Early exercise advances the maturation of glycosaminoglycans and collagen in the extracellular matrix of articular cartilage in the horse

Composition, architecture and biomechanical properties of articular cartilage in differently loaded areas of the equine stifle

BACKGROUND

Strategies for articular cartilage repair need to take into account topographical differences in tissue composition and architecture to achieve durable functional outcome. These have not yet been investigated in the equine stifle.

OBJECTIVES

To analyse the biochemical composition and architecture of three differently loaded areas of the equine stifle. We hypothesise that site differences correlate with the biomechanical characteristics of the cartilage.

STUDY DESIGN

Ex vivo study.

METHODS

Thirty osteochondral plugs per location were harvested from the lateral trochlear ridge (LTR), the distal intertrochlear groove (DITG) and the medial femoral condyle (MFC). These underwent biochemical, biomechanical and structural analysis. A linear mixed model with location as a fixed factor and horse as a random factor was applied, followed by pair-wise comparisons of estimated means with false discovery rate correction, to test for differences between locations. Correlations between biochemical and biomechanical parameters were tested using Spearman's correlation coefficient.

RESULTS

Glycosaminoglycan content was different between all sites (estimated mean [95% confidence interval (CI)] for LTR 75.4 [64.5, 88.2], for intercondylar notch (ICN) 37.3 [31.9, 43.6], for MFC 93.7 [80.1109.6] μg/mg dry weight), as were equilibrium modulus (LTR2.20 [1.96, 2.46], ICN0.48 [0.37, 0.6], MFC1.36 [1.17, 1.56] MPa), dynamic modulus (LTR7.33 [6.54, 8.17], ICN4.38 [3.77, 5.03], MFC5.62 [4.93, 6.36] MPa) and viscosity (LTR7.49 [6.76, 8.26], ICN16.99 [15.88, 18.14], MFC8.7 [7.91,9.5]°). The two weightbearing areas (LTR and MCF) and the non-weightbearing area (ICN) differed in collagen content (LTR 139 [127, 152], ICN176[162, 191], MFC 127[115, 139] μg/mg dry weight), parallelism index and angle of collagen fibres. The strongest correlations were between proteoglycan content and equilibrium modulus (r: 0.642; p: 0.001), dynamic modulus (r: 0.554; p < 0.001) and phase shift (r: -0.675; p < 0.001), and between collagen orientation angle and equilibrium modulus (r: -0.612; p < 0.001), dynamic modulus (r: -0.424; p < 0.001) and phase shift (r: 0.609; p < 0.001).

MAIN LIMITATIONS

Only a single sample per location was analysed.

CONCLUSIONS

There were significant differences in cartilage biochemical composition, biomechanics and architecture between the three differently loaded sites. The biochemical and structural composition correlated with the mechanical characteristics. These differences need to be acknowledged by designing cartilage repair strategies.

Systematic Comparison of Biomaterials-Based Strategies for Osteochondral and Chondral Repair in Large Animal Models

Joint repair remains a major challenge in orthopaedics. Recent progress in biomaterial design has led to the fabrication of a plethora of promising devices. Pre-clinical testing of any joint repair strategy typically requires the use of large animal models (e.g., sheep, goat, pig or horse). Despite the key role of such models in clinical translation, there is still a lack of consensus regarding optimal experimental design, making it difficult to draw conclusions on their efficacy. In this context, the authors performed a systematic literature review and a risk of bias assessment on large animal models published between 2010 and 2020, to identify key experimental parameters that significantly affect the biomaterial therapeutic outcome and clinical translation potential (including defect localization, animal age/maturity, selection of controls, cell-free versus cell-laden). They determined that mechanically strong biomaterials perform better at the femoral condyles; while highlighted the importance of including native tissue controls to better evaluate the quality of the newly formed tissue. Finally, in cell-laded biomaterials, the pre-culture conditions played a more important role in defect repair than the cell type. In summary, here they present a systematic evaluation on how the experimental design of preclinical models influences biomaterial-based therapeutic outcomes in joint repair.

Training Young Horses: The Science behind the Benefits

Simple Summary

Of common debate among equine professionals and enthusiasts alike, is whether entering race training at two years of age is detrimental or beneficial to the animal’s career and growth. This literature review evaluates epidemiological studies to elucidate that two-year-old horses are not at greater risk of injury compared to older horses. Horses which enter race training at two years of age are, in fact, found to have greater earnings and longer race careers. This review also tackles the impact that exercising an animal at two years of age or younger has on bone, articular cartilage, and tendons. Numerous studies on growing animals have found confinement to be detrimental to normal musculoskeletal growth. However, exercise of dynamic nature in moderate distances, such as that attained with pasture access or prescribed sprints, is beneficial to musculoskeletal development and may prevent injuries when entering race training. Based on scientific evidence, the research cited in this review supports the training and racing of two-year-old horses and advises caution in the use of medications such as corticosteroids.

Abstract

Conflicting research and anecdotal evidence have created disagreement among equestrians as to whether two-year-old horses should be trained and raced. The objective of this literature review is to evaluate epidemiological studies, as well as physiological data on equine bone, articular cartilage, and tendons to better determine the impact of training and racing two-year-old horses. The evaluation of numerous studies on the topic provides evidence that a horse which is trained or raced as a two-year-old has a lower risk of injury and better adapted tissues for the rigors of racing. Unfortunately, the current prolific use of pain-mitigating substances in the racing industry does place horses, including young cohorts, at greater risk of injury, and should be used with caution.

Sprint Exercise of Juvenile Animals Does Not Impact Cartilage Glycosaminoglycan or Synovial Fluid Neopeptide Collagenase Cleavage of Type I and II Collagen Content

Short sprints performed during growth can increase bone strength, mineral density, and cortical widths, but their impact on joint health is not fully understood. Some studies have found joints of young animals are damaged by forced sprints, while others found confinement hindered joint development. This study aimed to determine the impact of short sprints on synovial fluid neopeptide collagenase cleavage of type I and II collagen (C1,2C) and cartilage glycosaminoglycan (GAG) content. Calves were used as a model for young horses in this terminal study. Twenty-four Holstein bull calves were assigned to treatment groups of 1, 3, 5, or 0 days/week of sprinting (n = 6). A sprint consisted of an individual calf being walked from its stall and down a 71-m concrete aisle, at the end of which the calf was released, and encouraged to sprint towards the barn. Calves remained on treatment for 6 weeks and were euthanized on day 42. Immediately posteuthanasia synovial fluid was sampled from the middle carpal joint and cartilage discs sampled from 9 locations on the carpal bones. Analysis was performed in SAS 9.4 with fixed effects of treatment and bone. There were no differences in C1,2C or GAG concentrations between treatments (P = .73 and P = .96, respectively), but there was a difference between individual carpal bone GAG concentration (P = .03). Short sprints for 6 weeks during growth did not impact middle carpal joint C1,2C or carpal bone GAG content, and should be permitted given the benefits to bone health.

