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Jahn J, Halm-Pozniak A, Klutzny M, Noll M, Stärke C, Lohmann CH, Bertrand J. Collagen 1 gel may improve the regenerative capacity of minced adult and preosteoarthritic cartilage. Knee Surg Sports Traumatol Arthrosc 2024; 32:821-828. [PMID: 38415965 DOI: 10.1002/ksa.12101] [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: 11/02/2023] [Revised: 02/10/2024] [Accepted: 02/12/2024] [Indexed: 02/29/2024]
Abstract
PURPOSE Minced cartilage implantation (MCI) is an evolving technique for the treatment of osteochondral lesions. It was hypothesised that mincing of cartilage may affect chondrocyte viability and phenotype and that embedding in collagen 1 gel results in an improved outcome. The objective of this study was to evaluate the impact of cartilage mincing and whether collagen 1 gel mediates beneficial effects on the chondrocyte phenotype and viability. METHODS Human cartilage samples from 11 patients undergoing total knee arthroplasty were collected and minced according to the MCI protocol. Minced cartilage was cultured for 1 week with and without embedding in collagen 1 gel and was compared with unminced cartilage flakes as control. Quantitative reverse transcription-PCR and immunohistochemical staining for the chondrocyte marker genes SOX9, COL2, ACAN, COL10 and MMP13 were used to examine the chondrocyte phenotype. Cell death was assessed by the terminal deoxynucleotidyl transferase dUTP nick-end labeling assay. RESULTS Increased chondrocyte cell death of cultured cartilage after mincing was observed. Chondrocytes from minced cartilage exhibited significantly decreased expression and protein levels of homeostatic and hypertrophic chondrocyte markers. Embedding in collagen 1 gel showed no positive effect on viability. However, remarkable is the increased expression of ACAN and the preserved protein level of SOX9 in the collagen 1-embedded minced cartilage. CONCLUSIONS This study shows that the mincing of cartilage leads to increased chondrocyte death and decreased expression of chondrocyte phenotypic marker genes after 7 days. The use of collagen 1 gel may improve the stability of the phenotype, which needs to be further elucidated. LEVEL OF EVIDENCE Level III (therapeutic).
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Affiliation(s)
- Jannik Jahn
- Department of Orthopedic Surgery, Otto-von-Guericke University, Magdeburg, Germany
| | | | - Marcus Klutzny
- Department of Orthopedic Surgery, Otto-von-Guericke University, Magdeburg, Germany
| | - Michaela Noll
- Department of Orthopedic Surgery, Otto-von-Guericke University, Magdeburg, Germany
- Meidrix biomedicals GmbH, Esslingen, Germany
| | - Christian Stärke
- Department of Orthopedic Surgery, Otto-von-Guericke University, Magdeburg, Germany
| | - Christoph H Lohmann
- Department of Orthopedic Surgery, Otto-von-Guericke University, Magdeburg, Germany
| | - Jessica Bertrand
- Department of Orthopedic Surgery, Otto-von-Guericke University, Magdeburg, Germany
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Nakagawa S, Ando W, Shimomura K, Hart DA, Hanai H, Jacob G, Chijimatsu R, Yarimitu S, Fujie H, Okada S, Tsumaki N, Nakamura N. Repair of osteochondral defects: efficacy of a tissue-engineered hybrid implant containing both human MSC and human iPSC-cartilaginous particles. NPJ Regen Med 2023; 8:59. [PMID: 37857652 PMCID: PMC10587071 DOI: 10.1038/s41536-023-00335-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 10/09/2023] [Indexed: 10/21/2023] Open
Abstract
Both mesenchymal stromal cells (MSC) and induced pluripotent stem cells (iPSC) offer the potential for repair of damaged connective tissues. The use of hybrid implants containing both human MSC and iPSC was investigated to assess their combined potential to yield enhanced repair of osteochondral defects. Human iPSC-CP wrapped with tissue engineered constructs (TEC) containing human MSC attained secure defect filling with good integration to adjacent tissue in a rat osteochondral injury model. The presence of living MSC in the hybrid implants was required for effective biphasic osteochondral repair. Thus, the TEC component of such hybrid implants serves several critical functions including, adhesion to the defect site via the matrix and facilitation of the repair via live MSC, as well as enhanced angiogenesis and neovascularization. Based on these encouraging studies, such hybrid implants may offer an effective future intervention for repair of complex osteochondral defects.
