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Oláh T, Cucchiarini M, Madry H. Temporal progression of subchondral bone alterations in OA models involving induction of compromised meniscus integrity in mice and rats: A scoping review. Osteoarthritis Cartilage 2024:S1063-4584(24)01256-1. [PMID: 38876436 DOI: 10.1016/j.joca.2024.06.002] [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: 01/17/2024] [Revised: 05/17/2024] [Accepted: 06/06/2024] [Indexed: 06/16/2024]
Abstract
OBJECTIVE To categorize the temporal progression of subchondral bone alterations induced by compromising meniscus integrity in mouse and rat models of knee osteoarthritis (OA). METHOD Scoping review of investigations reporting subchondral bone changes with appropriate negative controls in the different mouse and rat models of OA induced by compromising meniscus integrity. RESULTS The available literature provides appropriate temporal detail on subchondral changes in these models, covering the entire spectrum of OA with an emphasis on early and mid-term time points. Microstructural changes of the subarticular spongiosa are comprehensively described; those of the subchondral bone plate are not. In mouse models, global subchondral bone alterations are unidirectional, involving an advancing sclerosis of the trabecular structure over time. In rats, biphasic subchondral bone alterations begin with an osteopenic degeneration and loss of subchondral trabeculae, progressing to a late sclerosis of the entire subchondral bone. Rat models, independently from the applied technique, relatively faithfully mirror the early bone loss detected in larger animals, and the late subchondral bone sclerosis observed in human advanced OA. CONCLUSION Mice and rats allow us to study the microstructural consequences of compromising meniscus integrity at high temporal detail. Thickening of the subchondral bone plate, an early loss of thinner subarticular trabecular elements, followed by a subsequent sclerosis of the entire subchondral bone are all important and reliable hallmarks that occur in parallel with the advancing articular cartilage degeneration. Thoughtful decisions on the study design, laterality, selection of controls and volumes of interest are crucial to obtain meaningful data.
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Affiliation(s)
- Tamás Oláh
- Center of Experimental Orthopaedics, Saarland University, Homburg, Germany; Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
| | - Magali Cucchiarini
- Center of Experimental Orthopaedics, Saarland University, Homburg, Germany.
| | - Henning Madry
- Center of Experimental Orthopaedics, Saarland University, Homburg, Germany.
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2
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Reinhard J, Oláh T, Laschke MW, Goebel LKH, Schmitt G, Speicher-Mentges S, Menger MD, Cucchiarini M, Pape D, Madry H. Modulation of early osteoarthritis by tibiofemoral re-alignment in sheep. Osteoarthritis Cartilage 2024; 32:690-701. [PMID: 38442768 DOI: 10.1016/j.joca.2024.02.892] [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: 07/20/2023] [Revised: 01/30/2024] [Accepted: 02/18/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE To investigate whether tibiofemoral alignment influences early knee osteoarthritis (OA). We hypothesized that varus overload exacerbates early degenerative osteochondral changes, and that valgus underload diminishes early OA. METHOD Normal, over- and underload were induced by altering alignment via high tibial osteotomy in adult sheep (n = 8 each). Simultaneously, OA was induced by partial medial anterior meniscectomy. At 6 weeks postoperatively, OA was examined in five individual subregions of the medial tibial plateau using Kellgren-Lawrence grading, quantification of macroscopic OA, semiquantitative histopathological OA and immunohistochemical type-II collagen, ADAMTS-5, and MMP-13 scoring, biochemical determination of DNA and proteoglycan contents, and micro-computed tomographic evaluation of the subchondral bone. RESULTS Multivariate analyses revealed that OA cartilaginous changes had a temporal priority over subchondral bone changes. Underload inhibited early cartilage degeneration in a characteristic topographic pattern (P ≥ 0.0983 vs. normal), in particular below the meniscal damage, avoided alterations of the subarticular spongiosa (P ≥ 0.162 vs. normal), and prevented the disturbance of otherwise normal osteochondral correlations. Overload induced early alterations of the subchondral bone plate microstructure towards osteopenia, including significantly decreased percent bone volume and increased bone surface-to-volume ratio (all P ≤ 0.0359 vs. normal). CONCLUSION The data provide high-resolution evidence that tibiofemoral alignment modulates early OA induced by a medial meniscus injury in adult sheep. Since underload inhibits early OA, these data also support the clinical value of strategies to reduce the load in an affected knee compartment to possibly decelerate structural OA progression.
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Affiliation(s)
- Jan Reinhard
- Center of Experimental Orthopaedics, Saarland University, 66421 Homburg, Germany.
| | - Tamás Oláh
- Center of Experimental Orthopaedics, Saarland University, 66421 Homburg, Germany; Cartilage Net of the Greater Region, 66421 Homburg, Germany.
| | - Matthias W Laschke
- Institute for Clinical and Experimental Surgery, Saarland University Medical Center and Saarland University, 66421 Homburg, Germany.
| | - Lars K H Goebel
- Center of Experimental Orthopaedics, Saarland University, 66421 Homburg, Germany; Cartilage Net of the Greater Region, 66421 Homburg, Germany.
| | - Gertrud Schmitt
- Center of Experimental Orthopaedics, Saarland University, 66421 Homburg, Germany.
| | | | - Michael D Menger
- Institute for Clinical and Experimental Surgery, Saarland University Medical Center and Saarland University, 66421 Homburg, Germany.
| | - Magali Cucchiarini
- Center of Experimental Orthopaedics, Saarland University, 66421 Homburg, Germany; Cartilage Net of the Greater Region, 66421 Homburg, Germany.
| | - Dietrich Pape
- Cartilage Net of the Greater Region, 66421 Homburg, Germany; Clinique d'Eich, Centre Hospitalier de Luxembourg, Eich, 1460 Luxembourg, Germany.
| | - Henning Madry
- Center of Experimental Orthopaedics, Saarland University, 66421 Homburg, Germany; Cartilage Net of the Greater Region, 66421 Homburg, Germany.
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Delsmann J, Eissele J, Simon A, Alimy AR, von Kroge S, Mushumba H, Püschel K, Busse B, Ries C, Amling M, Beil FT, Rolvien T. Alterations in compositional and cellular properties of the subchondral bone are linked to cartilage degeneration in hip osteoarthritis. Osteoarthritis Cartilage 2024; 32:535-547. [PMID: 38403152 DOI: 10.1016/j.joca.2024.01.007] [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: 06/12/2023] [Revised: 12/21/2023] [Accepted: 01/22/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVE The subchondral bone is an emerging regulator of osteoarthritis (OA). However, knowledge of how specific subchondral alterations relate to cartilage degeneration remains incomplete. METHOD Femoral heads were obtained from 44 patients with primary OA during total hip arthroplasty and from 30 non-OA controls during autopsy. A multiscale assessment of the central subchondral bone region comprising histomorphometry, quantitative backscattered electron imaging, nanoindentation, and osteocyte lacunocanalicular network characterization was employed. RESULTS In hip OA, thickening of the subchondral bone coincided with a higher number of osteoblasts (controls: 3.7 ± 4.5 mm-1, OA: 16.4 ± 10.2 mm-1, age-adjusted mean difference 10.5 mm-1 [95% CI 4.7 to 16.4], p < 0.001) but a similar number of osteoclasts compared to controls (p = 0.150). Furthermore, higher matrix mineralization heterogeneity (CaWidth, controls: 2.8 ± 0.2 wt%, OA: 3.1 ± 0.3 wt%, age-adjusted mean difference 0.2 wt% [95% CI 0.1 to 0.4], p = 0.011) and lower tissue hardness (controls: 0.69 ± 0.06 GPa, OA: 0.67 ± 0.06 GPa, age-adjusted mean difference -0.05 GPa [95% CI -0.09 to -0.01], p = 0.032) were detected. While no evidence of altered osteocytic perilacunar/canalicular remodeling in terms of fewer osteocyte canaliculi was found in OA, specimens with advanced cartilage degeneration showed a higher number of osteocyte canaliculi and larger lacunocanalicular network area compared to those with low-grade cartilage degeneration. Multiple linear regression models indicated that several subchondral bone properties, especially osteoblast and osteocyte parameters, were closely related to cartilage degeneration (R2 adjusted = 0.561, p < 0.001). CONCLUSION Subchondral bone properties in OA are affected at the compositional, mechanical, and cellular levels. Based on their strong interaction with cartilage degeneration, targeting osteoblasts/osteocytes may be a promising therapeutic OA approach. DATA AND MATERIALS AVAILABILITY All data are available in the main text or the supplementary materials.