Characterization of Adult and Neonatal Articular Cartilage From the Equine Stifle

A significant portion of equine lameness is localized to the stifle joint. Effective cartilage repair strategies are largely lacking, however, recent advances in surgical techniques, biomaterials, and cellular therapeutics have broadened the clinical strategies of cartilage repair. To date, no studies have been performed directly comparing neonatal and adult articular cartilage from the stifle across multiple sites. An understanding of the differences in properties between the therapeutic target cartilage (i.e., adult cartilage) as well as potential donor cartilage (i.e., neonatal cartilage) could aid in selection of optimal harvest sites within a donor joint as well as evaluation of the success of the grafted cells or tissues within the host. Given the dearth of characterization studies of the equine stifle joint, and in particular neonatal stifle cartilage, the goal of this study was to measure properties of both potential source tissue and host tissue. Articular cartilage of the distal femur and patella (P) was assessed in regards to two specific factors, age of the animal and specific site within the joint. Two age groups were considered: neonatal (<1 week) and adult (4-14 years). Cartilage samples were harvested from 17 sites across the distal femur and patella. It was hypothesized that properties would vary significantly between neonatal and adult horses as well as within age groups on a site-by-site basis. Adult thickness varied by site. With the exception of water content, there were no significant biochemical differences among sites within regions of the distal femur (condyles and trochlea) and the patella in either the adult or neonate. Neonatal cartilage had a significantly higher water content than adult. Surprisingly, biochemical measurements of cellularity did not differ significantly between neonatal and adult, however, adult cartilage had greater variance in cellularity than neonatal. Overall, there were no significant differences between neonatal and adult glycosaminoglycan content. Collagen per wet weight was found to be significantly higher in adult cartilage than neonatal when averaged across all levels. In terms of biomechanical properties, aggregate modulus varied significantly across the condyles of adult cartilage but not the neonate. Neonatal cartilage was significantly less permeable, and the Young's modulus of neonatal cartilage was significantly higher than the adult. The tensile strength did not vary in a statistically significant manner between age groups. An understanding of morphological, histological, biochemical, and biomechanical properties enhances the understanding of cartilage tissue physiology and structure-function relationships. This study revealed important differences in biomechanical and biochemical properties among the 17 sites and among the six joint regions, as well as age-related differences between neonatal and adult cartilage. These location and age-related variations are informative toward determining the donor tissue harvest site.

Equine musculoskeletal development and performance: impact of the production system and early training

The welfare debate around horse racing appears to be focussed on musculoskeletal injury and the racing of 2-year-olds. Much of this debate appears contrary to the evolutionary history of the horse as a cursorial animal and the capability of the equine musculoskeletal system to respond to the demands of race training. Epidemiological studies have reported that 2-year-old racehorses have a longer time period from entering training to the first race and a greater number of lost training days than older horses. However, this is, in part, due to the time taken to learn to train and the impact of dorsal metacarpal disease, which is due to loading of naïve as opposed to immature tissue. Across several racing jurisdictions and codes, it has been demonstrated that horses that train and race as 2-year-olds have longer, more successful, careers than those that start racing later in life. This positive trend has also been observed with horses starting in equestrian sport at an early age. The literature on the growth and development of the horse indicates that the musculoskeletal system is primed for activity and loading from an early age. Additional exercise for the young horse has a positive rather the negative effect, with many tissues having a sensitive period for ‘priming’ when the horse is a juvenile. This implies that under many modern management systems, the challenge to horse welfare is not ‘too much exercise too soon’ but ‘too little too late’. The current limitation in our understanding is the lack of knowledge of what is the correct exercise dose to optimise the musculoskeletal system. Modern management systems invariably provide too little exercise, but is the exercise data from feral horses the ‘gold standard’, or more a reflection of what the horse is capable of if resources such as food and water are limited? Further research is required to refine our understanding of the optimal exercise levels required and development of greater precision in identifying the sensitive periods for priming the musculoskeletal system.

Temporal and spatial changes in bone accrual, density, and strain energy density in growing foals

Bone adaptation is in part driven by mechanical loading, and exercise during youth has been shown to have life-long benefits for bone health. However, the development of early exercise-based interventions that reduce the incidence of fractures in racing horses is limited by the lack of characterization of normal development in growing bone. Previous efforts to quantify bone development in the horse have relied on repeated radiographs or peripheral quantitative computed tomography scans, which are limited in their assessment of the entire bone. In this study, we acquired computed tomography scans of three Standardbred trotting colts longitudinally between 2 and 12 months of age. Finite-element models were constructed of the left forelimb proximal phalanx and used to assess strain energy density during quiet standing. Growth related changes in mineral density and bone area fraction in the distal epiphysis, mid-diaphysis, and proximal epiphysis were evaluated. Mineral density and bone area fraction uniformly increased in the diaphysis and strain energy density was constant during growth, indicating adaptation to quiet standing. Bone mineral density and bone area fraction increased in the medial quadrant of the proximal epiphysis but not in the fracture-prone lateral quadrant. The data presented provides a benchmark of normal growth trajectories that can be used to evaluate the effect of training regimens during growth.

Does Juvenile Play Programme the Equine Musculoskeletal System?

