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Nakasone A, Guang Y, Wise A, Kim L, Babbin J, Rathod S, Mitchell AJ, Gerstenfeld LC, Morgan EF. Structural features of subchondral bone cysts and adjacent tissues in hip osteoarthritis. Osteoarthritis Cartilage 2022; 30:1130-1139. [PMID: 35569801 PMCID: PMC9296569 DOI: 10.1016/j.joca.2022.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 03/17/2022] [Accepted: 03/28/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Focal lesions within the subchondral bone, termed subchondral bone cysts (SBCs), are clinically accepted radiographic markers of advanced osteoarthritis (OA), but their etiology in the hip is not well understood. DESIGN This study used micro-computed tomography (μCT), and histological and immunocytological analysis to examine the prevalence, size, location, and morphological and cellular features of SBCs found within 34 femoral heads (14 male, 20 female; age range = 43-80 years) obtained from total hip arthroplasty procedures. RESULTS SBCs were common-present in 91% of the femoral heads examined-and frequently commuted with the surface of the femoral head, but otherwise showed no preferred anatomical location. Few associations were found between SBC features and patient characteristics such as BMI, age and sex. SBCs were also heterogenous in composition, ranging from fibrous (most common) to predominantly fatty (least common) and often containing vasculature, nerve fibers, cartilage islands, and bony spicules. Despite this heterogeneity, focal abnormalities in bone density and cartilage thickness were consistently observed. Bone adjacent to SBCs was denser than that in the primary compressive group, and cartilage thickness in regions overlying SBCs was lower than in non-overlying regions. In contrast to these local bony changes, μCT-based finite element analyses indicated that the stiffness of the primary compressive group was only mildly affected by SBCs. CONCLUSIONS These findings indicate that SBCs in the femoral head involve extensive perturbations in cellular activity, culminating in myriad skeletal tissue types and spatially heterogenous changes in bone and cartilage morphology that are likely to affect OA progression.
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Affiliation(s)
| | - Young Guang
- Department of Mechanical Engineering, Boston University,Department of Biomedical Engineering, Boston University
| | - Amelia Wise
- Department of Orthopaedic Surgery, Boston University
| | - Lindsey Kim
- Department of Orthopaedic Surgery, Boston University
| | - Joshua Babbin
- Department of Orthopaedic Surgery, Boston University
| | - Sonali Rathod
- Department of Orthopaedic Surgery, Boston University
| | | | | | - Elise F. Morgan
- Department of Mechanical Engineering, Boston University,Department of Biomedical Engineering, Boston University,Department of Orthopaedic Surgery, Boston University
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2
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Muruganandan S, Pierce R, Teguh DA, Perez RF, Bell N, Nguyen B, Hohl K, Snyder BD, Grinstaff MW, Alberico H, Woods D, Kong Y, Sima C, Bhagat S, Ho K, Rosen V, Gamer L, Ionescu AM. A FoxA2+ long-term stem cell population is necessary for growth plate cartilage regeneration after injury. Nat Commun 2022; 13:2515. [PMID: 35523895 PMCID: PMC9076650 DOI: 10.1038/s41467-022-30247-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 04/14/2022] [Indexed: 01/14/2023] Open
Abstract
Longitudinal bone growth, achieved through endochondral ossification, is accomplished by a cartilaginous structure, the physis or growth plate, comprised of morphologically distinct zones related to chondrocyte function: resting, proliferating and hypertrophic zones. The resting zone is a stem cell-rich region that gives rise to the growth plate, and exhibits regenerative capabilities in response to injury. We discovered a FoxA2+group of long-term skeletal stem cells, situated at the top of resting zone, adjacent the secondary ossification center, distinct from the previously characterized PTHrP+ stem cells. Compared to PTHrP+ cells, FoxA2+ cells exhibit higher clonogenicity and longevity. FoxA2+ cells exhibit dual osteo-chondro-progenitor activity during early postnatal development (P0-P28) and chondrogenic potential beyond P28. When the growth plate is injured, FoxA2+ cells expand in response to trauma, and produce physeal cartilage for growth plate tissue regeneration.