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Affiliation(s)
- Julian Delsmann
- Department of Trauma and Orthopaedic Surgery, Division of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julian Eissele
- Department of Trauma and Orthopaedic Surgery, Division of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alexander Simon
- Department of Trauma and Orthopaedic Surgery, Division of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Assil-Ramin Alimy
- Department of Trauma and Orthopaedic Surgery, Division of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Simon von Kroge
- Department of Trauma and Orthopaedic Surgery, Division of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Herbert Mushumba
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Klaus Püschel
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Björn Busse
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Ries
- Department of Trauma and Orthopaedic Surgery, Division of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Amling
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Frank Timo Beil
- Department of Trauma and Orthopaedic Surgery, Division of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tim Rolvien
- Department of Trauma and Orthopaedic Surgery, Division of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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Hildebrandt A, Dietrich T, Weber J, Günderoth MM, Zhou S, Fleckenstein FN, Jiang S, Winkler T, Duda GN, Tsitsilonis S, Keller J, Maleitzke T. The dual pro-inflammatory and bone-protective role of calcitonin gene-related peptide alpha in age-related osteoarthritis. Arthritis Res Ther 2023; 25:244. [PMID: 38102666 PMCID: PMC10722726 DOI: 10.1186/s13075-023-03215-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 11/15/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND The vasoactive neuropeptide calcitonin gene-related peptide alpha (αCGRP) enhances nociception in primary knee osteoarthritis (OA) and has been shown to disrupt cartilage and joint integrity in experimental rheumatoid arthritis (RA). Little is known about how αCGRP may alter articular structures in primary OA. We investigated whether αCGRP modulates local inflammation and concomitant cartilage and bone changes in a murine model of age-dependent OA. METHODS Sixteen- to 18-month-old αCGRP-deficient mice (αCGRP-/-aged) were compared to, first, age-matched wild type (WTaged) and, second, young 4- to 5-month-old non-OA αCGRP-deficient (αCGRP-/-CTRL) and non-OA WT animals (WTCTRL). αCGRP levels were measured in serum. Knee and hip joint inflammation, cartilage degradation, and bone alterations were assessed by histology (OARSI histopathological grading score), gene expression analysis, and µ-computed tomography. RESULTS WTaged mice exhibited elevated αCGRP serum levels compared to young WTCTRL animals. Marked signs of OA-induced cartilage destruction were seen in WTaged animals, while αCGRP-/-aged mice were mostly protected from this effect. Age-dependent OA was accompanied by an increased gene expression of pro-inflammatory Tnfa, Il1b, and Il6 and catabolic Mmp13, Adamts5, Ctsk, Tnfs11 (Rankl), and Cxcl12/Cxcr4 in WTaged but not in αCGRP-/-aged mice. αCGRP-deficiency however further aggravated subchondral bone sclerosis of the medial tibial plateau and accelerated bone loss in the epi- and metaphyseal trabecular tibial bone in age-dependent OA. CONCLUSIONS Similar to its function in experimental RA, αCGRP exerts a dual pro-inflammatory and bone-protective function in murine primary OA. Although anti-CGRP treatment was previously not successful in reducing pain in OA clinically, these data underline a crucial pathophysiological role of αCGRP in age-related OA.
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Affiliation(s)
- Alexander Hildebrandt
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Center for Musculoskeletal Surgery, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
| | - Tamara Dietrich
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Center for Musculoskeletal Surgery, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
| | - Jérôme Weber
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Center for Musculoskeletal Surgery, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
| | - Mara Meyer Günderoth
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Center for Musculoskeletal Surgery, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
| | - Sijia Zhou
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Center for Musculoskeletal Surgery, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
| | - Florian N Fleckenstein
- Department of Diagnostic and Interventional Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Clinician Scientist Program, Berlin, Germany
| | - Shan Jiang
- Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tobias Winkler
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Center for Musculoskeletal Surgery, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
- Berlin Institute of Health Center for Regenerative Therapies, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Georg N Duda
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
| | - Serafeim Tsitsilonis
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Center for Musculoskeletal Surgery, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
| | - Johannes Keller
- Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tazio Maleitzke
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Center for Musculoskeletal Surgery, Berlin, Germany.
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany.
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Clinician Scientist Program, Berlin, Germany.
- Department of Orthopaedic Surgery, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark.
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
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5
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Oláh T, Cucchiarini M, Madry H. Subchondral bone remodeling patterns in larger animal models of meniscal injuries inducing knee osteoarthritis - a systematic review. Knee Surg Sports Traumatol Arthrosc 2023; 31:5346-5364. [PMID: 37742232 PMCID: PMC10719152 DOI: 10.1007/s00167-023-07579-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 09/05/2023] [Indexed: 09/26/2023]
Abstract
PURPOSE Elucidating subchondral bone remodeling in preclinical models of traumatic meniscus injury may address clinically relevant questions about determinants of knee osteoarthritis (OA). METHODS Studies on subchondral bone remodeling in larger animal models applying meniscal injuries as standardizing entity were systematically analyzed. Of the identified 5367 papers reporting total or partial meniscectomy, meniscal transection or destabilization, 0.4% (in guinea pigs, rabbits, dogs, minipigs, sheep) remained eligible. RESULTS Only early or mid-term time points were available. Larger joint sizes allow reporting higher topographical details. The most frequently reported parameters were BV/TV (61%), BMD (41%), osteophytes (41%) and subchondral bone plate thickness (39%). Subchondral bone plate microstructure is not comprehensively, subarticular spongiosa microstructure is well characterized. The subarticular spongiosa is altered shortly before the subchondral bone plate. These early changes involve degradation of subarticular trabecular elements, reduction of their number, loss of bone volume and reduced mineralization. Soon thereafter, the previously normal subchondral bone plate becomes thicker. Its porosity first increases, then decreases. CONCLUSION The specific human topographical pattern of a thinner subchondral bone plate in the region below both menisci is present solely in the larger species (partly in rabbits), but absent in rodents, an important fact to consider when designing animal studies examining subchondral consequences of meniscus damage. Large animal models are capable of providing high topographical detail, suggesting that they may represent suitable study systems reflecting the clinical complexities. For advanced OA, significant gaps of knowledge exist. Future investigations assessing the subchondral bone in a standardized fashion are warranted.
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Affiliation(s)
- Tamás Oláh
- Center of Experimental Orthopaedics, Saarland University, Kirrberger Straße, Building 37, 66421, Homburg/Saar, Germany
| | - Magali Cucchiarini
- Center of Experimental Orthopaedics, Saarland University, Kirrberger Straße, Building 37, 66421, Homburg/Saar, Germany
| | - Henning Madry
- Center of Experimental Orthopaedics, Saarland University, Kirrberger Straße, Building 37, 66421, Homburg/Saar, Germany.
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Di J, Chen Z, Wang Z, He T, Wu D, Weng C, Deng J, Mai L, Wang K, He L, Rong L. Cartilage tissue from sites of weight bearing in patients with osteoarthritis exhibits a differential phenotype with distinct chondrocytes subests. RMD Open 2023; 9:e003255. [PMID: 37848267 PMCID: PMC10582868 DOI: 10.1136/rmdopen-2023-003255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 09/12/2023] [Indexed: 10/19/2023] Open
Abstract
OBJECTIVE Osteoarthritis (OA) is a degenerative joint disease associated with excessive mechanical loading. The aim here was to elucidate whether different subpopulations of chondrocytes exhibit distinct phenotypes in response to variations in loading conditions. Furthermore, we seek to investigate the transcriptional switches and cell crosstalk among these chondrocytes subsets. METHODS Proteomic analysis was performed on cartilage tissues isolated from weight-bearing and non-weight-bearing regions. Additionally, single-cell RNA sequencing was employed to identify different subsets of chondrocytes. For disease-specific cells, in vitro differentiation induction was performed, and their presence was confirmed in human cartilage tissue sections using immunofluorescence. The molecular mechanisms underlying transcriptional changes in these cells were analysed through whole-transcriptome sequencing. RESULTS In the weight-bearing regions of OA cartilage tissue, a subpopulation of chondrocytes called OA hypertrophic chondrocytes (OAHCs) expressing the marker genes SLC39A14 and COL10A1 are present. These cells exhibit unique characteristics of active cellular interactions mediated by the TGFβ signalling pathway and express OA phenotypes, distinct from hypertrophic chondrocytes in healthy cartilage. OAHCs are mainly distributed in the superficial region of damaged cartilage in human OA tissue, and on TGFβ stimulation, exhibit activation of transcriptional expression of iron metabolism-related genes, along with enrichment of associated pathways. CONCLUSION This study identified and validated the existence of a subset of OAHCs in the weight-bearing area of OA cartilage tissue. Our findings provide a theoretical basis for targeting OAHCs to slow down the progression of OA and facilitate the repair of cartilage injuries.
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Affiliation(s)
- Jiawei Di
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Center for Engineering and Technology Research of Minimally Invasive Spine Surgery, Guangzhou, Guangdong, China
- Guangdong Provincial Center for Quality Control of Minimally Invasive Spine Surgery, Guangzhou, Guangdong, China
| | - Zihao Chen
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Center for Engineering and Technology Research of Minimally Invasive Spine Surgery, Guangzhou, Guangdong, China
- Guangdong Provincial Center for Quality Control of Minimally Invasive Spine Surgery, Guangzhou, Guangdong, China
| | - Zhe Wang
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Center for Engineering and Technology Research of Minimally Invasive Spine Surgery, Guangzhou, Guangdong, China
- Guangdong Provincial Center for Quality Control of Minimally Invasive Spine Surgery, Guangzhou, Guangdong, China
- Department of Joint Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Tianwei He
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Center for Engineering and Technology Research of Minimally Invasive Spine Surgery, Guangzhou, Guangdong, China
- Guangdong Provincial Center for Quality Control of Minimally Invasive Spine Surgery, Guangzhou, Guangdong, China
| | - Depeng Wu
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Center for Engineering and Technology Research of Minimally Invasive Spine Surgery, Guangzhou, Guangdong, China
- Guangdong Provincial Center for Quality Control of Minimally Invasive Spine Surgery, Guangzhou, Guangdong, China
| | - Chuanggui Weng
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Center for Engineering and Technology Research of Minimally Invasive Spine Surgery, Guangzhou, Guangdong, China
- Guangdong Provincial Center for Quality Control of Minimally Invasive Spine Surgery, Guangzhou, Guangdong, China
| | - Jiajun Deng
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Center for Engineering and Technology Research of Minimally Invasive Spine Surgery, Guangzhou, Guangdong, China
- Guangdong Provincial Center for Quality Control of Minimally Invasive Spine Surgery, Guangzhou, Guangdong, China
| | - Lang Mai
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Center for Engineering and Technology Research of Minimally Invasive Spine Surgery, Guangzhou, Guangdong, China
- Guangdong Provincial Center for Quality Control of Minimally Invasive Spine Surgery, Guangzhou, Guangdong, China
| | - Kun Wang
- Department of Joint Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Lei He
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Center for Engineering and Technology Research of Minimally Invasive Spine Surgery, Guangzhou, Guangdong, China
- Guangdong Provincial Center for Quality Control of Minimally Invasive Spine Surgery, Guangzhou, Guangdong, China
| | - Limin Rong
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Center for Engineering and Technology Research of Minimally Invasive Spine Surgery, Guangzhou, Guangdong, China
- Guangdong Provincial Center for Quality Control of Minimally Invasive Spine Surgery, Guangzhou, Guangdong, China
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7
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Gao L, Beninatto R, Oláh T, Goebel L, Tao K, Roels R, Schrenker S, Glomm J, Venkatesan JK, Schmitt G, Sahin E, Dahhan O, Pavan M, Barbera C, Lucia AD, Menger MD, Laschke MW, Cucchiarini M, Galesso D, Madry H. A Photopolymerizable Biocompatible Hyaluronic Acid Hydrogel Promotes Early Articular Cartilage Repair in a Minipig Model In Vivo. Adv Healthc Mater 2023; 12:e2300931. [PMID: 37567219 DOI: 10.1002/adhm.202300931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 08/08/2023] [Indexed: 08/13/2023]
Abstract
Articular cartilage defects represent an unsolved clinical challenge. Photopolymerizable hydrogels are attractive candidates supporting repair. This study investigates the short-term safety and efficacy of two novel hyaluronic acid (HA)-triethylene glycol (TEG)-coumarin hydrogels photocrosslinked in situ in a clinically relevant large animal model. It is hypothesized that HA-hydrogel-augmented microfracture (MFX) is superior to MFX in enhancing early cartilage repair, and that the molar degree of substitution and concentration of HA affects repair. Chondral full-thickness defects in the knees of adult minipigs are treated with either 1) debridement (No MFX), 2) debridement and MFX, 3) debridement, MFX, and HA hydrogel (30% molar derivatization, 30 mg mL-1 HA; F3) (MFX+F3), and 4) debridement, MFX, and HA hydrogel (40% molar derivatization, 20 mg mL-1 HA; F4) (MFX+F4). After 8 weeks postoperatively, MFX+F3 significantly improves total macroscopic and histological scores compared with all other groups without negative effects, besides significantly enhancing the individual repair parameters "defect architecture," "repair tissue surface" (compared with No MFX, MFX), and "subchondral bone" (compared with MFX). These data indicate that photopolymerizable HA hydrogels enable a favorable metastable microenvironment promoting early chondrogenesis in vivo. This work also uncovers a mechanism for effective HA-augmented cartilage repair by combining lower molar derivatization with higher concentrations.