Simple Summary

Locomotor play is a common behaviour expressed across a diverse range of species. As a cursorial animal, the horse is capable of locomotor activity within a relatively short time after birth. In the foal, spontaneous locomotor play occurs early in life and has an obvious role in the development of locomotor skills. The intensity and vigour of locomotor play increases with age and this, in turn, provides cumulative increases in the loads the musculoskeletal system experiences. These progressive cumulative loading cycles (bouts of locomotor play), in both the timing and magnitude, reflect the microstrain required to stimulate bone development based on the mechanostat theorem. Data from the published literature were presented to provide empirical support for this hypothesis. Thus, spontaneous locomotor play may be vital to ensure optimal bone development in the horse. Modern production systems need to provide appropriate opportunities for foals to perform spontaneous locomotor play to optimise bone development and reduce the risk of future musculoskeletal injury later in life.

Abstract

In mammals, play behaviour appears innate and, because of this, may provide insight into the frequency and intensity of load that is required to stimulate positive musculoskeletal development. The objective of this review was to explore the interaction between play and tissue (bone) development at a molecular through to whole-animal level, with specific focus on the horse as a model. The basis of our understanding of the response of bone to loading is the mechanostat theorem. This assumes that at a tissue level, bone attempts to keep localised strain within the physiological range of 1500–2500 microstrain. Loads above this range result in a modelling response to reduce strain, and strain below this threshold results in remodelling to maintain the localised physiological range. In foals, locomotor play is dramatic and vigorous, with cumulative increases in both intensity and complexity. Based on published literature describing locomotor play in foals and the microstrain at different gaits in the horse, it was proposed that locomotor play in foal aligns with the mechanostat theorem in both the magnitude and frequency of load cycles applied. The cumulative increases in the complexity and intensity of locomotor play as the foal develops, in turn, ensure the strain rates associated with play remain above the local physiological range and promote material and architectural changes in the distal limb bones. Thus, spontaneous locomotor play may be vital to ensure optimal bone development in the horse. Modern management systems need to provide appropriate opportunities for foals to perform spontaneous locomotor play to optimise bone development and reduce the risk of future musculoskeletal injury later in life.

Influence of Exercise, Age, Body weight, and Growth on the Development of Tarsal Osteoarthritis in Young Mangalarga Marchador Horses

In this study, the effect of early exercise, age, body weight (BW), and growth on the articular cartilage and subchondral bones of the tarsocrural joints was evaluated in 40 young Mangalarga Marchador horses allowed free choice exercise in pasture. Twenty of the horses had additional controlled exercise 3 days per week from a mean age of 30 ± 20 days until 36 months. The training program consisted of an increasing number of 15-minute gallop sprints in an oval paddock with a concrete floor covered by a thick layer of sand. BW, withers height (WH), and neck circumference were measured and body condition scores, cresty neck scores, and obesity index were rated. For each tarsus and foal, 5 standard radiographic projections were evaluated. All evaluations were performed at time point 1 (18 months of age) and time point 2 (36 months of age). Radiographic changes suggestive of tarsal osteoarthritis were observed in two male foals of the trained group at time point 2 (10% of 20). No horses from the untrained group developed OA. Training of the foals did not result in alterations of the morphometric parameters evaluated. However, significant differences were found between time point 1 and 2 in trained and untrained animals. At time point 2, the animals presented greater weights and WHs than at time point 1. We conclude that specific levels of physical activity during initial development do not increase the prevalence of osteoarthritic injury in Mangalarga Marchador foals.

Early Signs of Bone and Cartilage Changes Induced by Treadmill Exercise in Rats

This study aims to investigate the earliest alterations of bone and cartilage tissues as a result of different exercise protocols in the knee joint of Wistar rats. We hypothesize that pretraining to a continuous intense running protocol would protect the animals from cartilage degeneration. Three groups of animals were used: (i) an adaptive (pretraining) running group that ran for 8 weeks with gradually increasing velocity and time of running followed by a constant running program (6 weeks of 1.12 km/hour running per day); (ii) a non-adaptive running (constant running) group that initially rested for 8 weeks followed by 6 weeks of constant running; and (iii) a non-running (control) group. At weeks 8, 14, and 20 bone and cartilage were analyzed. Both running groups developed mild symptoms of cartilage irregularities, such as chondrocyte hypertrophy and cell clustering in different cartilage zones, in particular after the adaptive running protocol. As a result of physical training in the adaptive running exercise a dynamic response of bone was detected at week 8, where bone growth was enhanced. Conversely, the thickness of epiphyseal trabecular and subchondral bone (at week 14) was reduced due to the constant running in the period between 8 and 14 weeks. Finally, the intermediate differences between the two running groups disappeared after both groups had a resting period (from 14 to 20 weeks). The adaptive running group showed an increase in aggrecan gene expression and reduction of MMP2 expression after the initial 8 weeks running. Thus, the running exercise models in this study showed mild bone and cartilage/chondrocyte alterations that can be considered as early-stage osteoarthritis. The pretraining adaptive protocol before constant intense running did not protect from mild cartilage degeneration. © 2017 The Authors. JBMR Plus is published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.

Descriptive statistics and the pattern of horse racing in New Zealand. 1. Thoroughbred racing

The aim of the present study was to describe the pattern of flat and jump races and starts, including temporal trends, in Thoroughbred racing in New Zealand. Data on all race starts between 1 August 2005 and 31 July 2011 were supplied by New Zealand Thoroughbred Racing. Descriptive statistics were used to describe the data at both race and start level, stratified by flat and jumps races. In total, 96% of races run were flat races and most races and starts occurred in the Northern region. There was an even distribution of flat races across season of the year, whereas most (60%; 514/863) jumps races were run in winter followed by autumn (21%; 183/863), with no races run in summer. Irrespective of region or season, most flat races were run on Good (37%; 7505/20 091) tracks and most (45%; 384/863) jumps races were run on Heavy tracks. There was no change in the number of horses per race or starts per horse across the years studied, and the median number of starts per trainer was 14 (interquartile range 6–38) for flat races and 3 (interquartile range 2–6) for jumps races. The results showed there is a relatively consistent product offered for Thoroughbred racing in New Zealand, which is primarily focussed on flat racing. The study provided baseline data on the pattern of Thoroughbred racing in New Zealand, which can be used as background for future industry-related studies.