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Affiliation(s)
- Shinichi Nakagawa
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, 565-0871, Japan
| | - Wataru Ando
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, 565-0871, Japan.
- Department of Orthopaedic Surgery, Kansai Rosai Hospital, Amagasaki, 660-8511, Japan.
| | - Kazunori Shimomura
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, 565-0871, Japan
| | - David A Hart
- McCaig Institute for Bone and Joint Health, Department of Surgery and Faculty of Kinesiology, University of Calgary, Calgary, AB, T2N 4N1, Canada
| | - Hiroto Hanai
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, 565-0871, Japan
| | - George Jacob
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, 565-0871, Japan
| | - Ryota Chijimatsu
- Department of Medical Data Science, Osaka University Graduate School of Medicine, Suita, 565-0871, Japan
| | - Seido Yarimitu
- Department of Mechanical Systems Engineering, Faculty of Systems Design, Tokyo Metropolitan University, Hachioji, 192-0364, Japan
| | - Hiromichi Fujie
- Department of Mechanical Systems Engineering, Faculty of Systems Design, Tokyo Metropolitan University, Hachioji, 192-0364, Japan
| | - Seiji Okada
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, 565-0871, Japan
| | - Noriyuki Tsumaki
- Department of Clinical Application, Center for iPS Cell Research and Application, Kyoto University, Kyoto, 606-8507, Japan
- Department of Tissue Biochemistry, Graduate School of Medicine and Frontier Biosciences, Osaka University, Suita, 565-0871, Japan
| | - Norimasa Nakamura
- Institute for Medical Science in Sports, Osaka Health Science University, Osaka, 530-0043, Japan
- Center for Advanced Medical Engineering and Informatics, Osaka University, Suita, 565-0871, Japan
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Wojcieszek A, Kurowska A, Majda A, Liszka H, Gądek A. The Impact of Chronic Pain, Stiffness and Difficulties in Performing Daily Activities on the Quality of Life of Older Patients with Knee Osteoarthritis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16815. [PMID: 36554695 PMCID: PMC9779661 DOI: 10.3390/ijerph192416815] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 11/09/2022] [Accepted: 12/10/2022] [Indexed: 06/17/2023]
Abstract
Osteoarthritis causes a number of physical ailments, which result in the deterioration of a persons' general health and reduction of their ability to move freely. This cross-sectional study was designed to assess the impact of physical ailments in the course of knee osteoarthritis (KOA) on the quality of life (QoL) of patients in early old age. An anonymous survey was conducted by the use of the recognized research tools: Western Ontario scale and McMaster Osteoarthritis Index (WOMAC), The Index of Severity for Knee Disease (ISK) and World Health Organization Quality of Life-BEFF (WHOQOL-BREF). The study involved 300 people aged between 60 and 75 years old, including 150 patients diagnosed with gonarthrosis and 150 people without lower limb complaints. The significant intensification of the symptoms of knee osteoarthritis was associated with a worse assessment of health (p < 0.001), overall quality of life (p < 0.001) and in the following domains: physical (p < 0.001), mental (p < 0.001) and environmental (p < 0.001) in a group of patients with KOA. These findings suggest that taking measures to reduce knee pain and improve function may have an impact on improving the overall quality of the life of people in their early old age.