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Affiliation(s)
- Liang Gao
- Center of Experimental Orthopaedics, Saarland University, Kirrberger Straße 100, Building 37, D-66421, Homburg, Germany
| | - Riccardo Beninatto
- Fidia Farmaceutici S.p.A., Via Ponte della Fabbrica 3/A, Abano Terme (PD), 35031, Italy
| | - Tamás Oláh
- Center of Experimental Orthopaedics, Saarland University, Kirrberger Straße 100, Building 37, D-66421, Homburg, Germany
| | - Lars Goebel
- Center of Experimental Orthopaedics, Saarland University, Kirrberger Straße 100, Building 37, D-66421, Homburg, Germany
| | - Ke Tao
- Center of Experimental Orthopaedics, Saarland University, Kirrberger Straße 100, Building 37, D-66421, Homburg, Germany
| | - Rebecca Roels
- Center of Experimental Orthopaedics, Saarland University, Kirrberger Straße 100, Building 37, D-66421, Homburg, Germany
| | - Steffen Schrenker
- Center of Experimental Orthopaedics, Saarland University, Kirrberger Straße 100, Building 37, D-66421, Homburg, Germany
| | - Julianne Glomm
- Center of Experimental Orthopaedics, Saarland University, Kirrberger Straße 100, Building 37, D-66421, Homburg, Germany
| | - Jagadeesh K Venkatesan
- Center of Experimental Orthopaedics, Saarland University, Kirrberger Straße 100, Building 37, D-66421, Homburg, Germany
| | - Gertrud Schmitt
- Center of Experimental Orthopaedics, Saarland University, Kirrberger Straße 100, Building 37, D-66421, Homburg, Germany
| | - Ebrar Sahin
- Center of Experimental Orthopaedics, Saarland University, Kirrberger Straße 100, Building 37, D-66421, Homburg, Germany
| | - Ola Dahhan
- Center of Experimental Orthopaedics, Saarland University, Kirrberger Straße 100, Building 37, D-66421, Homburg, Germany
| | - Mauro Pavan
- Fidia Farmaceutici S.p.A., Via Ponte della Fabbrica 3/A, Abano Terme (PD), 35031, Italy
| | - Carlo Barbera
- Fidia Farmaceutici S.p.A., Via Ponte della Fabbrica 3/A, Abano Terme (PD), 35031, Italy
| | - Alba Di Lucia
- Fidia Farmaceutici S.p.A., Via Ponte della Fabbrica 3/A, Abano Terme (PD), 35031, Italy
| | - Michael D Menger
- Institute for Clinical and Experimental Surgery, Saarland University, Kirrberger Straße 100, Building 65 and 66, D-66421, Homburg, Germany
| | - Matthias W Laschke
- Institute for Clinical and Experimental Surgery, Saarland University, Kirrberger Straße 100, Building 65 and 66, D-66421, Homburg, Germany
| | - Magali Cucchiarini
- Center of Experimental Orthopaedics, Saarland University, Kirrberger Straße 100, Building 37, D-66421, Homburg, Germany
| | - Devis Galesso
- Fidia Farmaceutici S.p.A., Via Ponte della Fabbrica 3/A, Abano Terme (PD), 35031, Italy
| | - Henning Madry
- Center of Experimental Orthopaedics, Saarland University, Kirrberger Straße 100, Building 37, D-66421, Homburg, Germany
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8
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Schrenker S, Cucchiarini M, Goebel L, Oláh T, Venkatesan JK, Schmitt G, Speicher-Mentges S, Maihöfer J, Gao L, Zurakowski D, Menger MD, Laschke MW, Madry H. In vivo rAAV-mediated human TGF-β overexpression reduces perifocal osteoarthritis and improves osteochondral repair in a large animal model at one year. Osteoarthritis Cartilage 2023; 31:467-481. [PMID: 36481450 DOI: 10.1016/j.joca.2022.11.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 09/20/2022] [Accepted: 11/03/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Osteoarthritis (OA) is a serious consequence of focal osteochondral defects. Gene transfer of human transforming growth factor beta (hTGF-β) with recombinant adeno-associated virus (rAAV) vectors offers a strategy to improve osteochondral repair. However, the long-term in vivo effects of such rAAV-mediated TGF-β overexpression including its potential benefits on OA development remain unknown. METHOD Focal osteochondral defects in minipig knees received rAAV-lacZ (control) or rAAV-hTGF-β in vivo. After one year, osteochondral repair and perifocal OA were visualized using validated macroscopic scoring, ultra-high-field MRI at 9.4 T, and micro-CT. A quantitative estimation of the cellular densities and a validated semi-quantitative scoring of histological and immunohistological parameters completed the analysis of microarchitectural parameters. RESULTS Direct rAAV-hTGF-β application induced and maintained significantly improved defect filling and safranin O staining intensity and overall cartilage repair at one year in vivo. In addition, rAAV-hTGF-β led to significantly higher chondrocyte densities within the cartilaginous repair tissue without affecting chondrocyte hypertrophy and minimized subarticular trabecular separation. Of note, rAAV-hTGF-β significantly improved the adjacent cartilage structure and chondrocyte density and reduced overall perifocal OA development after one year in vivo. CONCLUSIONS rAAV-hTGF-β treatment improves long-term osteochondral repair and delays the progression of perifocal OA in a translational model. These findings have considerable potential for targeted molecular approaches to treat focal osteochondral defects.
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Affiliation(s)
- S Schrenker
- Center of Experimental Orthopaedics, Saarland University and Saarland University Medical Center, 66421, Homburg, Saar, Germany.
| | - M Cucchiarini
- Center of Experimental Orthopaedics, Saarland University and Saarland University Medical Center, 66421, Homburg, Saar, Germany.
| | - L Goebel
- Center of Experimental Orthopaedics, Saarland University and Saarland University Medical Center, 66421, Homburg, Saar, Germany.
| | - T Oláh
- Center of Experimental Orthopaedics, Saarland University and Saarland University Medical Center, 66421, Homburg, Saar, Germany.
| | - J K Venkatesan
- Center of Experimental Orthopaedics, Saarland University and Saarland University Medical Center, 66421, Homburg, Saar, Germany.
| | - G Schmitt
- Center of Experimental Orthopaedics, Saarland University and Saarland University Medical Center, 66421, Homburg, Saar, Germany.
| | - S Speicher-Mentges
- Center of Experimental Orthopaedics, Saarland University and Saarland University Medical Center, 66421, Homburg, Saar, Germany.
| | - J Maihöfer
- Center of Experimental Orthopaedics, Saarland University and Saarland University Medical Center, 66421, Homburg, Saar, Germany.
| | - L Gao
- Center of Experimental Orthopaedics, Saarland University and Saarland University Medical Center, 66421, Homburg, Saar, Germany.
| | - D Zurakowski
- Departments of Anesthesia and Surgery, Children's Hospital Boston, Harvard Medical School, Boston, MA, 02115, USA.
| | - M D Menger
- Institute for Clinical & Experimental Surgery, Saarland University, 66421, Homburg, Saar, Germany.
| | - M W Laschke
- Institute for Clinical & Experimental Surgery, Saarland University, 66421, Homburg, Saar, Germany.
| | - H Madry
- Center of Experimental Orthopaedics, Saarland University and Saarland University Medical Center, 66421, Homburg, Saar, Germany.
