A Recruitment Model of Tendon Viscoelasticity That Incorporates Fibril Creep and Explains Strain-Dependent Relaxation

The alteration of the structure and macroscopic mechanical response of porcine patellar tendon by elastase digestion

Background: The treatment of patellar tendon injury has always been an unsolved problem, and mechanical characterization is very important for its repair and reconstruction. Elastin is a contributor to mechanics, but it is not clear how it affects the elasticity, viscoelastic properties, and structure of patellar tendon. Methods: The patellar tendons from six fresh adult experimental pigs were used in this study and they were made into 77 samples. The patellar tendon was specifically degraded by elastase, and the regional mechanical response and structural changes were investigated by: (1) Based on the previous study of elastase treatment conditions, the biochemical quantification of collagen, glycosaminoglycan and total protein was carried out; (2) The patellar tendon was divided into the proximal, central, and distal regions, and then the axial tensile test and stress relaxation test were performed before and after phosphate-buffered saline (PBS) or elastase treatment; (3) The dynamic constitutive model was established by the obtained mechanical data; (4) The structural relationship between elastin and collagen fibers was analyzed by two-photon microscopy and histology. Results: There was no statistical difference in mechanics between patellar tendon regions. Compared with those before elastase treatment, the low tensile modulus decreased by 75%-80%, the high tensile modulus decreased by 38%-47%, and the transition strain was prolonged after treatment. For viscoelastic behavior, the stress relaxation increased, the initial slope increased by 55%, the saturation slope increased by 44%, and the transition time increased by 25% after enzyme treatment. Elastin degradation made the collagen fibers of patellar tendon become disordered and looser, and the fiber wavelength increased significantly. Conclusion: The results of this study show that elastin plays an important role in the mechanical properties and fiber structure stability of patellar tendon, which supplements the structure-function relationship information of patellar tendon. The established constitutive model is of great significance to the prediction, repair and replacement of patellar tendon injury. In addition, human patellar tendon has a higher elastin content, so the results of this study can provide supporting information on the natural properties of tendon elastin degradation and guide the development of artificial patellar tendon biomaterials.

Direct measurements of collagen fiber recruitment in the posterior pole of the eye

Collagen is the main load-bearing component of the peripapillary sclera (PPS) and lamina cribrosa (LC) in the eye. Whilst it has been shown that uncrimping and recruitment of the PPS and LC collagen fibers underlies the macro-scale nonlinear stiffening of both tissues with increased intraocular pressure (IOP), the uncrimping and recruitment as a function of local stretch have not been directly measured. This knowledge is crucial to understanding their functions in bearing loads and maintaining tissue integrity. In this project we measured local stretch-induced collagen fiber bundle uncrimping and recruitment curves of the PPS and LC. Thin coronal samples of PPS and LC of sheep eyes were mounted and stretched biaxially quasi-statically using a custom system. At each step, we imaged the PPS and LC with instant polarized light microscopy and quantified pixel-level (1.5 μm/pixel) collagen fiber orientations. We used digital image correlation to measure the local stretch and quantified collagen crimp by the circular standard deviation of fiber orientations, or waviness. Local stretch-recruitment curves of PPS and LC approximated sigmoid functions. PPS recruited more fibers than the LC at the low levels of stretch. At 10% stretch the curves crossed with 75% bundles recruited. The PPS had higher uncrimping rate and waviness remaining after recruitment than the LC: 0.9º vs. 0.6º and 3.1º vs. 2.7º. Altogether our findings support describing fiber recruitment of both PPS and LC with sigmoid curves, with the PPS recruiting faster and at lower stretch than the LC, consistent with a stiffer tissue. STATEMENT OF SIGNIFICANCE: Peripapillary sclera (PPS) and lamina cribrosa (LC) collagen recruitment behaviors are central to the nonlinear mechanical behavior of the posterior pole of the eye. How PPS and LC collagen fibers recruit under stretch is crucial to develop constitutive models of the tissues but remains unclear. We used image-based stretch testing to characterize PPS and LC collagen fiber bundle recruitment under local stretch. We found that fiber-level stretch-recruitment curves of PPS and LC approximated sigmoid functions. PPS recruited more fibers at a low stretch, but at 10% bundle stretch the two curves crossed with 75% bundles recruited. We also found that PPS and LC fibers had different uncrimping rates and non-zero waviness's when recruited.