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Affiliation(s)
- Agata Wojcieszek
- Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, 30-126 Krakow, Poland
| | - Anna Kurowska
- Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, 30-126 Krakow, Poland
| | - Anna Majda
- Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, 30-126 Krakow, Poland
| | - Henryk Liszka
- Trauma and Orthopaedics Clinical Department, University Hospital, Jagiellonian University Medical College, 30-688 Krakow, Poland
| | - Artur Gądek
- Trauma and Orthopaedics Clinical Department, University Hospital, Jagiellonian University Medical College, 30-688 Krakow, Poland
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4
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[Three-dimensional finite element study on combined proximal and distal knee extension rearrangement for recurrent patellar dislocation]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2022; 36:573-581. [PMID: 35570631 PMCID: PMC9108646 DOI: 10.7507/1002-1892.202201015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To establish a three-dimensional finite element analysis model of the knee joint in fresh frozen cadavers, to verify the validity of the model and to simulate the stress distribution characteristics of the patellofemoral joint after combined proximal and distal knee extension rearrangement surgery for recurrent patellar dislocation. METHODS One male and one female fresh frozen cadavers (4 knees in total), using voluntary body donations, were used to measure the maximum pressure on the patellofemoral articular surface at each passive flexion angle (0°, 30°, 60°, 90°, 120°) of the normal knee joint and the model after combined proximal and distal knee extension rearrangement surgery for recurrent patellar dislocation with tibial tuberosity-trochlear groove distance (TT-TG) value >2.00 cm using pressure-sensitive paper, respectively. Then, the 2 freshly frozen cadavers were used to construct three-dimensional finite element models of normal knee joints and postoperative knee joints, and the maximum pressure on the patellofemoral articular surface was measured at various passive flexion angles. The maximum pressure was compared with the measurement results of the pressure-sensitive paper to verify the validity of the three-dimensional finite element model. In addition, the maximum pressure on the patellofemoral joint surface measured by three-dimensional finite element was compared between the normal knee joint and the postoperative knee joint at various passive flexion angles, so as to obtain an effective three-dimensional finite element model for the simulation study of the stress distribution characteristics of the patellofemoral joint after combined proximal and distal knee extension rearrangement surgery for recurrent patellar dislocation. RESULTS The maximum pressure on the patellofemoral joint surface measured by pressure-sensitive paper and three-dimensional finite element measurements were similar at all passive flexion angles in the normal knee joint, with a difference of -0.08-0.06 MPa; the maximum pressure on the patellofemoral joint surface measured by pressure-sensitive paper and three-dimensional finite element measurements were also similar at all passive flexion angles in the knee after combined proximal and distal knee extension rearrangement surgery, with a difference of -0.04-0.09 MPa. The maximum pressure on the patellofemoral joint surface measured by three-dimensional finite elements were also similar between the normal knee joint and the knee joint after combined proximal and distal knee extension rearrangement surgery at all passive flexion angles, with a difference of -0.50--0.03 MPa. CONCLUSION The three-dimensional finite element model of the normal knee joint and the knee joint after combined proximal and distal knee extension rearrangement surgery can accurately and effectively quantify the change in the maximum pressure on the patellofemoral joint surface; for recurrent patellar dislocations with TT-TG value>2.00 cm, the combined proximal and distal knee extension rearrangement surgery can achieve a maximum pressure of the patellofemoral joint surface similar to that of the normal knee joint.