Positive effects of cell-free porous PLGA implants and early loading exercise on hyaline cartilage regeneration in rabbits

The regeneration of hyaline cartilage remains clinically challenging. Here, we evaluated the therapeutic effects of using cell-free porous poly(lactic-co-glycolic acid) (PLGA) graft implants (PGIs) along with early loading exercise to repair a full-thickness osteochondral defect. Rabbits were randomly allocated to a treadmill exercise (TRE) group or a sedentary (SED) group and were prepared as either a PGI model or an empty defect (ED) model. TRE was performed as a short-term loading exercise; SED was physical inactivity in a free cage. The knees were evaluated at 6 and 12 weeks after surgery. At the end of testing, none of the knees developed synovitis, formed osteophytes, or became infected. Macroscopically, the PGI-TRE group regenerated a smooth articular surface, with transparent new hyaline-like tissue soundly integrated with the neighboring cartilage, but the other groups remained distinct at the margins with fibrous or opaque tissues. In a micro-CT analysis, the synthesized bone volume/tissue volume (BV/TV) was significantly higher in the PGI-TRE group, which also had integrating architecture in the regeneration site. The thickness of the trabecular (subchondral) bone was improved in all groups from 6 to 12 weeks. Histologically, remarkable differences in the cartilage regeneration were visible. At week 6, compared with SED groups, the TRE groups manifested modest inflammatory cells with pro-inflammatory cytokines (i.e., TNF-α and IL-6), improved collagen alignment and higher glycosaminoglycan (GAG) content, particularly in the PGI-TRE group. At week 12, the PGI-TRE group had the best regeneration outcomes, showing the formation of hyaline-like cartilage, the development of columnar rounded chondrocytes that expressed enriched levels of collagen type II and GAG, and functionalized trabecular bone with osteocytes. In summary, the combination of implanting cell-free PLGA and performing an early loading exercise can significantly promote the full-thickness osteochondral regeneration in rabbit knee joint models.

STATEMENT OF SIGNIFICANCE

Promoting effective hyaline cartilage regeneration rather than fibrocartilage scar tissue remains clinically challenging. To address the obstacle, we fabricated a spongy cell-free PLGA scaffold, and designed a reasonable exercise program to generate combined therapeutic effects. First, the implanting scaffold generates an affordable mechanical structure to bear the loading forces and bridge with the host to offer a space in the full-thickness osteochondral regeneration in rabbit knee joint. After implantation, rabbits were performed by an early treadmill exercise 15 min/day, 5 days/week for 2 weeks that directly exerts in situ endogenous growth factor and anti-inflammatory effects in the reparative site. The advanced therapeutic strategy showed that neo-hyaline cartilage formation with enriched collagen type II, higher glycosaminoglycan, integrating subchondral bone formation and modest inflammation.

Effect of treadmill exercise timing on repair of full-thickness defects of articular cartilage by bone-derived mesenchymal stem cells: an experimental investigation in rats

OBJECTIVE

Current medical practice for the treatment of articular cartilage lesions remains a clinical challenge due to the limited self-repair ability of articular cartilage. Both experimental and clinical researches show that moderate exercise can improve articular cartilage repair process. However, optimal timing of moderate exercise is unclear. We aimed to evaluate the effect of timing of moderate treadmill exercise on repair of full-thickness defects of articular cartilage.

DESIGN

Full-thickness cartilage defects were drilled in the patellar groove of bilateral femoral condyles in a total of 40 male SD rats before they were randomly assigned into four even groups. In sedentary control (SED) group, no exercise was given; in 2-week (2W), 4-week (4W) and 8-week groups, moderate treadmill exercise was initiated respectively two, four and eight weeks after operation. Half of the animals were sacrificed at week 10 after operation and half at week 14 after operation. Femoral condyles were harvested for gross observation and histochemical measurement by O'Driscoll scoring system. Collagen type II was detected by immunohistochemistry and mRNA expressions of aggrecan and collagen type II cartilage by RT-PCR.

RESULTS

Both 10 and 14 weeks post-operation, the best results were observed in 4W group and the worst results appeared in 2W group. The histochemistry scores and the expressions of collagen type II and aggrecan were significantly higher in 4W group than that in other three groups (P<0.05).

CONCLUSIONS

Moderate exercise at a selected timing (approximately 4 weeks) after injury can significantly promote the healing of cartilage defects but may hamper the repair process if performed too early while delayed intervention by moderate exercise may reduce its benefits in repair of the defects.

Histomorphometric evaluation of the effect of early exercise on subchondral vascularity in the third carpal bone of horses

OBJECTIVE

To investigate histomorphometric changes in the cartilage and subchondral bone of the third carpal bone associated with conditioning exercise in young Thoroughbreds.

ANIMALS

Nine 18-month-old Thoroughbreds. Procedures-Both third carpal bones of 9 horses (4 exercised spontaneously at pasture only and 5 given additional conditioning exercise beginning at a mean age of 3 weeks) were evaluated. Histomorphometric variables (hyaline and calcified cartilage thickness and collagen orientation; vascular channel area, number, and orientation; and osteochondral junction rugosity) of the third carpal bone, sampled at 4 dorsopalmar sites in the radial facet, were compared between the exercised and nonexercised groups.

RESULTS

The vascular channel area measured at the 4 dorsopalmar sites was larger in the exercised group than in the control group, but none of the variables were significantly different between groups. Both groups had significant site-specific variations in all measured variables. Most importantly, the vascular channel area was highest in the most dorsal aspect.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that the mild exercise imposed in both groups during the developmental period appeared to be associated with an increase in the vascular channel area beneath the calcified cartilage layer in the third carpal bone. This increased vascular channel area could also be associated with high stress in the dorsal aspect of the radial facet, a region that is known to be vulnerable to osteochondral fragmentation.

Proactive Management of the Equine Athlete

Simple Summary

The athletic career of a horse is relatively short. Career length can be positively influenced by the trainer and the age at which the horse starts competition. There are opportunities for a team approach of health professionals and changes in management to improve functional/competition life. The ability to improve the tolerance of the tissue to exercise load via the introduction of early exercise, which reflects the horse’s evolutionary cursorial lifestyle, could provide a proactive mechanism to attenuate injury risk.

