Spectrocolorimetric assessment of cartilage plugs after autologous osteochondral grafting: correlations between color indices and histological findings in a rabbit model

Intrinsic fluorescence and mechanical testing of articular cartilage in human patients with osteoarthritis

The degeneration of articular cartilage is the main cause of osteoarthritis (OA), a common cause of disability among elderly patients. The aim of this study is to understand the correlation between intrinsic fluorescence of articular cartilage and its biomechanical properties in patients with osteoarthritis. Cylindrical samples of articular cartilage 6 mm in diameter were extracted via biopsy punch from the femoral condyles of 6 patients with advanced OA undergoing knee replacement surgery. The mechanical stiffness and fluorescence of each cartilage plug were measured by indentation test and spectrofluorometry. Maps of fluorescence intensity, at excitation/emission wavelengths of 240-520/290-530 nm, were used to identify wavelengths of interest. The mechanical stiffness and fluorescence intensity were correlated using a Spearman analysis. The excitation/emission maps demonstrated three fluorescence peaks at excitation/emission wavelength pairs 330/390, 350/430 and 370/460 nm. The best correlation between the fluorescence intensity and stiffness of cartilage was obtained for the 330 nm excitation band [R=0.82, p=0.04]. The intrinsic fluorescence of articular cartilage may have application in optically assessing the state of cartilage in patients with osteoarthritis.

Optical spectral reflectance of human articular cartilage - relationships with tissue structure, composition and mechanical properties

The information from spectral reflectance of articular cartilage has been related to the integrity of the tissue. This study explores more in detail the interrelations between the cartilage composition, structure and mechanical properties, and optical spectral reflectance. Using human osteochondral samples the reflectance spectral images of articular cartilage were captured and analyzed by using CIELAB color space as well as principal component analysis. With both analysis methods statistically significant correlations were observed between the reflectance and histological integrity, as assessed by Mankin scoring, tissue proteoglycan content and dynamic modulus. In thick human cartilage, the reflectance was found to be independent of the cartilage thickness, suggesting negligible influence of the underlying subchondral bone. Based on the present results diagnostically relevant information on cartilage quality can be extracted using optical spectral reflectance measurements. These measurements could be feasible during arthroscopic surgery when more in-depth information of the properties of articular cartilage is needed.

Optical spectral imaging of degeneration of articular cartilage

Osteoarthritis (OA) is a common musculoskeletal disorder often diagnosed during arthroscopy. In OA, visual color changes of the articular cartilage surface are typically observed. We demonstrate in vitro the potential of visible light spectral imaging (420 to 720 nm) to quantificate these color changes. Intact bovine articular cartilage samples (n=26) are degraded both enzymatically using the collagenase and mechanically using the emery paper (P60 grit, 269 microm particle size). Spectral images are analyzed by using standard CIELAB color coordinates and the principal component analysis (PCA). After collagenase digestion, changes in the CIELAB coordinates and projection of the spectra to PCA eigenvector are statistically significant (p<0.05). After mechanical degradation, the grinding tracks could not be visualized in the RGB presentation, i.e., in the visual appearance of the sample to the naked eye under the D65 illumination. However, after projecting to the chosen eigenvector, the grinding tracks are revealed. The tracks are also seen by using only one wavelength, i.e., 469 nm, however, the contrast in the projection image is 1.6 to 2.5 times higher. Our results support the idea that the spectral imaging can be used for evaluation of the integrity of the cartilage surface.

Spectrocolorimetric evaluation of human articular cartilage

OBJECTIVE

The aim of this study was to investigate whether human articular cartilage can be quantitatively evaluated using a spectrocolorimeter.

MATERIALS AND METHODS

Human articular cartilage specimens were analyzed using a spectrocolorimeter after macroscopic evaluation using the Outerbridge classification. The cartilage characteristics were examined, the L*, a*, b* colorimetric system, the spectral reflectance distribution and the yellow/red spectral reflectance percentage (Y/R SRP). Moreover, the results of the spectrocolorimetric evaluation were compared with the histological score described by Mankin et al.

RESULTS

There were significant differences among the macroscopic four grades in the L*, a* and Y/R SRP values. The spectral reflectance distribution of grade 1 cartilage exhibited a gradual increase in the spectral reflectance ratio as the wavelength increased. The spectral reflectance curves of grades 2 to 4 cartilage had dips at a wavelength of around 580 nm. Across all the measured wavelengths, there were lower reflectance ratios with the progression of cartilage degeneration. Moreover, correlations were observed between the spectrocolorimetric values and Mankin score. A strong relationship existed between Mankin score and he Y/R SRP values.

CONCLUSIONS

The present study is the first to clearly demonstrate the relationship between spectrocolorimetric evaluation and the degeneration of human articular cartilage. The spectrocolorimeter may be a new quantitative evaluation tool for articular cartilage with clinical potential.

Spectrocolorimetric evaluation of repaired articular cartilage after a microfracture

Background

In clinical practice, surgeons differentiate color changes in repaired cartilage compared with surrounding intact cartilage, but cannot quantify these color changes. Objective assessments are required. A spectrocolorimeter was used to evaluate whether intact and repaired cartilage can be quantified.

Findings

We investigated the use of a spectrocolorimeter and the application of two color models (L* a* b* colorimetric system and spectral reflectance distribution) to describe and quantify articular cartilage. In this study, we measured the colors of intact and repaired cartilage after a microfracture. Histologically, the repaired cartilage was a mixture of fibrocartilage and hyaline cartilage. In the L* a* b* colorimetric system, the L* and a* values recovered to close to the values of intact cartilage, whereas the b* value decreased over time after the operation. Regarding the spectral reflectance distribution at 12 weeks after the operation, the repaired cartilage had a higher spectral reflectance ratio than intact cartilage between wavelengths of 400 to 470 nm.

Conclusion

This study reports the first results regarding the relationship between spectrocolorimetric evaluation and the histological findings of repair cartilage after a microfracture. Our findings demonstrate the ability of spectrocolorimetric measurement to judge the repair cartilage after treatment on the basis of objective data such as the L*, a* and b* values and the SRP as a coincidence index of the spectral reflectance curve.