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9
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Wang S, Ma J, Zhao X, Xue Y, Liu W, Huang H, Zhang L, Tian A, Ma X. The Osteoarthritis Natural Progress and Changes in Intraosseous Pressure of the Guinea Pig Model in Different Degeneration Stages. Orthop Surg 2022; 14:3036-3046. [PMID: 36168980 DOI: 10.1111/os.13496] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/12/2022] [Accepted: 08/13/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Articular cartilage and subchondral bone changes during the pathological progress of knee osteoarthritis (KOA) is a key event marking the development of the disease. The age varying alteration patterns within entire osteochondral unit remains poorly understood. The purpose of this study was to find a reasonable age range of the Dunkin-Hartley guinea pig model for the studying of KOA pathological process, and to investigate Intraosseous pressure (IOP) in the process during different degeneration stages of KOA. METHODS Male Dunkin-Hartley guinea pigs were selected and divided into groups of 3, 6, 9, 12, 18 months old by age, 10 in each group. All knees underwent imaging examination including X-ray, Micro-CT and MRI. Observed the imaging findings with the use of Kellgren-Lawrence (K-L) classification and knee osteoarthritis MRI scores. Measured the IOP of distal femur (DF) and proximal tibia (PT) in each group, and observed the differences of bilateral tibiofemoral articular cartilage in histological and immunohistochemistry, staining results were evaluated by using Mankin's score. Analysis of variance (ANOVA) and t-tests were used to compare the differences indicators between groups. RESULTS With the increase of age, changes in X-ray, Micro-CT and MRI imaging findings and pathological staining results of articular cartilage in all stages were consistent with the changing of degenerative KOA process. The IOP of DF and PT increased gradually with age, and reached its peak in 12-month age group, and then gradually decreased, there was a statistically significant difference of IOP between each group. The IOP of DF was slightly higher than that of PT, but the difference was not statistically significant. CONCLUSION Dunkin-Hartley guinea pigs can be used as an animal model to study different pathological stages of KOA. There might be a correlation between the changes of IOP and the pathological progress of articular cartilage and subchondral bone in DF and PT.
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Affiliation(s)
- Shuo Wang
- Orthopaedics Institute of Tianjin, Tianjin Hospital, Tianjin University, Tianjin, China.,Department of Orthopaedics, Chinese People's Liberation Army Joint Logistics Support Force Tianjin Rehabilitation Center (Former No. 464 Hospital of People's Liberation Army), Tianjin, China
| | - Jianxiong Ma
- Orthopaedics Institute of Tianjin, Tianjin Hospital, Tianjin University, Tianjin, China
| | - Xingwen Zhao
- Orthopaedics Institute of Tianjin, Tianjin Hospital, Tianjin University, Tianjin, China
| | - Yuan Xue
- Department of Orthopaedics, Tianjin Medical University General Hospital, Tianjin, China
| | - Wei Liu
- Department of Orthopaedics, Tianjin Baodi Hospital, Tianjin, China
| | - Hongchao Huang
- Orthopaedics Institute of Tianjin, Tianjin Hospital, Tianjin University, Tianjin, China
| | - Lei Zhang
- Department of Orthopaedics, Tianjin Medical University Hospital for Metabolic Diseases, Tianjin, China
| | - Aixian Tian
- Orthopaedics Institute of Tianjin, Tianjin Hospital, Tianjin University, Tianjin, China
| | - Xinlong Ma
- Orthopaedics Institute of Tianjin, Tianjin Hospital, Tianjin University, Tianjin, China
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10
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Oláh T, Cai X, Gao L, Walter F, Pape D, Cucchiarini M, Madry H. Quantifying the Human Subchondral Trabecular Bone Microstructure in Osteoarthritis with Clinical CT. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2022; 9:e2201692. [PMID: 35670136 PMCID: PMC9376842 DOI: 10.1002/advs.202201692] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/26/2022] [Indexed: 06/12/2023]
Abstract
Osteoarthritis (OA) is characterized by critical alterations of the subchondral bone microstructure, besides the well-known cartilaginous changes. Clinical computed tomography (CT) detection of quantitative 3D microstructural subchondral bone parameters is applied to monitor changes of subchondral bone structure in different stages of human OA and is compared with micro-CT, the gold standard. Determination by clinical CT (287 µm resolution) of key microstructural parameters in tibial plateaus with mild-to-moderate and severe OA reveals strong correlations to micro-CT (35 µm), high inter- and intraobserver reliability, and small relative differences. In vivo, normal, mild-to-moderate, and severe OA are compared with clinical CT (331 µm). All approaches detect characteristic expanded trabecular structure in severe OA and fundamental microstructural correlations with clinical OA stage. Multivariate analyses at various in vivo and ex vivo imaging resolutions always reliably separate mild-to-moderate from severe OA (except mild-to-moderate OA from normal), revealing a striking similarity between 287 µm clinical and 35 µm micro-CT. Thus, accurate structural measurements using clinical CT with a resolution near the trabecular dimensions are possible. Clinical CT offers an opportunity to quantitatively monitor subchondral bone microstructure in clinical and experimental settings as an advanced tool of investigating OA and other diseases affecting bone architecture.
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Affiliation(s)
- Tamás Oláh
- Center of Experimental OrthopaedicsSaarland UniversityKirrberger Straße 100, Building 37Homburg SaarD‐66421Germany
- Cartilage Net of the Greater RegionKirrberger Straße 100, Building 37Homburg SaarD‐66421Germany
| | - Xiaoyu Cai
- Center of Experimental OrthopaedicsSaarland UniversityKirrberger Straße 100, Building 37Homburg SaarD‐66421Germany
| | - Liang Gao
- Center of Experimental OrthopaedicsSaarland UniversityKirrberger Straße 100, Building 37Homburg SaarD‐66421Germany
- Cartilage Net of the Greater RegionKirrberger Straße 100, Building 37Homburg SaarD‐66421Germany
| | - Frédéric Walter
- Clinique d'EichCentre Hospitalier de Luxembourg78 Rue d'EichLuxembourg1460Luxembourg
| | - Dietrich Pape
- Cartilage Net of the Greater RegionKirrberger Straße 100, Building 37Homburg SaarD‐66421Germany
- Clinique d'EichCentre Hospitalier de Luxembourg78 Rue d'EichLuxembourg1460Luxembourg
| | - Magali Cucchiarini
- Center of Experimental OrthopaedicsSaarland UniversityKirrberger Straße 100, Building 37Homburg SaarD‐66421Germany
- Cartilage Net of the Greater RegionKirrberger Straße 100, Building 37Homburg SaarD‐66421Germany
| | - Henning Madry
- Center of Experimental OrthopaedicsSaarland UniversityKirrberger Straße 100, Building 37Homburg SaarD‐66421Germany
- Cartilage Net of the Greater RegionKirrberger Straße 100, Building 37Homburg SaarD‐66421Germany
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11
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Madry H. Surgical therapy in osteoarthritis. Osteoarthritis Cartilage 2022; 30:1019-1034. [PMID: 35183776 DOI: 10.1016/j.joca.2022.01.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 01/14/2022] [Accepted: 01/31/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To provide an evidence-based overview of the different surgical procedures in osteoarthritis (OA). DESIGN This narrative review reports on surgical therapies (1) for severe, end stage OA and (2) of surgical options aiming to possibly reduce OA development earlier in the course of the disease. RESULTS Surgical practice guidelines provide evidence-based recommendations to assist in the clinical decision-making. Total joint arthroplasty represents the only valuable, established surgical option for severe, end stage OA. For hip and knee OA, it is by far the most common surgical procedure and provides considerable pain relief, functional restoration, and improved quality of life. Surgical therapy aiming to postpone OA essentially addresses extra- or intraarticular pre-osteoarthritic deformities, defined as congenital or acquired disturbances of the joint structure that adversely affect its function. Approaches in this category include osteotomies and different cartilage repair procedures such as osteochondral autograft and allograft transfer, marrow stimulation techniques, and autologous chondrocyte implantation. However, they are not only less commonly performed than arthroplasty, but the scientific clinical evidence in favour of this type of surgery to reduce the long-term risk of developing OA is considerably reduced. CONCLUSION Total knee and hip arthroplasty are two of the most successful procedures in all of medicine. As the progression of this insidious disease is often asymptomatic and slow, it is imperative to judge reparative procedures at their potential to reduce OA development at long-term, besides their primary clinical outcomes. Evidence-based guidelines provide a valuable tool for high-quality surgical decision making in OA.
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Affiliation(s)
- H Madry
- Institute of Experimental Orthopaedics, Saarland University, Homburg, Saar, Germany; Department of Orthopaedic Surgery, Saarland University Medical Center, Homburg, Saar, Germany.
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12
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Yoshioka NK, Young GM, Khajuria DK, Karuppagounder V, Pinamont WJ, Fanburg-Smith JC, Abraham T, Elbarbary RA, Kamal F. Structural changes in the collagen network of joint tissues in late stages of murine OA. Sci Rep 2022; 12:9159. [PMID: 35650306 PMCID: PMC9160297 DOI: 10.1038/s41598-022-13062-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 04/28/2022] [Indexed: 11/23/2022] Open
Abstract
Osteoarthritis (OA) is the most prevalent degenerative joint disease, resulting in joint pain, impaired movement, and structural changes. As the ability of joint tissue to resist stress is mainly imparted by fibrillar collagens in the extracellular matrix, changes in the composition and structure of collagen fibers contribute to the pathological remodeling observed in OA joints that includes cartilage degeneration, subchondral bone (SCB) sclerosis, and meniscal damage. Using the established OA model of destabilization of the medial meniscus (DMM) in C57BL/6J mice, we performed a comprehensive analysis of the content and structure of collagen fibers in the articular cartilage, subchondral bone, and menisci using complementary techniques, which included second harmonic generation microscopy and immunofluorescence staining. We found that regions exposed to increased mechanical stress in OA mice, typically closest to the site of injury, had increased collagen fiber thickness, dysregulated fiber formation, and tissue specific changes in collagen I and II (Col I and Col II) expression. In cartilage, OA was associated with decreased Col II expression in all regions, and increased Col I expression in the anterior and posterior regions. Col I fiber thickness was increased in all regions with disorganization in the center region. In the superficial SCB, all regions exhibited increased Col I expression and fiber thickness in OA mice; no changes were detected in the deeper regions of the subchondral bone except for increased Col I fiber thickness. In the menisci, OA led to increased Col I and Col II expression in the vascular and avascular regions of the anterior meniscus with increased Col I fiber thickness in these regions. Similar changes were observed only in the vascular region of the posterior meniscus. Our findings provide, for the first time, comprehensive insights into the microarchitectural changes of extracellular matrix in OA and serve as guidelines for studies investigating therapies that target collagenous changes as means to impede the progression of osteoarthritis.