Abstract

Across many equestrian disciplines the median competition career of a horse is relatively short. One of the major reasons for short career length is musculoskeletal injury and a consistent variable is the trainer effect. There are significant opportunities within equestrian sport for a holistic approach to horse health to attenuate musculoskeletal injury. Proactive integration of care by health professionals could provide a mechanism to attenuate injury risk and the trainer effect. However, the limited data available on current exercise regimens for sport horses restricts interpretation of how management and exercise volume could be modified to reduce injury risk. Early exercise in the juvenile horse (i.e., pre weaning) has a positive effect on stimulating the musculoskeletal system and primes the horse for an athletic career. The early introduction to sport competition has also been identified to have a positive effect on career length. These data indicate that management systems reflecting the cursorial evolution of the horse may aid in attenuating loss from sport due to musculoskeletal injury.

Cartilage regeneration using zonal chondrocyte subpopulations: a promising approach or an overcomplicated strategy?

Cartilage defects heal imperfectly and osteoarthritic changes develop frequently as a result. Although the existence of specific behaviours of chondrocytes derived from various depth-related zones in vitro has been known for over 20 years, only a relatively small body of in vitro studies has been performed with zonal chondrocytes and current clinical treatment strategies do not reflect these native depth-dependent (zonal) differences. This is surprising since mimicking the zonal organization of articular cartilage in neo-tissue by the use of zonal chondrocyte subpopulations could enhance the functionality of the graft. Although some research groups including our own have made considerable progress in tailoring culture conditions using specific growth factors and biomechanical loading protocols, we conclude that an optimal regime has not yet been determined. Other unmet challenges include the lack of specific zonal cell sorting protocols and limited amounts of cells harvested per zone. As a result, the engineering of functional tissue has not yet been realized and no long-term in vivo studies using zonal chondrocytes have been described. This paper critically reviews the research performed to date and outlines our view of the potential future significance of zonal chondrocyte populations in regenerative approaches for the treatment of cartilage defects. Secondly, we briefly discuss the capabilities of additive manufacturing technologies that can not only create patient-specific grafts directly from medical imaging data sets but could also more accurately reproduce the complex 3D zonal extracellular matrix architecture using techniques such as hydrogel-based cell printing.

Histologic and histomorphometric evaluation of midcarpal joint defects in Thoroughbreds raised with and without early conditioning exercise

OBJECTIVE

To describe and measure histologic features of midcarpal joint cartilage defects in Thoroughbreds and evaluate the influence of early conditioning exercise on defect development.

SAMPLE

24 midcarpal joints from twelve 18-month-old Thoroughbreds.

PROCEDURES

Midcarpal joints from 12 horses (6 exercised spontaneously at pasture only and 6 given additional conditioning exercise beginning at a mean age of 3 weeks were evaluated. Gross cartilage defects were assessed histologically. Third and radial carpal bones were categorized with regard to the presence or absence of calcified cartilage (CC) abnormalities at the dorsoproximal and dorsodistal articular surfaces, respectively; histomorphometric assessment and statistical analysis were conducted for the third carpal bone.

RESULTS

Number and severity of defects did not appear different between exercise groups. Nine third or radial carpal bones had thickened CC with microcracks, matrix and osteochondral junction changes, and increased vascularity, without histologic changes in the hyaline cartilage. Third carpal bones with CC abnormalities had significantly thicker CC (452 vs 228 μm) than did those without CC abnormalities in the evaluated region. However, in the same region, there were no significant differences in hyaline cartilage thickness (681 vs 603 μm), vascular channel area in the subchondral bone (624,894 vs 490,320 μm(2)), or number of vascular channels (15.9 vs 18.0).

CONCLUSIONS AND CLINICAL RELEVANCE

Early exercise did not appear to influence the distribution or severity of cartilage defects in the midcarpal joint. Calcified cartilage abnormalities beneath the undisrupted hyaline cartilage in the dorsoproximal aspect of the third carpal bone may represent the first changes in the pathogenesis of midcarpal osteochondral disease.

Temporal changes in collagen cross-links in spontaneous articular cartilage repair

OBJECTIVE: Little is known about how the biochemical properties of collagen change during tissue regeneration following cartilage damage. In the current study, temporal changes in cartilage repair tissue biochemistry were assessed in a rabbit osteochondral defect. DESIGN: Bilateral full thickness 3mm osteochondral trochlear groove defects were created in 54 adult male skeletally mature New Zealand white rabbits and tissue repair monitored over 16 weeks. Collagen content, cross-links, lysyl hydroxylation, gene expression, histological grading, and FTIR analyses were performed at 2, 4, 6, 8, 12, and 16 weeks. RESULTS: Defect fill occurred at ~4 weeks post-injury, however, histological grading showed that the repair tissue never became normal, primarily due to the presence of fibrocartilage. Gene expression levels of Col1a1 and Col1a2 were higher in the defect compared to adjacent regions. Collagen content in the repair tissue reached the level of normal cartilage at 6 weeks, but it took 12 weeks for the extent of lysine hydroxylation to return to normal. Divalent immature cross-links markedly increased in the early stages of repair. Though the levels gradually diminished thereafter, they never returned to the normal levels. The mature cross-link, pyridinoline, gradually increased with time and nearly reached normal levels by week 16. Infrared imaging data of protein content paralleled the biochemical data. However, collagen maturity, a parameter previously shown to reflect collagen cross-link ratios in bone, did not correlate with the biochemical determination of cross-links in the repair tissue.. CONCLUSION: Collagen biochemical data could provide markers for clinical monitoring in a healing defect.

The relationship of training milestones with racing success in a population of Standardbred horses in New Zealand

AIM

To investigate the association between attainment of training milestones by 2-year-old horses with racing outcomes in a population of Standardbred racehorses in New Zealand.

METHODS

Retrospective records of the 2001/2002-born Standardbred foals were obtained. The three training milestones used were: registered with a trainer, entered in a trial, and competed in a race. The racing outcomes were length of career in years raced and number of race starts, and total earnings. Cox regression analysis was used to assess the association between attainment of the three milestones by 2-year-olds and the number of race starts and years raced. Logistic regression models were used to determine the association between attainment of the milestones by 2-year-olds and the outcomes won and placed in a race. Linear regression was used to model the association between attainment of the milestones by 2-year-olds and annual earnings and total earnings (transformed using Ln (earnings+NZ$100)).