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Affiliation(s)
- Shanmugam Muruganandan
- Department of Biology, 134 Mugar Life Sciences Building, Northeastern University, 360 Huntington Ave, Boston, MA, 02115, USA
| | - Rachel Pierce
- Department of Biology, 134 Mugar Life Sciences Building, Northeastern University, 360 Huntington Ave, Boston, MA, 02115, USA
| | - Dian Astari Teguh
- Centre for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215, USA
| | | | - Nicole Bell
- New York University College of Dentistry, 345 E.24th St, New York, NY, 10010, USA
| | - Brandon Nguyen
- Moderna Therapeutics, One Upland Rd, Norwood, Ohio, MA, 02062, USA
| | - Katherine Hohl
- Centre for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215, USA.,Departments of Biomedical Engineering, Chemistry, and Medicine, Boston University, 590 Commonwealth Ave, SCI 518, Boston, MA, 02215, USA
| | - Brian D Snyder
- Department of Orthopedic Surgery, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA
| | - Mark W Grinstaff
- Departments of Biomedical Engineering, Chemistry, and Medicine, Boston University, 590 Commonwealth Ave, SCI 518, Boston, MA, 02215, USA
| | - Hannah Alberico
- Department of Biology, 134 Mugar Life Sciences Building, Northeastern University, 360 Huntington Ave, Boston, MA, 02115, USA
| | - Dori Woods
- Department of Biology, 134 Mugar Life Sciences Building, Northeastern University, 360 Huntington Ave, Boston, MA, 02115, USA
| | - Yiwei Kong
- Department of Biology, 134 Mugar Life Sciences Building, Northeastern University, 360 Huntington Ave, Boston, MA, 02115, USA
| | - Corneliu Sima
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA, 02115, USA
| | - Sanket Bhagat
- Ultragenyx Pharmaceutical, 840 Memorial Drive, Cambridge, MA, 02139, USA
| | - Kailing Ho
- Department of Developmental Biology, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA, 02115, USA
| | - Vicki Rosen
- Department of Developmental Biology, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA, 02115, USA
| | - Laura Gamer
- Department of Developmental Biology, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA, 02115, USA
| | - Andreia M Ionescu
- Department of Biology, 134 Mugar Life Sciences Building, Northeastern University, 360 Huntington Ave, Boston, MA, 02115, USA.
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3
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Wang Z, Le H, Wang Y, Liu H, Li Z, Yang X, Wang C, Ding J, Chen X. Instructive cartilage regeneration modalities with advanced therapeutic implantations under abnormal conditions. Bioact Mater 2022; 11:317-338. [PMID: 34977434 PMCID: PMC8671106 DOI: 10.1016/j.bioactmat.2021.10.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 09/19/2021] [Accepted: 10/02/2021] [Indexed: 12/12/2022] Open
Abstract
The development of interdisciplinary biomedical engineering brings significant breakthroughs to the field of cartilage regeneration. However, cartilage defects are considerably more complicated in clinical conditions, especially when injuries occur at specific sites (e.g., osteochondral tissue, growth plate, and weight-bearing area) or under inflammatory microenvironments (e.g., osteoarthritis and rheumatoid arthritis). Therapeutic implantations, including advanced scaffolds, developed growth factors, and various cells alone or in combination currently used to treat cartilage lesions, address cartilage regeneration under abnormal conditions. This review summarizes the strategies for cartilage regeneration at particular sites and pathological microenvironment regulation and discusses the challenges and opportunities for clinical transformation.
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Affiliation(s)
- Zhonghan Wang
- Department of Plastic and Reconstruct Surgery, The First Hospital of Jilin University, 1 Xinmin Street, Changchun, 130021, PR China
- Department of Orthopedics, The Second Hospital of Jilin University, 218 Ziqiang Street, Changchun, 130041, PR China
| | - Hanxiang Le
- Department of Orthopedics, The Second Hospital of Jilin University, 218 Ziqiang Street, Changchun, 130041, PR China
| | - Yanbing Wang
- Department of Orthopedics, The Second Hospital of Jilin University, 218 Ziqiang Street, Changchun, 130041, PR China
| | - He Liu
- Department of Orthopedics, The Second Hospital of Jilin University, 218 Ziqiang Street, Changchun, 130041, PR China
| | - Zuhao Li
- Department of Orthopedics, The Second Hospital of Jilin University, 218 Ziqiang Street, Changchun, 130041, PR China
| | - Xiaoyu Yang
- Department of Orthopedics, The Second Hospital of Jilin University, 218 Ziqiang Street, Changchun, 130041, PR China
| | - Chenyu Wang
- Department of Plastic and Reconstruct Surgery, The First Hospital of Jilin University, 1 Xinmin Street, Changchun, 130021, PR China
| | - Jianxun Ding
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, 5625 Renmin Street, Changchun, 130022, PR China
| | - Xuesi Chen
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, 5625 Renmin Street, Changchun, 130022, PR China
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Wilson K, Usami Y, Hogarth D, Scheiber AL, Tian H, Oichi T, Wei Y, Qin L, Otsuru S, Toyosawa S, Iwamoto M, Abzug JM, Enomoto-Iwamoto M. Analysis of Association between Morphometric Parameters of Growth Plate and Bone Growth of Tibia in Mice and Humans. Cartilage 2021; 13:315S-325S. [PMID: 31997656 PMCID: PMC8804827 DOI: 10.1177/1947603519900800] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE The purposes of this study are to evaluate which growth plate parameters are associated with bone growth in mice and to compare the mouse results with those in humans. DESIGN The sagittal sections of the proximal growth plate of the mouse tibia from neonate to young adult stages were subjected to histomorphometric and functional analyses. The radiographic images of tibias of human patients until puberty were analyzed to obtain the tibia length and the proximal growth plate height. It was found that a linear correlation best modeled the relationship between the growth plate variables with the tibia growth rate and length. RESULTS In mice, total height, resting zone height, combined height of the proliferation and prehypertrophic zones, proliferation activity, and the total width of tibia growth plate showed high linear correlation with tibia bone length and bone growth rate, but the hypertrophic zone height and the growth plate area did not. In both mice and humans, the total growth plate width of tibia was found to have the strongest correlation with tibia length and growth rate. CONCLUSIONS The results validated that growth plate total height, the height of the resting zone and cell proliferation activity are appropriate parameters to evaluate the balance between growth plate activity and bone growth in mice, consistent with previous reports. The study also provided a new growth plate parameter candidate, growth plate width for growth plate activity evaluation in both mouse and human tibia bone.