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5
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Koh JL, Jacob KC, Kulkarni R, Vasilion Z, Amirouche FM. Consequences of Progressive Full-Thickness Focal Chondral Defects Involving the Medial and Lateral Femoral Condyles After Meniscectomy: A Biomechanical Study Using a Goat Model. Orthop J Sports Med 2022; 10:23259671221078598. [PMID: 35356308 PMCID: PMC8958688 DOI: 10.1177/23259671221078598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 11/30/2021] [Indexed: 11/15/2022] Open
Abstract
Background: Full-thickness chondral defects alter tibiofemoral joint homeostasis and, if left untreated, have the potential to progress to osteoarthritis. Purpose: To assess the effects of isolated and dual full-thickness chondral defect size and location on the biomechanical properties of the lateral femoral condyle (LFC) and medial femoral condyle (MFC) during dynamic knee flexion in goat knees without menisci. Methods: In 12 goat knees, we created progressively increasing full-thickness circular chondral defects (3-, 5-, and 7.5-mm diameter) in the weightbearing contact area of flexion and extension in the MFC, the LFC, or both. Each knee was fixed into a custom steel frame and attached to a motor with sensors inserted intra-articularly. For each testing condition, the knee was loaded to 100 N and underwent a dynamic range of motion between 90° of flexion and 30° of extension. The following parameters were collected: contact area, contact pressure, contact force, peak area, and peak pressure. Study Design: Controlled laboratory study. Results: The peak pressure at the defect rim of the MFC at full extension increased by 51.51% from no defect (1.887 MPa) to a 7.5-mm defect (2.859 MPa) (P < .001), and the peak pressure at the defect rim of the LFC at full extension increased by 139.14% from no defect (1.704 MPa) to a 7.5-mm defect (4.075 MPa) (P < .001). The peak pressures for LFC defects at all 3 diameters were significantly greater when compared with dual defects consisting of increasing LFC defect diameter and constant MFC defect diameter (P < .001 for all). Conclusion: Extremely large increases in peak pressure were seen at the rim of articular cartilage defects when evaluated under dynamic loading conditions. Isolated LFC defects experienced a greater increase in defect rim stress concentrations when compared with isolated MFC defects for equivalent increases in defect size. Defect size played a significant role independent of location for peak pressures on the MFC and LFC. Clinical Relevance: Significant rim-loading effects increase with defect size under dynamic loading and may result in increasingly rapid progression of articular cartilage lesions. Within the context of this goat model, findings suggest that lateral compartment chondral lesions are more likely to progress than medial compartment lesions of equivalent size.
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Affiliation(s)
- Jason L. Koh
- Department of Orthopaedic Surgery, Orthopaedic and Spine Institute, NorthShore University HealthSystem, Evanston, Illinois, USA
| | - Kevin C. Jacob
- Department of Orthopaedic Surgery, University of Illinois, Chicago, Illinois, USA
| | - Rohan Kulkarni
- Department of Orthopaedic Surgery, University of Illinois, Chicago, Illinois, USA
| | - Zachary Vasilion
- Department of Orthopaedic Surgery, Orthopaedic and Spine Institute, NorthShore University HealthSystem, Evanston, Illinois, USA
| | - Farid M.L. Amirouche
- Department of Orthopaedic Surgery, Orthopaedic and Spine Institute, NorthShore University HealthSystem, Evanston, Illinois, USA
- Department of Orthopaedic Surgery, University of Illinois, Chicago, Illinois, USA
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Sun Y, Wang N, Yu J, Yan Y, Dong H, Wu X, Zhang M, Wang Y, Li P, Wei X, Chen W. Study on the poroelastic behaviors of the defected articular cartilage. Comput Methods Biomech Biomed Engin 2021; 25:1288-1300. [PMID: 34807804 DOI: 10.1080/10255842.2021.2007376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This article presented the possible mechanism of arthritis damaged changes in cartilage's interstitial fluid flowing behavior. Firstly, the analytical solutions for the pore fluid pressure and velocity in the idealized cartilage defect model were obtained, which are employed to validate the finite element (FE) method. Then according to the MRI data, an articular cartilage FE model was developed to study the effects of defect characteristics on its poroelastic behaviors. The results showed the interstitial fluid pressure and velocity in defected articular cartilage is diminished, moreover, this trend is even more severe as the defect radius or thickness increased. As the development of osteoarthritis goes, the fluid velocity is decreased and cause the even serious nutrients loss.
