calcium signaling in chondrocyte mechanobiology, including exciting findings on the function of mechanically activated cation channels newly found to be expressed in chondrocytes. Finally, AFM-based nano-rheology systems have enabled studies of thin murine tissues and brush layers of matrix molecules over a wide range of loading rates including high rates corresponding to impact injury. With OA acknowledged to be a disease of the joint as an organ, understanding mechanical behavior at each length scale helps to elucidate the connections between cell biology, matrix biochemistry and tissue structure/function that may play a role in the pathomechanics of OA.
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20
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Pauly HM, Larson BE, Coatney GA, Button KD, DeCamp CE, Fajardo RS, Haut RC, Donahue TLH. Assessment of cortical and trabecular bone changes in two models of post-traumatic osteoarthritis. J Orthop Res 2015; 33:1835-45. [PMID: 26147652 PMCID: PMC4628602 DOI: 10.1002/jor.22975] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 06/29/2015] [Indexed: 02/04/2023]
Abstract
Subchondral bone is thought to play a significant role in the initiation and progression of the post-traumatic osteoarthritis. The goal of this study was to document changes in tibial and femoral subchondral bone that occur as a result of two lapine models of anterior cruciate ligament injury, a modified ACL transection model and a closed-joint traumatic compressive impact model. Twelve weeks post-injury bones were scanned via micro-computed tomography. The subchondral bone of injured limbs from both models showed decreases in bone volume and bone mineral density. Surgical transection animals showed significant bone changes primarily in the medial hemijoint of femurs and tibias, while significant changes were noted in both the medial and lateral hemijoints of both bones for traumatic impact animals. It is believed that subchondral bone changes in the medial hemijoint were likely caused by compromised soft tissue structures seen in both models. Subchondral bone changes in the lateral hemijoint of traumatic impact animals are thought to be due to transmission of the compressive impact force through the joint. The joint-wide bone changes shown in the traumatic impact model were similar to clinical findings from studies investigating the progression of osteoarthritis in humans.
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Affiliation(s)
- Hannah M Pauly
- School of Biomedical Engineering, Colorado State University, Fort Collins, CO USA
| | - Blair E Larson
- Department of Chemical and Biological Engineering, Colorado State University, Fort Collins, CO USA
| | - Garrett A Coatney
- School of Biomedical Engineering, Colorado State University, Fort Collins, CO USA,Department of Mechanical Engineering, Colorado State University, Fort Collins, CO USA
| | - Keith D. Button
- Orthopaedic Biomechanics Laboratories, College of Osteopathic Medicine, Michigan State University, East Lansing, MI USA
| | - Charlie E DeCamp
- Small Animal Clinical Sciences, College of Veterinary, Michigan State University, East Lansing, MI USA
| | - Ryan S Fajardo
- Department of Radiology, Michigan State University, East Lansing, MI USA
| | - Roger C Haut
- Orthopaedic Biomechanics Laboratories, College of Osteopathic Medicine, Michigan State University, East Lansing, MI USA,Department of Radiology, Michigan State University, East Lansing, MI USA
| | - Tammy L Haut Donahue
- School of Biomedical Engineering, Colorado State University, Fort Collins, CO USA,Department of Mechanical Engineering, Colorado State University, Fort Collins, CO USA
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21
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Fischenich KM, Lewis J, Kindsfater KA, Bailey TS, Haut Donahue TL. Effects of degeneration on the compressive and tensile properties of human meniscus. J Biomech 2015; 48:1407-11. [DOI: 10.1016/j.jbiomech.2015.02.042] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 02/17/2015] [Indexed: 01/03/2023]
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22
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Efficacy of P188 on lapine meniscus preservation following blunt trauma. J Mech Behav Biomed Mater 2015; 47:57-64. [PMID: 25846264 DOI: 10.1016/j.jmbbm.2015.03.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 03/02/2015] [Accepted: 03/10/2015] [Indexed: 11/22/2022]
Abstract
Traumatic injury to the knee leads to the development of post-traumatic osteoarthritis. The objective of this study was to characterize the effects of a single intra-articular injection of a non-ionic surfactant, Poloxamer 188 (P188), in preservation of meniscal tissue following trauma through maintenance of meniscal glycosaminoglycan (GAG) content and mechanical properties. Flemish Giant rabbits were subjected to a closed knee joint, traumatic compressive impact with the joint constrained to prevent anterior tibial translation. The contralateral limb served as an un-impacted control. Six animals (treated) received an injection of P188 in phosphate buffered saline (PBS) post trauma, and another six animals (sham) received a single injection of PBS to the impacted limb. Histological analyses for GAG was determined 6 weeks post trauma, and functional outcomes were assessed using stress relaxation micro-indentation. The impacted limbs of the sham group demonstrated a significant decrease in meniscal GAG coverage compared to non-impacted limbs (p<0.05). GAG coverage of the impacted P188 treated limbs was not significantly different than contralateral non-impacted limbs in all regions except the medial anterior (p<0.05). No significant changes were documented in mechanics for either the sham or treated groups compared to their respective control limbs. This suggests that a single intra-articular injection of P188 shows promise in prevention of trauma induced GAG loss.