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Affiliation(s)
- Kimberly Wilson
- Department of Orthopaedics, School of
Medicine, University of Maryland, Baltimore, MD, USA
| | - Yu Usami
- Department of Oral Pathology, Osaka
University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Danielle Hogarth
- Department of Orthopaedics, School of
Medicine, University of Maryland, Baltimore, MD, USA
| | - Amanda L. Scheiber
- Department of Orthopaedics, School of
Medicine, University of Maryland, Baltimore, MD, USA
| | - Hongying Tian
- Department of Orthopaedics, School of
Medicine, University of Maryland, Baltimore, MD, USA
| | - Takeshi Oichi
- Department of Orthopaedics, School of
Medicine, University of Maryland, Baltimore, MD, USA
| | - Yulong Wei
- Mckay Orthopaedic Research Laboratory,
Department of Orthopaedic Surgery, Perelman School of Medicine, University of
Pennsylvania, Philadelphia, PA, USA
| | - Ling Qin
- Mckay Orthopaedic Research Laboratory,
Department of Orthopaedic Surgery, Perelman School of Medicine, University of
Pennsylvania, Philadelphia, PA, USA
| | - Satoru Otsuru
- Department of Orthopaedics, School of
Medicine, University of Maryland, Baltimore, MD, USA
| | - Satoru Toyosawa
- Department of Oral Pathology, Osaka
University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Masahiro Iwamoto
- Department of Orthopaedics, School of
Medicine, University of Maryland, Baltimore, MD, USA
| | - Joshua M. Abzug
- Department of Orthopaedics, School of
Medicine, University of Maryland, Baltimore, MD, USA
| | - Motomi Enomoto-Iwamoto
- Department of Orthopaedics, School of
Medicine, University of Maryland, Baltimore, MD, USA,Motomi Enomoto-Iwamoto, Department of
Orthopaedics, School of Medicine, University of Maryland, Baltimore, 20 Penn
Street, HSFII S022, Baltimore, MD, 21209, USA.
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5
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Wang X, Li Z, Wang C, Bai H, Wang Z, Liu Y, Bao Y, Ren M, Liu H, Wang J. Enlightenment of Growth Plate Regeneration Based on Cartilage Repair Theory: A Review. Front Bioeng Biotechnol 2021; 9:654087. [PMID: 34150725 PMCID: PMC8209549 DOI: 10.3389/fbioe.2021.654087] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 05/10/2021] [Indexed: 01/21/2023] Open
Abstract
The growth plate (GP) is a cartilaginous region situated between the epiphysis and metaphysis at the end of the immature long bone, which is susceptible to mechanical damage because of its vulnerable structure. Due to the limited regeneration ability of the GP, current clinical treatment strategies (e.g., bone bridge resection and fat engraftment) always result in bone bridge formation, which will cause length discrepancy and angular deformity, thus making satisfactory outcomes difficult to achieve. The introduction of cartilage repair theory and cartilage tissue engineering technology may encourage novel therapeutic approaches for GP repair using tissue engineered GPs, including biocompatible scaffolds incorporated with appropriate seed cells and growth factors. In this review, we summarize the physiological structure of GPs, the pathological process, and repair phases of GP injuries, placing greater emphasis on advanced tissue engineering strategies for GP repair. Furthermore, we also propose that three-dimensional printing technology will play a significant role in this field in the future given its advantage of bionic replication of complex structures. We predict that tissue engineering strategies will offer a significant alternative to the management of GP injuries.