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Affiliation(s)
- Yuqin Sun
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, China
| | - Ningning Wang
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, China
| | - Jianhao Yu
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, China
| | - Yang Yan
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, China
| | - Hao Dong
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, China
| | - Xiaogang Wu
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, China
| | - Meizhen Zhang
- College of Physical Education, Taiyuan University of Technology, Taiyuan, China
| | - Yanqin Wang
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, China
| | - Pengcui Li
- Shanxi Provincial Key Laboratory for Repair of Bone and Soft Tissue Injury, Taiyuan, China
| | - Xiaochun Wei
- Shanxi Provincial Key Laboratory for Repair of Bone and Soft Tissue Injury, Taiyuan, China
| | - Weiyi Chen
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, China
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7
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Ji X, Ito A, Nakahata A, Nishitani K, Kuroki H, Aoyama T. Effects of in vivo cyclic compressive loading on the distribution of local Col2 and superficial lubricin in rat knee cartilage. J Orthop Res 2021; 39:543-552. [PMID: 32716572 DOI: 10.1002/jor.24812] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 05/20/2020] [Accepted: 07/09/2020] [Indexed: 02/04/2023]
Abstract
This study aimed to examine the effects of an episode of in vivo cyclic loading on rat knee articular cartilage (AC) under medium-term observation, while also investigating relevant factors associated with the progression of post-traumatic osteoarthritis (PTOA). Twelve-week-old Wistar rats underwent one episode comprising 60 cycles of 20 N or 50 N dynamic compression on the right knee joint. Spatiotemporal changes in the AC after loading were evaluated using histology and immunohistochemistry at 3 days and 1, 2, 4, and 8 weeks after loading (n = 6 for each condition). Chondrocyte vitality was assessed at 1, 3, 6, and 12 hours after loading (n = 2 for each condition). A localized AC lesion on the lateral femoral condyle was confirmed in all subjects. The surface and intermediate cartilage in the affected area degenerated after loading, but the calcified cartilage remained intact. Expression of type II collagen in the lesion cartilage was upregulated after loading, whereas the superficial lubricin layer was eroded in response to cyclic compression. However, the distribution of superficial lubricin gradually recovered to the normal level 4 weeks after loading-induced injury. We confirmed that 60 repetitions of cyclic loading exceeding 20 N could result in cartilage damage in the rat knee. Endogenous repairs in well-structured joints work well to rebuild protective layers on the lesion cartilage surface, which may be the latent factor delaying the progression of PTOA.
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Affiliation(s)
- Xiang Ji
- Department of Development and Rehabilitation of Motor Function, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akira Ito
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akihiro Nakahata
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kohei Nishitani
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroshi Kuroki
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomoki Aoyama
- Department of Development and Rehabilitation of Motor Function, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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8
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Schreiner AJ, Stoker AM, Bozynski CC, Kuroki K, Stannard JP, Cook JL. Clinical Application of the Basic Science of Articular Cartilage Pathology and Treatment. J Knee Surg 2020; 33:1056-1068. [PMID: 32583400 DOI: 10.1055/s-0040-1712944] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The joint is an organ with each tissue playing critical roles in health and disease. Intact articular cartilage is an exquisite tissue that withstands incredible biologic and biomechanical demands in allowing movement and function, which is why hyaline cartilage must be maintained within a very narrow range of biochemical composition and morphologic architecture to meet demands while maintaining health and integrity. Unfortunately, insult, injury, and/or aging can initiate a cascade of events that result in erosion, degradation, and loss of articular cartilage such that joint pain and dysfunction ensue. Importantly, articular cartilage pathology affects the health of the entire joint and therefore should not be considered or addressed in isolation. Treating articular cartilage lesions is challenging because left alone, the tissue is incapable of regeneration or highly functional and durable repair. Nonoperative treatments can alleviate symptoms associated with cartilage pathology but are not curative or lasting. Current surgical treatments range from stimulation of intrinsic repair to whole-surface and whole-joint restoration. Unfortunately, there is a relative paucity of prospective, randomized controlled, or well-designed cohort-based clinical trials with respect to cartilage repair and restoration surgeries, such that there is a gap in knowledge that must be addressed to determine optimal treatment strategies for this ubiquitous problem in orthopedic health care. This review article discusses the basic science rationale and principles that influence pathology, symptoms, treatment algorithms, and outcomes associated with articular cartilage defects in the knee.
