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Marchiori G, Berni M, Boi M, Filardo G. Cartilage mechanical tests: Evolution of current standards for cartilage repair and tissue engineering. A literature review. Clin Biomech (Bristol, Avon) 2019; 68:58-72. [PMID: 31158591 DOI: 10.1016/j.clinbiomech.2019.05.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 05/07/2019] [Accepted: 05/10/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Repair procedures and tissue engineering are solutions available in the clinical practice for the treatment of damaged articular cartilage. Regulatory bodies defined the requirements that any products, intended to regenerate cartilage, should have to be applied. In order to verify these requirements, the Food and Drug Administration (FDA, USA) and the International Standard Organization (ISO) indicated some Standard tests, which allow evaluating, in a reproducible way, the performances of scaffolds/treatments for cartilage tissue regeneration. METHODS A review of the literature about cartilage mechanical characterization found 394 studies, from 1970 to date. They were classified by material (simulated/animal/human cartilage) and method (theoretical/applied; static/dynamic; standard/non-standard study), and analyzed by nation and year of publication. FINDINGS While Standard methods for cartilage mechanical characterization still refer to studies developed in the eighties, expertise and interest on cartilage mechanics research are evolving continuously and internationally, with studies both in vitro - on human and animal tissues - and in silico, dealing with tissue function and modelling, using static and dynamic loading conditions. INTERPRETATION there is a consensus on the importance of mechanical characterization that should be considered to evaluate cartilage treatments. Still, relative Standards need to be updated to describe advanced constructs and procedures for cartilage regeneration in a more exhaustive way. The use of the more complex, fibre-reinforced biphasic model, instead of the standard simple biphasic model, to describe cartilage response to loading, and the standardisation of dynamic tests can represent a first step in this direction.
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Affiliation(s)
- Gregorio Marchiori
- IRCCS Istituto Ortopedico Rizzoli, Laboratory of Biomechanics and Technology Innovation, Via di Barbiano 1/10, 40136 Bologna, Italy.
| | - Matteo Berni
- IRCCS Istituto Ortopedico Rizzoli, Laboratory of Biomechanics and Technology Innovation, Via di Barbiano 1/10, 40136 Bologna, Italy
| | - Marco Boi
- IRCCS Istituto Ortopedico Rizzoli, NanoBiotechnology Laboratory (NaBi), Via di Barbiano 1/10, 40136 Bologna, Italy
| | - Giuseppe Filardo
- IRCCS Istituto Ortopedico Rizzoli, NanoBiotechnology Laboratory (NaBi), Via di Barbiano 1/10, 40136 Bologna, Italy; IRCCS Istituto Ortopedico Rizzoli, Applied and Translational Research Center, Via di Barbiano 1/10, 40136 Bologna, Italy
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Moshtagh PR, Pouran B, van Tiel J, Rauker J, Zuiddam MR, Arbabi V, Korthagen NM, Weinans H, Zadpoor AA. Micro- and nano-mechanics of osteoarthritic cartilage: The effects of tonicity and disease severity. J Mech Behav Biomed Mater 2016; 59:561-571. [PMID: 27043052 DOI: 10.1016/j.jmbbm.2016.03.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 02/23/2016] [Accepted: 03/09/2016] [Indexed: 10/22/2022]
Abstract
The present study aims to discover the contribution of glycosaminoglycans (GAGs) and collagen fibers to the mechanical properties of the osteoarthritic (OA) cartilage tissue. We used nanoindentation experiments to understand the mechanical behavior of mild and severe osteoarthritic cartilage at micro- and nano-scale at different swelling conditions. Contrast enhanced micro-computed tomography (EPIC-μCT) was used to confirm that mild OA specimens had significantly higher GAGs content compared to severe OA specimens. In micro-scale, the semi-equilibrium modulus of mild OA specimens significantly dropped after immersion in a hypertonic solution and at nano-scale, the histograms of the measured elastic modulus revealed three to four components. Comparing the peaks with those observed for healthy cartilage in a previous study indicated that the first and third peaks represent the mechanical properties of GAGs and the collagen network. The third peak shows considerably stiffer elastic modulus for mild OA samples as compared to the severe OA samples in isotonic conditions. Furthermore, this peak clearly dropped when the tonicity increased, indicating the loss of collagen (pre-) stress in the shrunk specimen. Our observations support the association of the third peak with the collagen network. However, our results did not provide any direct evidence to support the association of the first peak with GAGs. For severe OA specimens, the peak associated with the collagen network did not drop when the tonicity increased, indicating a change in the response of OA cartilage to hypertonicity, likely collagen damage, as the disease progresses to its latest stages.
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Affiliation(s)
- P R Moshtagh
- Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology (TU Delft), Mekelweg 2, 2628 CD, Delft, The Netherlands; Department of Orthopaedics, University Medical Center Utrecht, Q.03.2.103-1, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
| | - B Pouran
- Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology (TU Delft), Mekelweg 2, 2628 CD, Delft, The Netherlands; Department of Orthopaedics, University Medical Center Utrecht, Q.03.2.103-1, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
| | - J van Tiel
- Department of Orthopaedics and Radiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
| | - J Rauker
- Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology (TU Delft), Mekelweg 2, 2628 CD, Delft, The Netherlands.
| | - M R Zuiddam
- Kavli Institute of Nanoscience, Delft University of Technology, Lorentzweg 1, 2628 CJ, Delft, The Netherlands.
| | - V Arbabi
- Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology (TU Delft), Mekelweg 2, 2628 CD, Delft, The Netherlands.
| | - N M Korthagen
- Department of Orthopaedics, University Medical Center Utrecht, Q.03.2.103-1, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands; Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.
| | - H Weinans
- Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology (TU Delft), Mekelweg 2, 2628 CD, Delft, The Netherlands; Department of Orthopaedics, University Medical Center Utrecht, Q.03.2.103-1, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands; Department of Rheumatology, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - A A Zadpoor
- Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology (TU Delft), Mekelweg 2, 2628 CD, Delft, The Netherlands.
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