RESULTS

Of 3,032 horses in the population, 1,018 (33.6%) registered with a trainer, 609 (20.1%) trialled, and 272 (9.0%) raced as 2-year-olds. Horses that first raced as 2-year-olds had a longer racing career and more race starts than those that that did not race as 2-year-olds (p<0.001); this was also true when starts in the 2-year-olds were omitted from analyses. Horses that were registered with a trainer, trialled or raced as 2-year-olds were more likely to have won or placed in a race than those that did not achieve the milestones as 2-year-olds (p<0.001). Linear regression showed horses that trialled and raced as 2-year-olds had greater total earnings than those that did not, and male horses had a greater total earnings than female horses.

CONCLUSION

Only one third the Standardbred racehorses born in 2001/2002 registered with a trainer as 2-year-olds, but the results of this study indicate that horses that began training, trialling, or racing as 2-year-olds had longer and more successful careers than those that did not achieve the milestones as 2-year-olds. Further investigation is required to quantify the management practices of these horses to determine the factors that may be associated with a successful racing career.

Minor influence of lifelong voluntary exercise on composition, structure, and incidence of osteoarthritis in tibial articular cartilage of mice compared with major effects caused by growth, maturation, and aging

We investigated the effects of lifelong voluntary exercise on articular cartilage of mice. At the age of 4 weeks C57BL mice (n = 152) were divided into two groups, with one group serving as a sedentary control whereas the other was allowed free access to a running wheel from the age of 1 month onward. Mice were euthanized at four different time points (1, 2, 6, and 18 months of age). Articular cartilage samples were gathered from the load-bearing area of the tibial medial plateaus, and osteoarthritis was graded. Additionally, the proteoglycan content distribution was assessed using digital densitometry, collagen fibril orientation, and parallelism with polarized light microscopy, and collagen content using Fourier transform infrared imaging spectroscopy. The incidence of osteoarthritis increased with aging, but exercise had no effect on this trend. Furthermore, the structure and composition revealed significant growth, maturation, and age-dependent properties. Exercise exerted a minor effect on collagen fibril orientation in the superficial zone. Fibril orientation at 2 months of age was more perpendicular to surface (p < 0.05) in controls compared with runners, whereas the situation was reversed at the age of 18 months (p < 0.05). The collagen content of the superficial zone was higher (p < 0.01) at the age of 18 months in controls compared with runners but the proteoglycan content did not display any exercise-dependent changes. In conclusion, growth, maturation, and aging exerted a clear effect on integrity, structure, and composition of medial tibial plateau articular cartilage in mice, whereas lifelong voluntary exercise had only a minor effect on collagen architecture and content.

Biomechanical influence of cartilage homeostasis in health and disease

There is an urgent demand for long term solutions to improve osteoarthritis treatments in the ageing population. There are drugs that control the pain but none that stop the progression of the disease in a safe and efficient way. Increased intervention efforts, augmented by early diagnosis and integrated biophysical therapies are therefore needed. Unfortunately, progress has been hampered due to the wide variety of experimental models which examine the effect of mechanical stimuli and inflammatory mediators on signal transduction pathways. Our understanding of the early mechanopathophysiology is poor, particularly the way in which mechanical stimuli influences cell function and regulates matrix synthesis. This makes it difficult to identify reliable targets and design new therapies. In addition, the effect of mechanical loading on matrix turnover is dependent on the nature of the mechanical stimulus. Accumulating evidence suggests that moderate mechanical loading helps to maintain cartilage integrity with a low turnover of matrix constituents. In contrast, nonphysiological mechanical signals are associated with increased cartilage damage and degenerative changes. This review will discuss the pathways regulated by compressive loading regimes and inflammatory signals in animal and in vitro 3D models. Identification of the chondroprotective pathways will reveal novel targets for osteoarthritis treatments.

The effect of previous conditioning exercise on diaphyseal and metaphyseal bone to imposition and withdrawal of training in young Thoroughbred horses

This study recorded the response to training of the diaphysis of the proximal phalangeal bone and the third metacarpal bone (Mc3) and the Mc3 proximal metaphysis. Nineteen 2- and 3-year old horses in training were exposed either to spontaneous exercise at pasture (PASTEX group) or additional imposed exercise (CONDEX group) from a very young age. Quantitative computed tomography scans were analysed for bone mineral content, size, bone mineral density, periosteal and endosteal circumference, cortical thickness and an estimate of bone strength. The bones of the CONDEX horses were bigger and stronger than those of the PASTEX horses at the start of the observation period, and these differences were maintained after adjusting for training workload. Increase in the bone strength index was through size and not density increase. Density increased during training and decreased during paddock rest between the two training campaigns, during which time bone strength continued to increase because of the slow growth that was still occurring. The greatest variance in the response to the training exercise of diaphyseal bone mineral content, bone strength index or cortical thickness was associated with the cumulative workload index at the gallop, although statistically significant unexplained variances remained. There were no differences in bone response to training, with the exception of the endosteal circumference at 55% of the Mc3 length from the carpometacarpal joint space between CONDEX and PASTEX, which indicated that young horses may be able to be exercised slightly more vigorously than currently accepted.

Mild exercise early in life produces changes in bone size and strength but not density in proximal phalangeal, third metacarpal and third carpal bones of foals