Bayesian inference on a microstructural, hyperelastic model of tendon deformation

Microstructural models of soft-tissue deformation are important in applications including artificial tissue design and surgical planning. The basis of these models, and their advantage over their phenomenological counterparts, is that they incorporate parameters that are directly linked to the tissue's microscale structure and constitutive behaviour and can therefore be used to predict the effects of structural changes to the tissue. Although studies have attempted to determine such parameters using diverse, state-of-the-art, experimental techniques, values ranging over several orders of magnitude have been reported, leading to uncertainty in the true parameter values and creating a need for models that can handle such uncertainty. We derive a new microstructural, hyperelastic model for transversely isotropic soft tissues and use it to model the mechanical behaviour of tendons. To account for parameter uncertainty, we employ a Bayesian approach and apply an adaptive Markov chain Monte Carlo algorithm to determine posterior probability distributions for the model parameters. The obtained posterior distributions are consistent with parameter measurements previously reported and enable us to quantify the uncertainty in their values for each tendon sample that was modelled. This approach could serve as a prototype for quantifying parameter uncertainty in other soft tissues.

Quantifying the Elasticity Properties of the Median Nerve during the Upper Limb Neurodynamic Test 1

Background

The upper limb neurodynamic test 1 (ULNT1) consists of a series of movements that are thought to detect an increase in neuromechanical sensitivity. In vivo, no trail was made to quantify the association between the nerve elasticity and different limb postures during ULNT1.

Objectives

(1) To investigate the relationship between nerve elasticity and limb postures during ULNT1 and (2) to investigate the intra- and interoperator reliabilities of shear wave elastography (SWE) in quantifying the elasticity of median nerve.

Methods

Twenty healthy subjects (mean age: 19.9 ± 1.4 years old) participated in this study. The median nerve was imaged during elbow extension in the following postures: (1) with neutral posture, (2) with wrist extension (WE), (3) with contralateral cervical flexion (CCF), and (4) with both WE and CCF. The intra- and interoperator reliabilities measured by two operators at NP and CCF+WE and intraclass correlation coefficients (ICCs) were calculated.

Results

The intraoperator (ICC = 0.72–0.75) and interoperator (ICC = 0.89–0.94) reliabilities for measuring the elasticity of the median nerve ranged from good to excellent. The mean shear modulus of the median nerve increased by 53.68% from NP to WE+CCF.

Conclusion

SWE is a reliable tool to quantify the elasticity of the median nerve. There was acute modulation in the elasticity of the median nerve during the ULNT1 when healthy participants reported substantial discomfort. Further studies need to focus on the elasticity properties of the median nerve in patients with peripheral neuropathic pain.

Collagen fibril assembly: New approaches to unanswered questions

Collagen fibrils are essential for metazoan life. They are the largest, most abundant, and most versatile protein polymers in animals, where they occur in the extracellular matrix to form the structural basis of tissues and organs. Collagen fibrils were first observed at the turn of the 20th century. During the last 40 years, the genes that encode the family of collagens have been identified, the structure of the collagen triple helix has been solved, the many enzymes involved in the post-translational modifications of collagens have been identified, mutations in the genes encoding collagen and collagen-associated proteins have been linked to heritable disorders, and changes in collagen levels have been associated with a wide range of diseases, including cancer. Yet despite extensive research, a full understanding of how cells assemble collagen fibrils remains elusive. Here, we review current models of collagen fibril self-assembly, and how cells might exert control over the self-assembly process to define the number, length and organisation of fibrils in tissues.