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Affiliation(s)
- Anna J Schreiner
- Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri.,Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri.,BG Center for Trauma and Reconstructive Surgery, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Aaron M Stoker
- Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri.,Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri
| | - Chantelle C Bozynski
- Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri.,Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri
| | - Keiichi Kuroki
- Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri
| | - James P Stannard
- Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri.,Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri
| | - James L Cook
- Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri.,Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri
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9
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Hunt MA, Charlton JM, Esculier JF. Osteoarthritis year in review 2019: mechanics. Osteoarthritis Cartilage 2020; 28:267-274. [PMID: 31877382 DOI: 10.1016/j.joca.2019.12.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 09/25/2019] [Accepted: 12/09/2019] [Indexed: 02/02/2023]
Abstract
Mechanics play a critical - but not sole - role in the pathogenesis of osteoarthritis, and recent research has highlighted how mechanical constructs are relevant at the cellular, joint, and whole-body level related to osteoarthritis outcomes. This review examined papers from April 2018 to April 2019 that reported on the role of mechanics in osteoarthritis etiology, with a particular emphasis on studies that focused on the interaction between movement and tissue biomechanics with other clinical outcomes relevant to the pathophysiology of osteoarthritis. Studies were grouped by themes that were particularly prevalent from the past year. Results of the search highlighted the large exposure of knee-related research relative to other body areas, as well as studies utilizing laboratory-based motion capture technology. New research from this past year highlighted the important role that rate of exerted loads and rate of muscle force development - rather than simply force capacity (strength) - have in OA etiology and treatment. Further, the role of muscle activation patterns in functional and structural aspects of joint health has received much interest, though findings remain equivocal. Finally, new research has identified potential mechanical outcome measures that may be related to osteoarthritis disease progression. Future research should continue to combine knowledge of mechanics with other relevant research techniques, and to identify mechanical markers of joint health and structural and functional disease progression that are needed to best inform disease prevention, monitoring, and treatment.
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Affiliation(s)
- M A Hunt
- Motion Analysis and Biofeedback Laboratory, University of British Columbia, Vancouver, BC, Canada; Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.
| | - J M Charlton
- Motion Analysis and Biofeedback Laboratory, University of British Columbia, Vancouver, BC, Canada; Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, BC, Canada.
| | - J-F Esculier
- Motion Analysis and Biofeedback Laboratory, University of British Columbia, Vancouver, BC, Canada; Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.
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10
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Watanabe K, Mutsuzaki H, Fukaya T, Aoyama T, Nakajima S, Sekine N, Mori K. Development of a Knee Joint CT-FEM Model in Load Response of the Stance Phase During Walking Using Muscle Exertion, Motion Analysis, and Ground Reaction Force Data. ACTA ACUST UNITED AC 2020; 56:medicina56020056. [PMID: 32013100 PMCID: PMC7074273 DOI: 10.3390/medicina56020056] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 01/16/2020] [Accepted: 01/26/2020] [Indexed: 02/04/2023]
Abstract
Background and objectives: There are no reports on articular stress distribution during walking based on any computed tomography (CT)-finite element model (CT-FEM). This study aimed to develop a calculation model of the load response (LR) phase, the most burdensome phase on the knee, during walking using the finite element method of quantitative CT images. Materials and Methods: The right knee of a 43-year-old man who had no history of osteoarthritis or surgeries of the knee was examined. An image of the knee was obtained using CT and the extension position image was converted to the flexion angle image in the LR phase. The bone was composed of heterogeneous materials. The ligaments were made of truss elements; therefore, they do not generate strain during expansion or contraction and do not affect the reaction force or pressure. The construction of the knee joint included material properties of the ligament, cartilage, and meniscus. The extensor and flexor muscles were calculated and set as the muscle exercise tension around the knee joint. Ground reaction force was vertically applied to suppress the rotation of the knee, and the thigh was restrained. Results: An FEM was constructed using a motion analyzer, floor reaction force meter, and muscle tractive force calculation. In a normal knee, the equivalent stress and joint contact reaction force in the LR phase were distributed over a wide area on the inner upper surface of the femur and tibia. Conclusions: We developed a calculation model in the LR phase of the knee joint during walking using a CT-FEM. Methods to evaluate the heteromorphic risk, mechanisms of transformation, prevention of knee osteoarthritis, and treatment may be developed using this model.