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Affiliation(s)
- Natalie K Yoshioka
- Center for Orthopedic Research and Translational Sciences (CORTS), Penn State College of Medicine, Hershey, PA, USA
- Department of Orthopedics and Rehabilitation, Penn State College of Medicine, Hershey, PA, USA
| | - Gregory M Young
- Center for Orthopedic Research and Translational Sciences (CORTS), Penn State College of Medicine, Hershey, PA, USA
- Department of Orthopedics and Rehabilitation, Penn State College of Medicine, Hershey, PA, USA
| | - Deepak Kumar Khajuria
- Center for Orthopedic Research and Translational Sciences (CORTS), Penn State College of Medicine, Hershey, PA, USA
- Department of Orthopedics and Rehabilitation, Penn State College of Medicine, Hershey, PA, USA
| | - Vengadeshprabhu Karuppagounder
- Center for Orthopedic Research and Translational Sciences (CORTS), Penn State College of Medicine, Hershey, PA, USA
- Department of Orthopedics and Rehabilitation, Penn State College of Medicine, Hershey, PA, USA
| | - William J Pinamont
- Center for Orthopedic Research and Translational Sciences (CORTS), Penn State College of Medicine, Hershey, PA, USA
- Department of Orthopedics and Rehabilitation, Penn State College of Medicine, Hershey, PA, USA
| | - Julie C Fanburg-Smith
- Department of Pathology, Penn State Health/Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Thomas Abraham
- Department of Neural and Behavioral Science, Penn State University College of Medicine, Hershey, PA, USA
- Microscopy Imaging Facility, Penn State University College of Medicine, Hershey, PA, USA
| | - Reyad A Elbarbary
- Center for Orthopedic Research and Translational Sciences (CORTS), Penn State College of Medicine, Hershey, PA, USA.
- Department of Orthopedics and Rehabilitation, Penn State College of Medicine, Hershey, PA, USA.
- Department of Biochemistry and Molecular Biology, Penn State College of Medicine, Hershey, PA, USA.
| | - Fadia Kamal
- Center for Orthopedic Research and Translational Sciences (CORTS), Penn State College of Medicine, Hershey, PA, USA.
- Department of Orthopedics and Rehabilitation, Penn State College of Medicine, Hershey, PA, USA.
- Department of Pharmacology, Penn State College of Medicine, Hershey, PA, USA.
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13
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Michaelis JC, Oláh T, Schrenker S, Cucchiarini M, Madry H. A high‐resolution cross‐species comparative analysis of the subchondral bone provides insight into critical topographical patterns of the osteochondral unit. Clin Transl Med 2022; 12:e745. [PMID: 35220683 PMCID: PMC8882244 DOI: 10.1002/ctm2.745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/02/2022] [Accepted: 02/08/2022] [Indexed: 11/08/2022] Open
Affiliation(s)
| | - Tamás Oláh
- Center of Experimental Orthopaedics Saarland University Homburg Germany
- Cartilage Net of the Greater Region Homburg Germany
| | - Steffen Schrenker
- Center of Experimental Orthopaedics Saarland University Homburg Germany
| | - Magali Cucchiarini
- Center of Experimental Orthopaedics Saarland University Homburg Germany
- Cartilage Net of the Greater Region Homburg Germany
| | - Henning Madry
- Center of Experimental Orthopaedics Saarland University Homburg Germany
- Cartilage Net of the Greater Region Homburg Germany
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14
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Oláh T, Reinhard J, Laschke MW, Goebel LKH, Walter F, Schmitt G, Speicher-Mentges S, Menger MD, Cucchiarini M, Pape D, Madry H. Axial alignment is a critical regulator of knee osteoarthritis. Sci Transl Med 2022; 14:eabn0179. [PMID: 35080913 DOI: 10.1126/scitranslmed.abn0179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Although osteoarthritis (OA), a leading cause of disability, has been associated with joint malalignment, scientific translational evidence for this link is lacking. In a clinical case study, we provide evidence of osteochondral recovery upon unloading symptomatic isolated medial tibiofemoral knee OA associated with varus malalignment. By mapping response correlations at high resolution, we identify spatially complex degenerative changes in cartilage after overloading in a clinically relevant ovine model. We further report that unloading diminishes OA cartilage degeneration and alterations of critical parameters of the subchondral bone plate in a similar topographic fashion. Last, therapeutic unloading shifted the articular cartilage and subchondral bone phenotype to normal and restored several physiological correlations disturbed in neutral and varus OA, suggesting a protective effect on the integrity of the entire osteochondral unit. Collectively, these findings identify modifiable trajectories with considerable translational potential to reduce the burden of human OA.
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Affiliation(s)
- Tamás Oláh
- Institute of Experimental Orthopaedics and Osteoarthritis Research, Saarland University, Homburg 66421, Germany.,Cartilage Net of the Greater Region, Saarland University, Homburg 66421, Germany
| | - Jan Reinhard
- Institute of Experimental Orthopaedics and Osteoarthritis Research, Saarland University, Homburg 66421, Germany
| | - Matthias W Laschke
- Institute for Clinical and Experimental Surgery, Saarland University Medical Center and Saarland University, Homburg 66421, Germany
| | - Lars K H Goebel
- Institute of Experimental Orthopaedics and Osteoarthritis Research, Saarland University, Homburg 66421, Germany.,Cartilage Net of the Greater Region, Saarland University, Homburg 66421, Germany
| | - Frédéric Walter
- Clinique d'Eich, Centre Hospitalier de Luxembourg, Eich 1460, Luxembourg
| | - Gertrud Schmitt
- Institute of Experimental Orthopaedics and Osteoarthritis Research, Saarland University, Homburg 66421, Germany
| | - Susanne Speicher-Mentges
- Institute of Experimental Orthopaedics and Osteoarthritis Research, Saarland University, Homburg 66421, Germany
| | - Michael D Menger
- Institute for Clinical and Experimental Surgery, Saarland University Medical Center and Saarland University, Homburg 66421, Germany
| | - Magali Cucchiarini
- Institute of Experimental Orthopaedics and Osteoarthritis Research, Saarland University, Homburg 66421, Germany.,Cartilage Net of the Greater Region, Saarland University, Homburg 66421, Germany
| | - Dietrich Pape
- Cartilage Net of the Greater Region, Saarland University, Homburg 66421, Germany.,Clinique d'Eich, Centre Hospitalier de Luxembourg, Eich 1460, Luxembourg
| | - Henning Madry
- Institute of Experimental Orthopaedics and Osteoarthritis Research, Saarland University, Homburg 66421, Germany.,Cartilage Net of the Greater Region, Saarland University, Homburg 66421, Germany
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15
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Roemer FW, Eckstein F, Duda G, Guermazi A, Maschek S, Sharma L, Wirth W. Is Laminar Cartilage Composition as Determined by T2 Relaxometry Associated with Incident and Worsening of Cartilage or Bone Marrow Abnormalities? Cartilage 2021; 13:757S-766S. [PMID: 32527154 PMCID: PMC8808850 DOI: 10.1177/1947603520932197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To test the hypothesis that superficial cartilage composition (T2) is associated with subsequent incidence or worsening of cartilage damage, and deep T2 with that of bone marrow lesions (BMLs) in knees without radiographic osteoarthritis (ROA). DESIGN A total of 201 knees from the Osteoarthritis Initiative without ROA were included: 78 from the healthy reference cohort, 60 without ROA but with risk factors, and 63 without ROA but with contralateral ROA. Year 1 (Y1) superficial and deep cartilage T2 were derived in the medial and lateral (weightbearing) femur (MF/LF) and tibia (MT/LT), using sagittal multiecho spin echo magnetic resonance images. Cartilage and BMLs were assessed in the medial (MFTJ) and lateral femorotibial joint (LFTJ) at Y1 and 3 years later. Binary logistic regression statistics were applied. RESULTS Incidence or worsening of cartilage damage was more frequent (MFTJ 15%, LFTJ 13%) than incidence or worsening of BMLs (6.0%, 4.5%). In knees with incident or worsening cartilage lesions in the MF and LT, deep layer T2 in the same plate was elevated (MF, 43.6 ± 4.0 vs. 41.3 ± 3.8 ms, P = 0.047; LT, 33.8 ± 2.3 vs. 32.0 ± 2.2 ms, P = 0.008) compared to those without. In knees with incident or worsening of BMLs in the LFTC and LT, superficial layer T2 was elevated (LFTJ, 49.6 ± 4.8 vs. 46.7 ± 3.1 ms; LT, 47.4 ± 4.9 vs. 44.0 ± 3.3 ms, both Ps = 0.04). CONCLUSIONS Contrary to our hypothesis, increased deep layer cartilage T2 was associated with subsequent worsening of cartilage damage, whereas superficial layer T2 was related to subsequent BML worsening. Yet, this relationship was observed in some, but not in all cartilage plates.