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Wheatley BB, Fischenich KM, Button KD, Haut RC, Haut Donahue TL. An optimized transversely isotropic, hyper-poro-viscoelastic finite element model of the meniscus to evaluate mechanical degradation following traumatic loading. J Biomech 2015; 48:1454-60. [PMID: 25776872 DOI: 10.1016/j.jbiomech.2015.02.028] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 02/15/2015] [Indexed: 01/13/2023]
Abstract
Inverse finite element (FE) analysis is an effective method to predict material behavior, evaluate mechanical properties, and study differences in biological tissue function. The meniscus plays a key role in load distribution within the knee joint and meniscal degradation is commonly associated with the onset of osteoarthritis. In the current study, a novel transversely isotropic hyper-poro-viscoelastic constitutive formulation was incorporated in a FE model to evaluate changes in meniscal material properties following tibiofemoral joint impact. A non-linear optimization scheme was used to fit the model output to indentation relaxation experimental data. This study is the first to investigate rate of relaxation in healthy versus impacted menisci. Stiffness was found to be decreased (p=0.003), while the rate of tissue relaxation increased (p=0.010) at twelve weeks post impact. Total amount of relaxation, however, did not change in the impacted tissue (p=0.513).
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Affiliation(s)
- Benjamin B Wheatley
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA
| | | | - Keith D Button
- Orthopaedic Biomechanics Laboratories, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA
| | - Roger C Haut
- Orthopaedic Biomechanics Laboratories, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA; Department of Radiology, Michigan State University, East Lansing, MI, USA
| | - Tammy L Haut Donahue
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA; School of Biomedical Engineering, Colorado State University, Fort Collins, CO, USA.
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Fischenich KM, Button KD, Coatney GA, Fajardo RS, Leikert KM, Haut RC, Haut Donahue TL. Chronic changes in the articular cartilage and meniscus following traumatic impact to the lapine knee. J Biomech 2014; 48:246-53. [PMID: 25523754 DOI: 10.1016/j.jbiomech.2014.11.038] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 11/23/2014] [Accepted: 11/24/2014] [Indexed: 01/13/2023]
Abstract
The objective of this study was to induce anterior cruciate ligament (ACL) and meniscal damage, via a single tibiofemoral compressive impact, in order to document articular cartilage and meniscal changes post-impact. Tibiofemoral joints of Flemish Giant rabbits were subjected to a single blunt impact that ruptured the ACL and produced acute meniscal damage. Animals were allowed unrestricted cage activity for 12 weeks before euthanasia. India ink analysis of the articular cartilage revealed higher degrees of surface damage on the impacted tibias (p=0.018) and femurs (p<0.0001) compared to controls. Chronic meniscal damage was most prevalent in the medial central and medial posterior regions. Mechanical tests revealed an overall 19.4% increase in tibial plateau cartilage thickness (p=0.026), 34.8% increase in tibial plateau permeability (p=0.054), 40.8% increase in femoral condyle permeability (p=0.029), and 20.1% decrease in femoral condyle matrix modulus (p=0.012) in impacted joints compared to controls. Both instantaneous and equilibrium moduli of the lateral and medial menisci were decreased compared to control (p<0.02). Histological analyses revealed significantly increased presence of fissures in the medial femur (p=0.036). In both meniscus and cartilage there was a significant decrease in GAG coverage for the impacted limbs. Based on these results it is clear that an unattended combined meniscal and ACL injury results in significant changes to the soft tissues in this experimental joint 12 weeks post-injury. Such changes are consistent with a clinical description of mid to late stage PTOA of the knee.
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Affiliation(s)
- Kristine M Fischenich
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA
| | - Keith D Button
- Orthopaedic Biomechanics Laboratories, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA
| | - Garrett A Coatney
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA; School of Biomedical Engineering, Colorado State University, Fort Collins, CO, USA
| | - Ryan S Fajardo
- Department of Radiology, Michigan State University, East Lansing, MI, USA
| | - Kevin M Leikert
- Orthopaedic Biomechanics Laboratories, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA
| | - Roger C Haut
- Department of Radiology, Michigan State University, East Lansing, MI, USA; Orthopaedic Biomechanics Laboratories, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA
| | - Tammy L Haut Donahue
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA; School of Biomedical Engineering, Colorado State University, Fort Collins, CO, USA.
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