Exercise or lack of it in early life affects chondro-osseous development. Two groups of horses were used to investigate the effects of age and exercise regimen on bone parameters of diaphyseal, metaphyseal, epiphyseal and cuboidal bones of the distal limb of Thoroughbreds. One group had exercised only spontaneously from an early age at pasture (PASTEX group), while the other group of horses were exposed to a 30% greater workload through additional defined exercise (CONDEX). Longitudinal data from peripheral quantitative computed tomography (pQCT) were obtained from eight scan sites of the left forelimb (proximal phalangeal (P(p); 1 site), third metacarpal (Mc3; six sites) and third carpal (C(3); one site) bones) of 32 Thoroughbred foals scanned five times from ∼3 weeks to 17 months of age. The primary outcome measures were bone mineral content (BMC), bone area (BA), and periosteal circumference (Peri C) in diaphyseal bone, with cortical thickness (CortTh), volumetric bone mineral density (BMD(v)) and a bone strength index (SSI) also being analysed. At the P(p) site within the model there was a significant effect (P=0.00-0.025) of conditioning exercise increasing bone parameters, except endosteal circumference (Endo C) and BMD(v). The BMC, BA, and SSI of P(p) were significantly greater in the CONDEX than PASTEX groups at 12 and 17 months (P=0.015-0.042) and CortTh at 17 months (P=0.033). At the M55 site of Mc3 BMC, BA and SSI (P=0.02-0.04), and at the M33 site, SSI (P=0.05) were higher in the CONDEX than PASTEX group. The adaptive responses, consistent with diaphyseal strengthening, were more marked in the diaphysis of P(p) than Mc3. In the Mc3, metaphysis, trabecular BMD(v) was less in the CONDEX than PASTEX group, associated with greater bone mineral accretion in the outer cortical-sub-cortical bone in the CONDEX group. There were no significant between-group differences in any epiphyseal or cuboidal bone parameter. Although the early imposed exercise regimen was not intensive, it had significant effects on diaphyseal bone strength, through change in size but not bone density.

Effects of growth and exercise on composition, structural maturation and appearance of osteoarthritis in articular cartilage of hamsters

Articular cartilage composition and structure are maintained and remodeled by chondrocytes under the influence of loading. Exercise-induced changes in the composition, structure, mechanical properties and tissue integrity of growing and aging hamster articular cartilage were investigated. Articular cartilage samples (n = 191) were harvested from the proximal tibiae of hamsters aged 1, 3, 6, 12 and 15 months. The hamsters were divided into runners and controls. The runners had free access to a running wheel between 1 and 3 months (runner groups 3-, 12- and 15-month-old hamsters) or 1 and 6 months (runner group 6-month-old hamsters) of age. Control animals were subjected to a sedentary lifestyle. Mechanical indentation tests and depth-wise compositional and structural analyses were performed for the cartilage samples. Furthermore, the integrity of articular cartilage was assessed using histological osteoarthritis grading. Exercise affected the collagen network organization after a 5-month exercise period, especially in the middle and deep zones. However, no effect on the mechanical properties was detected after exercise. Before the age of 12 months, the runners showed less osteoarthritis than the controls, whereas at 15 months of age the situation was reversed. It is concluded that, in hamsters, physical exercise at a young age enhances cartilage maturation and alters the depth-wise cartilage structure and composition. This may be considered beneficial. However, exercise at a young age demonstrated adverse effects on cartilage at a later age with a significant increase in the incidence of osteoarthritis.

Biomechanical, biochemical and structural correlations in immature and mature rabbit articular cartilage

OBJECTIVE

The structure and composition of articular cartilage change during development and growth. These changes lead to alterations in the mechanical properties of cartilage. In the present study, biomechanical, biochemical and structural relationships of articular cartilage during growth and maturation of rabbits are investigated.

DESIGN

Articular cartilage specimens from the tibial medial plateaus and femoral medial condyles of female New Zealand white rabbits were collected from seven age-groups; 0 days (n=29), 11 days (n=30), 4 weeks (n=30), 6 weeks (n=30), 3 months (n=24), 6 months (n=24) and 18 months (n=19). The samples underwent mechanical testing under creep indentation. From the mechanical response, instantaneous and equilibrium moduli were determined. Biochemical analyses of tissue collagen, hydroxylysylpyridinoline (HP) and pentosidine (PEN) cross-links in full thickness cartilage samples were conducted. Proteoglycans were investigated depth-wise from the tissue sections by measuring the optical density of Safranin-O-stained samples. Furthermore, depth-wise collagen architecture of articular cartilage was analyzed with polarized light microscopy. Finite element analyses of the samples from different age-groups were conducted to reveal tensile and compressive properties of the fibril network and the matrix of articular cartilage, respectively.

RESULTS

Tissue thickness decreased from approximately 3 to approximately 0.5mm until the age of 3 months, while the instantaneous modulus increased with age prior to peak at 4-6 weeks. A lower equilibrium modulus was observed before 3-month-age, after which the equilibrium modulus continued to increase. Collagen fibril orientation angle and parallelism index were inversely related to the instantaneous modulus, tensile fibril modulus and tissue thickness. Collagen content and cross-linking were positively related to the equilibrium compressive properties of the tissue.

CONCLUSIONS

During maturation, significant modulation of tissue structure, composition and mechanical properties takes place. Importantly, the present study provides insight into the mechanical, chemical and structural interactions that lead to functional properties of mature articular cartilage.

Influence of exercise and joint topography on depth-related spatial distribution of proteoglycan and collagen content in immature equine articular cartilage

REASONS FOR PERFORMING STUDY

There is ample evidence on topographical heterogeneity of the principal biochemical components of articular cartilage over the surface of the joint and the influence of loading thereon, but no information on depth-related zonal variation in horses.

OBJECTIVES

To study depth-related zonal variation in proteoglycan (PG) and collagen content in equine articular cartilage.

METHODS

Two techniques (safranin-O densitometry and Fourier transform infrared spectroscopy) were applied to sections of articular cartilage from the proximal phalangeal bone of the metacarpophalangeal joint of 18-month-old Thoroughbreds that had been raised at pasture from age 0-18 months without (PASTEX) and with (CONDEX) additional exercise. Two sites were investigated: site 1 at the joint margin that is unloaded at rest or at slow gaits, but subjected to high-intensity loading during athletic activity; and site 2, a continuously, but less intensively, loaded site in the centre of the joint.

RESULTS

Proteoglycan values increased from the surface to the deep layers of the cartilage, collagen content showed a reverse pattern. PG content was significantly higher at site 2 in both PASTEX and CONDEX animals without an effect of exercise. In the PASTEX animals collagen content was significantly higher at site 1, but in the CONDEX group the situation was reversed, due to a significant exercise effect on site 1, leading to a reduced collagen content.

CONCLUSIONS

Collagen and PG content gradients agree with findings in other species. The observations on PG levels suggest that the exercise level was not strenuous. The collagen results in the PASTEX group confirmed earlier findings, the lower levels at site 1 in the CONDEX group being possibly due to an advancement of the physiological maturation process of collagen remodelling.

POTENTIAL RELEVANCE

This study confirms earlier observations that even moderate variations in exercise level in early age may have significant effects on the collagen network of articular cartilage.