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Affiliation(s)
- Frank W. Roemer
- Quantitative Imaging Center, Department
of Radiology, Boston University School of Medicine, Boston, MA, USA
- Department of Radiology,
Friedrich-Alexander University Erlangen-Nürnberg (FAU) and Universitätsklinikum
Erlangen, Erlangen, Germany
| | - Felix Eckstein
- Chondrometrics GmbH, Ainring,
Germany
- Department of Imaging & Functional
Musculoskeletal Research, Institute of Anatomy & Cell Biology, Paracelsus
Medical University Salzburg & Nuremberg, Salzburg, Austria
- Ludwig Boltzmann Institute for Arthritis
and Rehabilitation, Paracelsus Medical University Salzburg & Nuremberg,
Salzburg, Austria
| | - Georg Duda
- Julius Wolff Institute and Berlin
Institute of Health Center for Regenerative Therapies, Charité-Universitätsmedizin,
Berlin, Germany
| | - Ali Guermazi
- Quantitative Imaging Center, Department
of Radiology, Boston University School of Medicine, Boston, MA, USA
- Department of Radiology, VA Boston
Healthcare System, West Roxbury, MA, USA
| | - Susanne Maschek
- Chondrometrics GmbH, Ainring,
Germany
- Department of Imaging & Functional
Musculoskeletal Research, Institute of Anatomy & Cell Biology, Paracelsus
Medical University Salzburg & Nuremberg, Salzburg, Austria
| | - Leena Sharma
- Division of Rheumatology, Feinberg
School of Medicine, Northwestern University, Chicago, IL, USA
| | - Wolfgang Wirth
- Chondrometrics GmbH, Ainring,
Germany
- Department of Imaging & Functional
Musculoskeletal Research, Institute of Anatomy & Cell Biology, Paracelsus
Medical University Salzburg & Nuremberg, Salzburg, Austria
- Ludwig Boltzmann Institute for Arthritis
and Rehabilitation, Paracelsus Medical University Salzburg & Nuremberg,
Salzburg, Austria
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16
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Bansal S, Meadows KD, Miller LM, Saleh KS, Patel JM, Stoeckl BD, Lemmon EA, Hast MW, Zgonis MH, Scanzello CR, Elliott DM, Mauck RL. Six-Month Outcomes of Clinically Relevant Meniscal Injury in a Large-Animal Model. Orthop J Sports Med 2021; 9:23259671211035444. [PMID: 34796238 PMCID: PMC8593308 DOI: 10.1177/23259671211035444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 05/04/2021] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The corrective procedures for meniscal injury are dependent on tear type, severity, and location. Vertical longitudinal tears are common in young and active individuals, but their natural progression and impact on osteoarthritis (OA) development are not known. Root tears are challenging and they often indicate poor outcomes, although the timing and mechanisms of initiation of joint dysfunction are poorly understood, particularly in large-animal and human models. PURPOSE/HYPOTHESIS In this study, vertical longitudinal and root tears were made in a large-animal model to determine the progression of joint-wide dysfunction. We hypothesized that OA onset and progression would depend on the extent of injury-based load disruption in the tissue, such that root tears would cause earlier and more severe changes to the joint. STUDY DESIGN Controlled laboratory study. METHODS Sham surgeries and procedures to create either vertical longitudinal or root tears were performed in juvenile Yucatan mini pigs through randomized and bilateral arthroscopic procedures. Animals were sacrificed at 1, 3, or 6 months after injury and assessed at the joint and tissue level for evidence of OA. Functional measures of joint load transfer, cartilage indentation mechanics, and meniscal tensile properties were performed, as well as histological evaluation of the cartilage, meniscus, and synovium. RESULTS Outcomes suggested a progressive and sustained degeneration of the knee joint and meniscus after root tear, as evidenced by histological analysis of the cartilage and meniscus. This occurred in spite of spontaneous reattachment of the root, suggesting that this reattachment did not fully restore the function of the native attachment. In contrast, the vertical longitudinal tear did not cause significant changes to the joint, with only mild differences compared with sham surgery at the 6-month time point. CONCLUSION Given that the root tear, which severs circumferential connectivity and load transfer, caused more intense OA compared with the circumferentially stable vertical longitudinal tear, our findings suggest that without timely and mechanically competent fixation, root tears may cause irreversible joint damage. CLINICAL RELEVANCE More generally, this new model can serve as a test bed for experimental surgical, scaffold-based, and small molecule-driven interventions after injury to prevent OA progression.
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Affiliation(s)
- Sonia Bansal
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA.,Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kyle D. Meadows
- Department of Biomedical Engineering, University of Delaware, Newark, Delaware, USA
| | - Liane M. Miller
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA
| | - Kamiel S. Saleh
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA
| | - Jay M. Patel
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA
| | - Brendan D. Stoeckl
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA
| | - Elisabeth A. Lemmon
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA
| | - Michael W. Hast
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA.,Biedermann Lab for Orthopaedic Research, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Miltiadis H. Zgonis
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA
| | - Carla R. Scanzello
- Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA.,Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Dawn M. Elliott
- Biedermann Lab for Orthopaedic Research, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Robert L. Mauck
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA.,Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Robert L. Mauck, PhD, Department of Orthopedic Surgery, University of Pennsylvania, 3450 Hamilton Walk, 371 Stemmler Hall, Philadelphia, PA 19104, USA () (Twitter: @MauckLab)
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17
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Madry H. [Therapy of osteoarthritis]. DER ORTHOPADE 2021; 50:781-784. [PMID: 34468812 PMCID: PMC8408813 DOI: 10.1007/s00132-021-04142-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/02/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Henning Madry
- Lehrstuhl für Experimentelle Orthopädie und Arthroseforschung, Institut für Experimentelle Orthopädie und Arthroseforschung, Universität des Saarlandes, Gebäude 37, Kirrberger Str. 100, 66421, Homburg/Saar, Deutschland.
- Klinik für Orthopädie und Orthopädische Chirurgie, Universitätsklinikum des Saarlandes, Homburg/Saar, Deutschland.
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18
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Haberkamp S, Oláh T, Orth P, Cucchiarini M, Madry H. Analysis of spatial osteochondral heterogeneity in advanced knee osteoarthritis exposes influence of joint alignment. Sci Transl Med 2021; 12:12/562/eaba9481. [PMID: 32967975 DOI: 10.1126/scitranslmed.aba9481] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 08/31/2020] [Indexed: 12/14/2022]
Abstract
Osteoarthritis (OA) is considerably affected by joint alignment. Here, we investigate the patterns of spatial osteochondral heterogeneity in patients with advanced varus knee OA together with clinical data. We report strong correlations of osteochondral parameters within individual topographical patterns, highlighting their fundamental and location-dependent interactions in OA. We further identify site-specific effects of varus malalignment on the lesser loaded compartment and, conversely, an unresponsive overloaded compartment. Last, we trace compensatory mechanisms to the overloaded subarticular spongiosa in patients with additional high body weight. We therefore propose to consider and to determine axial alignment in clinical trials when selecting the location to assess structural changes in OA. Together, these findings broaden the scientific basis of therapeutic load redistribution and weight loss in varus knee OA.
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Affiliation(s)
- Sophie Haberkamp
- Center of Experimental Orthopaedics, Saarland University, 66421 Homburg, Germany
| | - Tamás Oláh
- Center of Experimental Orthopaedics, Saarland University, 66421 Homburg, Germany
| | - Patrick Orth
- Center of Experimental Orthopaedics, Saarland University, 66421 Homburg, Germany
| | - Magali Cucchiarini
- Center of Experimental Orthopaedics, Saarland University, 66421 Homburg, Germany
| | - Henning Madry
- Center of Experimental Orthopaedics, Saarland University, 66421 Homburg, Germany.
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19
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Grässel S, Zaucke F, Madry H. Osteoarthritis: Novel Molecular Mechanisms Increase Our Understanding of the Disease Pathology. J Clin Med 2021; 10:jcm10091938. [PMID: 33946429 PMCID: PMC8125020 DOI: 10.3390/jcm10091938] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 12/12/2022] Open
Abstract
Although osteoarthritis (OA) is the most common musculoskeletal condition that causes significant health and social problems worldwide, its exact etiology is still unclear. With an aging and increasingly obese population, OA is becoming even more prevalent than in previous decades. Up to 35% of the world’s population over 60 years of age suffers from symptomatic (painful, disabling) OA. The disease poses a tremendous economic burden on the health-care system and society for diagnosis, treatment, sick leave, rehabilitation, and early retirement. Most patients also experience sleep disturbances, reduced capability for exercising, lifting, and walking and are less capable of working, and maintaining an independent lifestyle. For patients, the major problem is disability, resulting from joint tissue destruction and pain. So far, there is no therapy available that effectively arrests structural deterioration of cartilage and bone or is able to successfully reverse any of the existing structural defects. Here, we elucidate novel concepts and hypotheses regarding disease progression and pathology, which are relevant for understanding underlying the molecular mechanisms as a prerequisite for future therapeutic approaches. Emphasis is placed on topographical modeling of the disease, the role of proteases and cytokines in OA, and the impact of the peripheral nervous system and its neuropeptides.
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Affiliation(s)
- Susanne Grässel
- Department of Orthopaedic Surgery, Experimental Orthopaedics, Centre for Medical Biotechnology (ZMB), Bio Park 1, University of Regensburg, 93053 Regensburg, Germany
- Correspondence:
| | - Frank Zaucke
- Dr. Rolf M. Schwiete Research Unit for Osteoarthritis, Orthopedic University Hospital Friedrichsheim, 60528 Frankfurt am Main, Germany;
| | - Henning Madry
- Center of Experimental Orthopaedics, Saarland University, 66421 Homburg, Germany;
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20
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Risch M, Easley JT, McCready EG, Troyer KL, Johnson JW, Gadomski BC, McGilvray KC, Kisiday JD, Nelson BB. Mechanical, biochemical, and morphological topography of ovine knee cartilage. J Orthop Res 2021; 39:780-787. [PMID: 32833239 DOI: 10.1002/jor.24835] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/11/2020] [Accepted: 08/18/2020] [Indexed: 02/04/2023]
Abstract
The knee is the most common site for translational cartilage research in sheep, though topographic features of articular cartilage across surfaces are unspecified. We aimed to characterize the mechanical, morphological, and biochemical properties of articular cartilage across ovine knee surfaces and document variations between and within surface locations. Regions of interest (ROIs) were delineated across surfaces of 10 healthy ovine knees. Articular cartilage at each ROI was measured for creep indentation, thickness, and glycosaminoglycan (GAG) and collagen content. Variables were compared between surface locations (trochlea, and lateral [LFC] and medial [MFC] femoral condyles) and between ROIs within each surface location. Correlations between variables were also assessed. Articular surface location had a significant effect on creep (P < .0001), thickness (P < .0001), and collagen (P = .0007), but not GAG (P = .28). Significant differences in percent creep between ROIs were found within the LFC (P < .0001), MFC (P < .0001), and trochlea (P = .0002). Cartilage thickness was different between ROIs within the LFC, MFC, and trochlea (all P < .0001). The LFC (P = .002) and trochlea (P = .01) each had significant differences in GAG between ROIs. Collagen content between ROIs was different within the LFC (P = .0003), MFC (P = .0005), and trochlea (P < .0001). Collagen content was correlated with thickness (r = -.55), percent creep (r = .47), and GAG (r = -.21). Percent creep was correlated with thickness (r = -.64) and GAG (r = -.19). Topographic variations in mechanical, morphological, and biochemical properties exist across knee cartilage surfaces in sheep. Recognition of this variability is important to optimize study protocols and improve accuracy of results.