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Affiliation(s)
- Kunihiro Watanabe
- Department of Radiology, Saitama Prefecture Saiseikai Kurihashi Hospital, Kuki, Saitama 349-1105, Japan;
- Department of Radiological Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Arakawa, Tokyo 116-8551, Japan;
| | - Hirotaka Mutsuzaki
- Center for Medical Sciences, Ibaraki Prefectural University of Health Sciences, Ami, Ibaraki 300-0394, Japan;
- Department of Orthopaedic Surgery, Ibaraki Prefectural University of Health Sciences Hospital, Ami, Ibaraki 300-0331, Japan
| | - Takashi Fukaya
- Department of Physical Therapy, Faculty of Health Sciences, Tsukuba International University, Tsuchiura, Ibaraki 300-0051, Japan;
| | - Toshiyuki Aoyama
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, Ami, Ibaraki 300-0394, Japan;
| | - Syuichi Nakajima
- Department of Radiological Sciences, Ibaraki Prefectural University of Health Sciences, Ami, Ibaraki 300-0394, Japan;
| | - Norio Sekine
- Department of Radiological Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Arakawa, Tokyo 116-8551, Japan;
| | - Koichi Mori
- Department of Radiological Sciences, Ibaraki Prefectural University of Health Sciences, Ami, Ibaraki 300-0394, Japan;
- Correspondence: ; Tel.: +81-29-888-4000
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11
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Aoki K, Ogihara N, Tanaka M, Haniu H, Saito N. Carbon nanotube-based biomaterials for orthopaedic applications. J Mater Chem B 2020; 8:9227-9238. [DOI: 10.1039/d0tb01440k] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Carbon nanotubes can enhance the functionality of orthopedic applications.
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Affiliation(s)
- Kaoru Aoki
- Physical Therapy Division
- School of Health Sciences
- Shinshu University
- Nagano 390-8621
- Japan
| | - Nobuhide Ogihara
- Department of Orthopaedic Surgery
- Ina Central Hospital
- Nagano 396-8555
- Japan
| | - Manabu Tanaka
- Department of Orthopaedic Surgery
- Okaya City Hospital
- Nagano 394-8512
- Japan
| | - Hisao Haniu
- Department of Biomedical Engineering
- Graduate School of Medicine
- Science and Technology
- Shinshu University
- Nagano 390-8621
| | - Naoto Saito
- Institute for Biomedical Sciences
- Interdisciplinary Cluster for Cutting Edge Research
- Shinshu University
- Matsumoto
- Nagano 390-8621
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12
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Malekipour F, Hitchens PL, Whitton RC, Lee PVS. Effects of in vivo fatigue-induced subchondral bone microdamage on the mechanical response of cartilage-bone under a single impact compression. J Biomech 2019; 100:109594. [PMID: 31924348 DOI: 10.1016/j.jbiomech.2019.109594] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 12/03/2019] [Accepted: 12/21/2019] [Indexed: 11/30/2022]
Abstract
Subchondral bone (SCB) microdamage is prevalent in the joints of human athletes and animals subjected to high rate and magnitude cyclic loading of the articular surface. Quantifying the effect of such focal in vivo fatigue-induced microdamage on the mechanical response of the tissue is critical for the understanding of joint surface injury and the development of osteoarthritis. Thus, we aimed to quantify the mechanical properties of cartilage-bone from equine third metacarpal (MC3) condyles, which is a common area of accumulated microdamage due to repetitive impact loading. We chose a non-destructive technique, i.e. high-resolution microcomputed tomography (µCT) imaging, to identify various degrees of in vivo microdamage in SCB prior to mechanical testing; because µCT imaging can only identify a proportion of accumulated microdamage, we aimed to identify racing and training history variables that provide additional information on the prior loading history of the samples. We then performed unconfined high-rate compression of approximately 2% strain at 45%/s strain rate to simulate a cycle of gallop and used real-time strain measurements using digital image correlation (DIC) techniques to find the stiffness and shock absorbing ability (relative energy loss) of the cartilage-bone unit, and those associated with cartilage and SCB. Results indicated that stiffness of cartilage-bone and those associated with the SCB decreased with increasing grade of damage. Whole specimen stiffness also increased, and relative energy loss decreased with higher TMD, whereas bone volume fraction of the SCB was only associated negatively with the stiffness of the bone. Overall, the degree of subchondral bone damage observed with µCT was the main predictor of stiffness and relative energy loss of the articular surface of the third metacarpal bone of Thoroughbred racehorses under impact loading.