Effect of loading on the organization of the collagen fibril network in juvenile equine articular cartilage

We investigated the effects of exercise-induced loading on the collagen network of equine articular cartilage. Collagen fibril architecture at a site (1) subjected to intermittent high-intensity loading was compared with that of an adjacent site (2) sustaining continuous low-level load. From horses exposed to forced exercise (CONDEX group) or not (PASTEX group), the spatial parallelism of fibrils and the orientation angle between fibrils and the surface at depths 9 microm apart through cartilage from surface to tidemark were determined using polarized light microscopy, and expressed as parallelism index (PI) and orientation index (OI). PI was significantly higher in site 2 than 1 in CONDEX and PASTEX groups. PI was significantly higher in forced exercised horses at site 2 but not site 1. OI was significantly greater (more perpendicular to the surface) in the superficial and deep cartilage of site 2 than 1 in both CONDEX and PASTEX groups. Superficial zone OI was higher in exercised horses at site 1 but not at site 2. Exercise increased collagen parallelism and affected orientation. The site differences in OI indicate that Benninghoff's classic predominantly perpendicular arcades appear not to be a consistent architectural feature, but adapt to local forces sustained.

Influence of early conditioning exercise on the development of gross cartilage defects and swelling behavior of cartilage extracellular matrix in the equine midcarpal joint

OBJECTIVE

To investigate the influence of early conditioning exercise on the development of gross cartilage defects and swelling behavior of cartilage extracellular matrix (ECM) in the midcarpal joint of horses.

ANIMALS

12 Thoroughbreds.

PROCEDURES

6 horses underwent early conditioning exercise from birth to 18 months of age (CONDEX group), and 6 horses were used as control animals (PASTEX group). The horses were euthanized at 18 months of age, and the midcarpal joints were harvested. Gross defects of the cartilage surface were classified and mapped. Opposing surfaces of the third and radial carpal bones were used to quantify swelling behavior of the cartilage ECM.

RESULTS

A wide range of gross defects was detected in the cartilage on the opposing surfaces of the bones of the midcarpal joint; however, there was no significant difference between the CONDEX and PASTEX groups. Similarly, no significant difference in swelling behavior of the cartilage ECM was evident between the CONDEX and PASTEX groups.

CONCLUSIONS AND CLINICAL RELEVANCE

In the study reported here, we did not detect negative influences of early conditioning exercise on the prevalence of gross defects in cartilage of the midcarpal joint or the quality of the cartilage ECM as defined by swelling behavior. These results suggested that early conditioning exercise may be used without negative consequences for the midcarpal joint and the cartilage ECM of the third and radial carpal bones.

Changes in spatial collagen content and collagen network architecture in porcine articular cartilage during growth and maturation

OBJECTIVES

The present study was designed to reveal changes in the collagen network architecture and collagen content in cartilage during growth and maturation of pigs.

METHODS

Femoral groove articular cartilage specimens were collected from 4-, 11- and 21-month-old domestic pigs (n=12 in each group). The animal care conditions were kept constant throughout the study. Polarized light microscopy was used to determine the collagen fibril network birefringence, fibril orientation and parallelism. Infrared spectroscopy was used to monitor changes in the spatial collagen content in cartilage tissue.

RESULTS

During growth, gradual alterations were recorded in the collagen network properties. At 4 months of age, a major part of the collagen fibrils was oriented parallel to the cartilage surface throughout the tissue. However, the fibril orientation changed considerably as skeletal maturation progressed. At 21 months of age, the fibrils of the deep zone cartilage ran predominantly at right angles to the cartilage surface. The collagen content increased and its depthwise distribution changed during growth and maturation. A significant increase of the collagen network birefringence was observed in the deep tissue at the age of 21 months.

CONCLUSIONS

The present study revealed dynamic changes of the collagen network during growth and maturation of the pigs. The structure of the collagen network of young pigs gradually approached a network with the classical Benninghoff architecture. The probable explanation for the alterations is growth of the bone epiphysis with simultaneous adaptation of the cartilage to increased joint loading. The maturation of articular cartilage advances gradually with age and offers, in principle, the possibility to influence the quality of the tissue, especially by habitual joint loading. These observations in porcine cartilage may be of significance with respect to the maturation of human articular cartilage.

Changes in subchondral bone mineral density and collagen matrix organization in growing horses

OBJECTIVE

The effects of growth and maturation on the mineral deposition and the collagen framework of equine subchondral bone (SCB) were studied.

MATERIALS AND METHODS

Osteochondral specimens (diameter 6 mm) from the left metacarpophalangeal joint of 5-(n=8), 11-(n=8) and 18-month-old (n=6) horses were investigated at two differently loaded sites (Site 1 (S1): intermittent peak loading; Site 2 (S2): habitual loading). The SCB mineral density (BMD) was measured with peripheral quantitative computer tomography (pQCT), and the data were adjusted against the volume fraction (Vv) of the bone extracellular matrix (ECM). Polarised light microscopy (PLM) was used to analyze the Vv, the collagen fibril parallelism index and the orientation angle distribution in two fractions (1 mm/fraction) beneath the osteochondral junction of the SCB. PLM analysis was made along two randomly selected perpendicularly oriented vertical sections to measure the tissue anisotropy in the x-, y-, and z-directions.

RESULTS

The BMD of SCB at S1 and S2 increased significantly during maturation. At the same time, the Vv of the ECM increased even more. This meant that the Vv-adjusted BMD decreased. There were no significant differences between sites. The basic collagen fibril framework of SCB seems to be established already at the age of 5 months. During maturation, the extracellular matrix underwent a decrease in collagen fibril parallelism but no changes in collagen orientation. The variation was negligible in the collagen network estimates in the two section planes.

CONCLUSIONS

Growth and maturation induce significant changes in the equine SCB. The BMD increase in SCB is primarily due to the growth of bone volume and not to any increase in mineral deposition. An increase in weight-bearing appears to greatly affect the BMD and the volume of the extracellular matrix. Growth and maturation induce a striking change in collagen fibril parallelism but not in fibril orientation. The structural anisotropy of the subchondral bone is significant along the vertical (x-y) direction but not in the transversal (z) direction.