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Affiliation(s)
- Makayla Risch
- Preclinical Surgical Research Laboratory, C. Wayne McIlwraith Translational Medicine Institute, Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado
| | - Jeremiah T Easley
- Preclinical Surgical Research Laboratory, C. Wayne McIlwraith Translational Medicine Institute, Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado
| | - Erin G McCready
- Preclinical Surgical Research Laboratory, C. Wayne McIlwraith Translational Medicine Institute, Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado
| | - Kevin L Troyer
- Orthopaedic Bioengineering Research Laboratory, Department of Mechanical Engineering, Colorado State University, Fort Collins, Colorado.,Woodward, Inc., Fort Collins, Colorado
| | - James W Johnson
- Orthopaedic Bioengineering Research Laboratory, Department of Mechanical Engineering, Colorado State University, Fort Collins, Colorado
| | - Benjamin C Gadomski
- Orthopaedic Bioengineering Research Laboratory, Department of Mechanical Engineering, Colorado State University, Fort Collins, Colorado
| | - Kirk C McGilvray
- Orthopaedic Bioengineering Research Laboratory, Department of Mechanical Engineering, Colorado State University, Fort Collins, Colorado
| | - John D Kisiday
- Orthopaedic Research Center, C. Wayne McIlwraith Translational Medicine Institute, Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado
| | - Brad B Nelson
- Preclinical Surgical Research Laboratory, C. Wayne McIlwraith Translational Medicine Institute, Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado.,Orthopaedic Research Center, C. Wayne McIlwraith Translational Medicine Institute, Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado
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21
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Meng W, Gao L, Huang Z, Wang H, Wang D, Luo Z, Bai Y, Wang G, Zhou Z. Supercapsular percutaneously-assisted total hip (SuperPath) versus mini-incision posterolateral total hip arthroplasty for hip osteoarthritis: a prospective randomized controlled trial. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:392. [PMID: 33842613 PMCID: PMC8033341 DOI: 10.21037/atm-20-1793a] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background Supercapsular percutaneously-assisted total hip (SuperPath) arthroplasty has been proposed to be minimally invasive and tissue sparing, with possible superior postoperative outcomes compared with conventional approaches for total hip arthroplasty (THA). However, previous studies have underlined the shortcomings of conventional THA approaches, including higher dislocation, more blood loss, longer incisions, more tissue damage, and delayed postoperative rehabilitation. In the present study, we compared the short-term outcomes of unilateral THA with those of SuperPath and the mini-incision posterolateral approach (PLA) for hip osteoarthritis (OA). Methods Patients with unilateral hip OA were prospectively recruited and underwent either SuperPath (SuperPath group) or mini-incision PLA THA (PLA group). Perioperative status [operative time, incision length, intraoperative blood loss, soft tissue damage, and length of hospital stay (LOS)], and postoperative function outcomes, including range of motion (ROM), pain visual analog scale (VAS), and Harris Hip Score (HHS), were evaluated and compared between the groups at scheduled time points within 12 months postoperatively. Results Compared with the PLA group, the SuperPath group yielded a significantly shorter incision length (7.83 vs. 12.45 cm, P<0.001), longer operative time (102.72 vs. 66.22 min, P<0.001), more blood loss (1,007.38 vs. 844.55 mL, P=0.005), and more soft tissue damage (creatine kinase: 1,056.05 vs. 821.50 U/L, P=0.006) on postoperative day 3. The SuperPath group also showed deficient acetabular cup positioning (abduction angle: 36.94° vs. 42.66°, P=0.004) and a greater decrease in ROM (flexion: 107.66° vs. 114.44°, P=0.004; 109.83° vs. 116.11°, P=0.002; 111.66° vs. 118.88°, P<0.001) on postoperative days 1, 3, and 14, as well as severe early-term pain symptoms (pain VAS on postoperative day 3: 7.05 vs. 6.55, P=0.041). However, the LOS, C-reactive protein levels, erythrocyte sedimentation rate (within 2 weeks postoperatively), and HHS were comparable between the groups during the 12 months postoperatively. Conclusions SuperPath may be a promising, minimally invasive technique for the treatment of OA in the future. Further investigation is necessary to evidence the possible superiority of SuperPath over other conventional mini-incision THA approaches.
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Affiliation(s)
- Weikun Meng
- Department of Orthopaedics, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China.,Center of Experimental Orthopaedics, Saarland University Medical Center, Homburg/Saar, Germany.,Sino Euro Orthopaedics Network (SEON), Homburg/Saar, Germany
| | - Liang Gao
- Center of Experimental Orthopaedics, Saarland University Medical Center, Homburg/Saar, Germany.,Sino Euro Orthopaedics Network (SEON), Homburg/Saar, Germany
| | - Zhong Huang
- Department of Orthopaedics, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China.,Sino Euro Orthopaedics Network (SEON), Homburg/Saar, Germany
| | - Haoyang Wang
- Department of Orthopaedics, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Duan Wang
- Department of Orthopaedics, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Zeyu Luo
- Department of Orthopaedics, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Yang Bai
- Department of Immunization, Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Guanglin Wang
- Department of Orthopaedics, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Zongke Zhou
- Department of Orthopaedics, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
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22
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Oláh T, Cai X, Michaelis JC, Madry H. Comparative anatomy and morphology of the knee in translational models for articular cartilage disorders. Part I: Large animals. Ann Anat 2021; 235:151680. [PMID: 33548412 DOI: 10.1016/j.aanat.2021.151680] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 01/08/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND The human knee is a complex joint, and affected by a variety of articular cartilage disorders. Large animal models are critical to model the complex disease mechanisms affecting a functional joint. Species-dependent differences highly affect the results of a pre-clinical study and need to be considered, necessitating specific knowledge not only of macroscopic and microscopic anatomical and pathological aspects, but also characteristics of their individual gait and joint movements. METHODS Literature search in Pubmed. RESULTS AND DISCUSSION This narrative review summarizes the most relevant anatomical structural and functional characteristics of the knee (stifle) joints of the major translational large animal species, comprising dogs, (mini)pigs, sheep, goats, and horses in comparison with humans. Specific characteristics of each species, including kinematical gait parameters are provided. Considering these multifactorial dimensions will allow to select the appropriate model for answering the research questions in a clinically relevant fashion.
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Affiliation(s)
- Tamás Oláh
- Center of Experimental Orthopaedics, Saarland University, Homburg, Germany
| | - Xiaoyu Cai
- Center of Experimental Orthopaedics, Saarland University, Homburg, Germany
| | | | - Henning Madry
- Center of Experimental Orthopaedics, Saarland University, Homburg, Germany; Department of Orthopaedic Surgery, Saarland University Medical Center, Homburg, Germany.
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23
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Bansal S, Miller LM, Patel JM, Meadows KD, Eby MR, Saleh KS, Martin AR, Stoeckl BD, Hast M, Elliott DM, Zgonis MH, Mauck RL. Transection of the medial meniscus anterior horn results in cartilage degeneration and meniscus remodeling in a large animal model. J Orthop Res 2020; 38:2696-2708. [PMID: 32285971 PMCID: PMC7735384 DOI: 10.1002/jor.24694] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 03/06/2020] [Accepted: 03/25/2020] [Indexed: 02/04/2023]
Abstract
The meniscus plays a central load-bearing role in the knee joint. Unfortunately, meniscus injury is common and can lead to joint degeneration and osteoarthritis (OA). In small animal models, progressive degenerative changes occur with the unloading of the meniscus via destabilization of the medial meniscus (DMM). However, few large animal models of DMM exist and the joint-wide initiation of the disease has not yet been defined in these models. Thus, the goal of this study is to develop and validate a large animal model of surgically induced DMM and to use multimodal (mechanical, histological, and magnetic resonance imaging) and multiscale (joint to tissue level) quantitative measures to evaluate degeneration in both the meniscus and cartilage. DMM was achieved using an arthroscopic approach in 13 Yucatan minipigs. One month after DMM, joint contact area decreased and peak pressure increased, indicating altered load transmission as a result of meniscus destabilization. By 3 months, the joint had adapted to the injury and load transmission patterns were restored to baseline, likely due to the formation and maturation of a fibrovascular scar at the anterior aspect of the meniscus. Despite this, we found a decrease in the indentation modulus of the tibial cartilage and an increase in cartilage histopathology scores at 1 month compared to sham-operated animals; these deleterious changes persisted through 3 months. Over this same time course, meniscus remodeling was evident through decreased proteoglycan staining in DMM compared to sham menisci at both 1 and 3 months. These findings support that arthroscopic DMM results in joint degeneration in the Yucatan minipig and provide a new large animal testbed in which to evaluate therapeutics and interventions to treat post-traumatic OA that originates from a meniscal injury.