Basic Structure, Physiology, and Biochemistry of Connective Tissues and Extracellular Matrix Collagens

The physiology of connective tissues like tendons and ligaments is highly dependent upon the collagens and other such extracellular matrix molecules hierarchically organized within the tissues. By dry weight, connective tissues are mostly composed of fibrillar collagens. However, several other forms of collagens play essential roles in the regulation of fibrillar collagen organization and assembly, in the establishment of basement membrane networks that provide support for vasculature for connective tissues, and in the formation of extensive filamentous networks that allow for cell-extracellular matrix interactions as well as maintain connective tissue integrity. The structures and functions of these collagens are discussed in this chapter. Furthermore, collagen synthesis is a multi-step process that includes gene transcription, translation, post-translational modifications within the cell, triple helix formation, extracellular secretion, extracellular modifications, and then fibril assembly, fibril modifications, and fiber formation. Each step of collagen synthesis and fibril assembly is highly dependent upon the biochemical structure of the collagen molecules created and how they are modified in the cases of development and maturation. Likewise, when the biochemical structures of collagens or are compromised or these molecules are deficient in the tissues - in developmental diseases, degenerative conditions, or injuries - then the ultimate form and function of the connective tissues are impaired. In this chapter, we also review how biochemistry plays a role in each of the processes involved in collagen synthesis and assembly, and we describe differences seen by anatomical location and region within tendons. Moreover, we discuss how the structures of the molecules, fibrils, and fibers contribute to connective tissue physiology in health, and in pathology with injury and repair.

Poly(Lactic Acid)/Graphite Nanoplatelet Nanocomposite Filaments for Ligament Scaffolds

The anterior cruciate ligament (ACL) is one of the most prone to injury in the human body. Due to its insufficient vascularization and low regenerative capacity, surgery is often required when it is ruptured. Most of the current tissue engineering (TE) strategies are based on scaffolds produced with fibers due to the natural ligament's fibrous structure. In the present work, composite filaments based on poly(L-lactic acid) (PLA) reinforced with graphite nanoplatelets (PLA+EG) as received, chemically functionalized (PLA+f-EG), or functionalized and decorated with silver nanoparticles [PLA+((f-EG)+Ag)] were produced by melt mixing, ensuring good filler dispersion. These filaments were produced with diameters of 0.25 mm and 1.75 mm for textile-engineered and 3D-printed ligament scaffolds, respectively. The resulting composite filaments are thermally stable, and the incorporation of graphite increases the stiffness of the composites and decreases the electrical resistivity, as compared to PLA. None of the filaments suffered significant degradation after 27 days. The composite filaments were processed into 3D scaffolds with finely controlled dimensions and porosity by textile-engineered and additive fabrication techniques, demonstrating their potential for ligament TE applications.

A microstructural model of tendon failure

Collagen fibrils are the most important structural component of tendons. Their crimped structure and parallel arrangement within the tendon lead to a distinctive non-linear stress-strain curve when a tendon is stretched. Microstructural models can be used to relate microscale collagen fibril mechanics to macroscale tendon mechanics, allowing us to identify the mechanisms behind each feature present in the stress-strain curve. Most models in the literature focus on the elastic behaviour of the tendon, and there are few which model beyond the elastic limit without introducing phenomenological parameters. We develop a model, built upon a collagen recruitment approach, that only contains microstructural parameters. We split the stress in the fibrils into elastic and plastic parts, and assume that the fibril yield stretch and rupture stretch are each described by a distribution function, rather than being single-valued. By changing the shapes of the distributions and their regions of overlap, we can produce macroscale tendon stress-strain curves that generate the full range of features observed experimentally, including those that could not be explained using existing models. These features include second linear regions occurring after the tendon has yielded, and step-like failure behaviour present after the stress has peaked. When we compare with an existing model, we find that our model reduces the average root mean squared error from 4.53MPa to 2.29MPa, and the resulting parameter values are closer to those found experimentally. Since our model contains only parameters that have a direct physical interpretation, it can be used to predict how processes such as ageing, disease, and injury affect the mechanical behaviour of tendons, provided we can quantify the effects of these processes on the microstructure.