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Affiliation(s)
- Fatemeh Malekipour
- Department of Biomedical Engineering, University of Melbourne, Parkville, VIC 3010, Australia
| | - Peta L Hitchens
- Equine Centre, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, VIC 3030, Australia
| | - R Chris Whitton
- Equine Centre, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, VIC 3030, Australia
| | - Peter Vee-Sin Lee
- Department of Biomedical Engineering, University of Melbourne, Parkville, VIC 3010, Australia.
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13
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Patel JM, Wise BC, Bonnevie ED, Mauck RL. A Systematic Review and Guide to Mechanical Testing for Articular Cartilage Tissue Engineering. Tissue Eng Part C Methods 2019; 25:593-608. [PMID: 31288616 DOI: 10.1089/ten.tec.2019.0116] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Articular cartilage is integral to the mechanical function of many joints in the body. When injured, cartilage lacks the capacity to self-heal, and thus, therapies and replacements have been developed in recent decades to treat damaged cartilage. Given that the primary function of articular cartilage is mechanical in nature, rigorous physical evaluation of cartilage tissues undergoing treatment and cartilage constructs intended for replacement is an absolute necessity. With the large number of groups developing cartilage tissue engineering strategies, however, a variety of mechanical testing protocols have been reported in the literature. This lack of consensus in testing methods makes comparison between studies difficult at times, and can lead to misinterpretation of data relative to native tissue. Therefore, the purpose of this study was to systematically review mechanical testing of articular cartilage and cartilage repair constructs over the past 10 years (January 2009-December 2018), to highlight the most common testing configurations, and to identify key testing parameters. For the most common tests, key parameters identified in this systematic review were validated by characterizing both cartilage tissue and hydrogels commonly used in cartilage tissue engineering. Our findings show that compression testing was the most common test performed (80.2%; 158/197), followed by evaluation of frictional properties (18.8%; 37/197). Upon further review of those studies performing compression testing, the various modes (ramp, stress relaxation, creep, dynamic) and testing configurations (unconfined, confined, in situ) are described and systematically reviewed for parameters, including strain rate, equilibrium time, and maximum strain. This systematic analysis revealed considerable variability in testing methods. Our validation testing studies showed that such variations in testing criteria could have large implications on reported outcome parameters (e.g., modulus) and the interpretation of findings from these studies. This analysis is carried out for all common testing methods, followed by a discussion of less common trends and directions in the mechanical evaluation of cartilage tissues and constructs. Overall, this work may serve as a guide for cartilage tissue engineers seeking to rigorously evaluate the physical properties of their novel treatment strategies. Impact Statement Articular cartilage tissue engineering has made significant strides with regard to treatments and replacements for injured tissue. The evaluation of these approaches typically involves mechanical testing, yet the plethora of testing techniques makes comparisons between studies difficult, and often leads to misinterpretation of data compared with native tissue. This study serves as a guide for the mechanical testing of cartilage tissues and constructs, highlighting recent trends in test conditions and validating these common procedures. Cartilage tissue engineers, especially those unfamiliar with mechanical testing protocols, will benefit from this study in their quest to physically evaluate novel treatment and regeneration approaches.
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Affiliation(s)
- Jay M Patel
- McKay Orthopedic Research Laboratory, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Translational Musculoskeletal Research Center, Corporal Michael J Crescenz VA Medical Center, Philadelphia, Pennsylvania
| | - Brian C Wise
- McKay Orthopedic Research Laboratory, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Edward D Bonnevie
- McKay Orthopedic Research Laboratory, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Translational Musculoskeletal Research Center, Corporal Michael J Crescenz VA Medical Center, Philadelphia, Pennsylvania
| | - Robert L Mauck
- McKay Orthopedic Research Laboratory, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Translational Musculoskeletal Research Center, Corporal Michael J Crescenz VA Medical Center, Philadelphia, Pennsylvania.,Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania
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