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Affiliation(s)
- Sonia Bansal
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA.,Department of Bioengineering, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Liane M. Miller
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA
| | - Jay M. Patel
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA
| | - Kyle D. Meadows
- Department of Biomedical Engineering, University of Delaware, Newark, DE 19716, USA
| | - Michael R. Eby
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA
| | - Kamiel S. Saleh
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA
| | - Anthony R. Martin
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA
| | - Brendan D. Stoeckl
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA
| | - Michael Hast
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA.,Biedermann Lab for Orthopaedic Research, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Dawn M. Elliott
- Department of Biomedical Engineering, University of Delaware, Newark, DE 19716, USA
| | - Miltiadis H. Zgonis
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA
| | - Robert L. Mauck
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA.,Department of Bioengineering, University of Pennsylvania, Philadelphia, PA 19104, USA
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24
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Ticha P, Pilawski I, Yuan X, Pan J, Tulu US, Coyac BR, Hoffmann W, Helms JA. A novel cryo-embedding method for in-depth analysis of craniofacial mini pig bone specimens. Sci Rep 2020; 10:19510. [PMID: 33177543 PMCID: PMC7658236 DOI: 10.1038/s41598-020-76336-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 10/05/2020] [Indexed: 12/21/2022] Open
Abstract
The disconnect between preclinical and clinical results underscores the imperative for establishing good animal models, then gleaning all available data on efficacy, safety, and potential toxicities associated with a device or drug. Mini pigs are a commonly used animal model for testing orthopedic and dental devices because their skeletons are large enough to accommodate human-sized implants. The challenge comes with the analyses of their hard tissues: current methods are time-consuming, destructive, and largely limited to histological observations made from the analysis of very few tissue sections. We developed and employed cryo-based methods that preserved the microarchitecture and the cellular/molecular integrity of mini pig hard tissues, then demonstrated that the results of these histological, histochemical, immunohistochemical, and dynamic histomorphometric analyses e.g., mineral apposition rates were comparable with similar data from preclinical rodent models. Thus, the ability to assess static and dynamic bone states increases the translational value of mini pig and other large animal model studies. In sum, this method represents logical means to minimize the number of animals in a study while simultaneously maximizing the amount of information collected from each specimen.
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Affiliation(s)
- Pavla Ticha
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, 1651 Page Mill Road, Palo Alto, CA, 94304, USA.,Department of Plastic Surgery, 3rd Faculty of Medicine and University Hospital Kralovske Vinohrady, Charles University in Prague, Srobarova 50, 10034, Prague 10, Czech Republic
| | - Igor Pilawski
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, 1651 Page Mill Road, Palo Alto, CA, 94304, USA
| | - Xue Yuan
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, 1651 Page Mill Road, Palo Alto, CA, 94304, USA
| | - Jie Pan
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, 1651 Page Mill Road, Palo Alto, CA, 94304, USA
| | - Ustun S Tulu
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, 1651 Page Mill Road, Palo Alto, CA, 94304, USA
| | - Benjamin R Coyac
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, 1651 Page Mill Road, Palo Alto, CA, 94304, USA
| | | | - Jill A Helms
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, 1651 Page Mill Road, Palo Alto, CA, 94304, USA.
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Ries C, Boese CK, Stürznickel J, Koehne T, Hubert J, Pastor MF, Hahn M, Meier SL, Beil FT, Püschel K, Amling M, Rolvien T. Age-related changes of micro-morphological subchondral bone properties in the healthy femoral head. Osteoarthritis Cartilage 2020; 28:1437-1447. [PMID: 32795512 DOI: 10.1016/j.joca.2020.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 07/30/2020] [Accepted: 08/03/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Alterations in the subchondral bone (SCB) are likely to play a decisive role in the development of osteoarthritis (OA). Since aging represents a major risk factor for OA, the aim of the current study was to assess the microstructural changes of the subchondral bone in the femoral head during aging. DESIGN Femoral heads and matched iliac crest biopsies of 80 individuals (age 21-99 years) were collected post-mortem. The bone microstructure of the subchondral trabecular bone as well as the cartilage thickness (Cg.Th) and subchondral bone plate thickness (SCB.Th) were quantified using histomorphometry. The different subregions of the SCB were also imaged by quantitative backscattered electron imaging (qBEI) in 31 aged cases to assess the bone mineral density distribution (BMDD). RESULTS The detected linear decline of bone volume per tissue volume (BV/TV) in the femoral head with aging (Slope, 95% CI: -0.208 to -0.109 %/yr.) was primarily due to a decrease in trabecular thickness (Tb.Th, Slope, 95% CI: -0.774 to -0.343 μm/yr). While SCB.Th declined with aging (Slope, 95% CI: -1.941 to -0.034 μm/yr), no changes in Cg.Th were detected (Slope, 95% CI: -0.001 to 0.005 mm/yr). The matrix mineralization of the subchondral bone was lower compared to the trabecular bone and also decreased with aging. CONCLUSIONS Regular changes of the SCB during aging primarily involve a reduction of Tb.Th, SCB.Th and matrix mineralization. Our findings facilitate future interpretations of early and late OA specimens to decipher the role of the SCB in OA pathogenesis.
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Affiliation(s)
- C Ries
- Department of Orthopedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Osteology and Biomechanics, University Medical Center Hamburg Eppendorf, Hamburg, Germany.
| | - C K Boese
- Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Cologne, Germany
| | - J Stürznickel
- Department of Osteology and Biomechanics, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - T Koehne
- Department of Osteology and Biomechanics, University Medical Center Hamburg Eppendorf, Hamburg, Germany; Department of Orthodontics, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - J Hubert
- Department of Orthopedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M-F Pastor
- Department of Osteology and Biomechanics, University Medical Center Hamburg Eppendorf, Hamburg, Germany; Department of Orthopedic Surgery, Medical School Hannover, DIAKOVERE Annastift, Hannover, Germany
| | - M Hahn
- Department of Osteology and Biomechanics, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - S L Meier
- Department of Osteology and Biomechanics, University Medical Center Hamburg Eppendorf, Hamburg, Germany; Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - F T Beil
- Department of Orthopedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - K Püschel
- Department of Forensic Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Amling
- Department of Osteology and Biomechanics, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - T Rolvien
- Department of Orthopedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Osteology and Biomechanics, University Medical Center Hamburg Eppendorf, Hamburg, Germany.
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Wang K, Li F, Yuan Y, Shan L, Cui Y, Qu J, Lian F. Synovial Mesenchymal Stem Cell-Derived EV-Packaged miR-31 Downregulates Histone Demethylase KDM2A to Prevent Knee Osteoarthritis. MOLECULAR THERAPY. NUCLEIC ACIDS 2020; 22:1078-1091. [PMID: 33294294 PMCID: PMC7691165 DOI: 10.1016/j.omtn.2020.09.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 09/11/2020] [Indexed: 12/26/2022]
Abstract
Extracellular vesicles (EVs) derived from mesenchymal stem cells (MSCs) have emerged as important mediators of intercellular communication in response to cartilage damage. In this study, we sought to characterize the inhibitory role of microRNA (miR)-31 encapsulated in synovial MSC (SMSC)-derived EVs in knee osteoarthritis (OA). The expression of miR-31, lysine demethylase 2A (KDM2A), E2F transcription factor 1 (E2F1), and pituitary tumor transforming gene 1 (PTTG1) was validated in cartilage tissues of knee OA patients. Following SMSC-EV extraction and identification, chondrocytes with the miR-31 inhibitor were added with SMSC-EVs, whereupon the effects of miR-31 on proliferation and migration of chondrocytes were assessed. The interaction among miR-31, KDM2A, E2F1, and PTTG1 in chondrocyte activities was probed in vitro, along with an in vivo mouse knee OA model. We identified downregulated miR-31, E2F1, and PTTG1 and upregulated KDM2A in cartilage tissues of knee OA patients. SMSC-EV-packaged miR-31 potentiated chondrocyte proliferation and migration as well as cartilage formation by targeting KDM2A. Mechanistically, KDM2A bound to the transcription factor E2F1 and inhibited its transcriptional activity. Enrichment of E2F1 in the PTTG1 promoter region activated PTTG1 transcription, accelerating chondrocyte proliferation and migration. SMSC-EVs and EVs from miR-31-overexpressed SMSCs alleviated cartilage damage and inflammation in knee joints in vivo. SMSC-EV-encapsulated miR-31 ameliorates knee OA via the KDM2A/E2F1/PTTG1 axis.
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Affiliation(s)
- Kunpeng Wang
- Department of Orthopaedics, The Fourth Hospital of Harbin Medical University, Harbin 150001, P.R. China
| | - Feng Li
- Department of Orthopaedics, the Second Hospital of Harbin Medical University, Harbin 150001, P.R. P. China
| | - Yuan Yuan
- Department of Obstetrics, The Fourth Hospital of Harbin Medical University, Harbin 150001, P.R. China
| | - Liang Shan
- Department of Outpatient, The Fourth Hospital of Harbin Medical University, Harbin 150001, P.R. China
| | - Yong Cui
- Department of Orthopaedics, The Fourth Hospital of Harbin Medical University, Harbin 150001, P.R. China
| | - Jing Qu
- Department of Orthopaedics, The Fourth Hospital of Harbin Medical University, Harbin 150001, P.R. China
| | - Feng Lian
- Department of Orthopaedics, The Fourth Hospital of Harbin Medical University, Harbin 150001, P.R. China
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Babel H, Omoumi P, Andriacchi TP, Jolles BM, Favre J. New insight on the subchondral bone and cartilage functional unit: Bone mineral density and cartilage thickness are spatially correlated in non-osteoarthritic femoral condyles. OSTEOARTHRITIS AND CARTILAGE OPEN 2020; 2:100079. [DOI: 10.1016/j.ocarto.2020.100079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 05/27/2020] [Indexed: 01/02/2023] Open
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28
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Gonarthrose. ARTHROSKOPIE 2020. [DOI: 10.1007/s00142-020-00362-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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