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Affiliation(s)
- Xianggang Wang
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China.,Orthopaedic Research Institute of Jilin Province, Changchun, China
| | - Zuhao Li
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China.,Orthopaedic Research Institute of Jilin Province, Changchun, China
| | - Chenyu Wang
- Department of Plastic and Reconstructive Surgery, The First Hospital of Jilin University, Changchun, China
| | - Haotian Bai
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China.,Orthopaedic Research Institute of Jilin Province, Changchun, China
| | - Zhonghan Wang
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China.,Orthopaedic Research Institute of Jilin Province, Changchun, China
| | - Yuzhe Liu
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China.,Orthopaedic Research Institute of Jilin Province, Changchun, China
| | - Yirui Bao
- Department of Orthopedics, Chinese PLA 965 Hospital, Jilin, China
| | - Ming Ren
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China.,Orthopaedic Research Institute of Jilin Province, Changchun, China
| | - He Liu
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China.,Orthopaedic Research Institute of Jilin Province, Changchun, China
| | - Jincheng Wang
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China.,Orthopaedic Research Institute of Jilin Province, Changchun, China
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6
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Yu Y, Rodriguez-Fontan F, Eckstein K, Muralidharan A, Uzcategui AC, Fuchs JR, Weatherford S, Erickson CB, Bryant SJ, Ferguson VL, Hadley Miller N, Li G, Payne KA. Rabbit Model of Physeal Injury for the Evaluation of Regenerative Medicine Approaches. Tissue Eng Part C Methods 2019; 25:701-710. [PMID: 31552802 DOI: 10.1089/ten.tec.2019.0180] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Physeal injuries can lead to bony repair tissue formation, known as a bony bar. This can result in growth arrest or angular deformity, which is devastating for children who have not yet reached their full height. Current clinical treatment involves resecting the bony bar and replacing it with a fat graft to prevent further bone formation and growth disturbance, but these treatments frequently fail to do so and require additional interventions. Novel treatments that could prevent bone formation but also regenerate the injured physeal cartilage and restore normal bone elongation are warranted. To test the efficacy of these treatments, animal models that emulate human physeal injury are necessary. The rabbit model of physeal injury quickly establishes a bony bar, which can then be resected to test new treatments. Although numerous rabbit models have been reported, they vary in terms of size and location of the injury, tools used to create the injury, and methods to assess the repair tissue, making comparisons between studies difficult. The study presented here provides a detailed method to create a rabbit model of proximal tibia physeal injury using a two-stage procedure. The first procedure involves unilateral removal of 25% of the physis in a 6-week-old New Zealand white rabbit. This consistently leads to a bony bar, significant limb length discrepancy, and angular deformity within 3 weeks. The second surgical procedure involves bony bar resection and treatment. In this study, we tested the implantation of a fat graft and a photopolymerizable hydrogel as a proof of concept that injectable materials could be delivered into this type of injury. At 8 weeks post-treatment, we measured limb length, tibial angle, and performed imaging and histology of the repair tissue. By providing a detailed, easy to reproduce methodology to perform the physeal injury and test novel treatments after bony bar resection, comparisons between studies can be made and facilitate translation of promising therapies toward clinical use. Impact Statement This study provides details to create a rabbit model of physeal injury that can facilitate comparisons between studies and test novel regenerative medicine approaches. Furthermore, this model mimics the human, clinical situation that requires a bony bar resection followed by treatment. In addition, identification of a suitable treatment can be seen in the correction of the growth deformity, allowing this model to facilitate the development of novel physeal cartilage regenerative medicine approaches.
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Affiliation(s)
- Yangyi Yu
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | | | - Kevin Eckstein
- Department of Mechanical Engineering, University of Colorado Boulder, Boulder, Colorado
| | - Archish Muralidharan
- Material Science and Engineering Program, University of Colorado Boulder, Boulder, Colorado
| | - Asais Camila Uzcategui
- Material Science and Engineering Program, University of Colorado Boulder, Boulder, Colorado
| | - Joseph R Fuchs
- Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Shane Weatherford
- Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Christopher B Erickson
- Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, Colorado.,Department of Bioengineering, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Stephanie J Bryant
- Material Science and Engineering Program, University of Colorado Boulder, Boulder, Colorado.,Department of Chemical and Biological Engineering, University of Colorado Boulder, Boulder, Colorado.,BioFrontiers Institute, University of Colorado Boulder, Boulder, Colorado
| | - Virginia L Ferguson
- Department of Mechanical Engineering, University of Colorado Boulder, Boulder, Colorado.,Material Science and Engineering Program, University of Colorado Boulder, Boulder, Colorado.,BioFrontiers Institute, University of Colorado Boulder, Boulder, Colorado
| | - Nancy Hadley Miller
- Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Guangheng Li
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Karin A Payne
- Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, Colorado.,Gates Center for Regenerative Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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