Maturation of proteoglycan matrix in articular cartilage under increased and decreased joint loading. A study in young rabbits

The relationship between subchondral bone cysts and cartilage health in the Tibiotalar joint: A finite element analysis

BACKGROUND

Subchondral bone cysts are a common presentation in ankle haemarthropathy. The relationship with ankle joint health has however not previously been investigated. The aim of this study was to assess the influence of subchondral bone cysts of differing shapes, volumes and depths on joint health.

METHODS

Chronologically sequential Magnetic Resonance imaging scans of four hemophilic ankles with subchondral bone cysts present (N = 18) were used to build patient specific finite element models under two cystic conditions to assess their influence on cartilage contact pressures. Variables such as location, volume and depth were considered individually, to investigate whether certain cystic conditions may be more detrimental to cartilage health.

FINDINGS

Significant quantifiable contact redistribution was seen in the presence of subchondral bone cysts and this redistribution reflected the shape and size of the cysts, however, with the presence of cysts in both bones in 10 of the 18 cases a direct relationship to volume could not be correlated.

INTERPRETATION

This work demonstrated a redistribution of contact pressures in the presence of subchondral bone cysts. This alteration to loading history could be linked to cartilage degeneration due to the biological response to abnormal loading.

Bone replaces unloaded articular cartilage during knee immobilization. A longitudinal study in the rat

BACKGROUND

Joint immobility results in deleterious changes such as capsule shortening, bone loss and articular cartilage damage. Immobilization of rat knees in flexion for 32 weeks resulted in the distinctive feature of well-established replacement of articular cartilage by bone. Determining the time of onset of bone replacement is critical for the prevention of this likely irreversible complication of joint immobilization.

OBJECTIVES

To determine the onset and progression of bone replacement in the anterior tibial articular cartilage following knee immobilization in flexion.

METHODS

One hundred forty-nine adult male Sprague-Dawley rats were used. The experimental groups had one knee immobilized at 135°of flexion for durations of 2, 4, 8, 16 or 32 weeks and were compared to age-matched controls. The knees were evaluated histologically for the presence and cross-sectional area of bone within the articular cartilage of the tibia. Distance between the anterior aspect of the tibia and intact articular cartilage and cross-sectional bone area of the tibial epiphysis were also measured.

RESULT

Bone replacement in the articular cartilage was observed in 14%, 75%, 95%, 100% and 100% of knees after 2, 4, 8, 16 and 32 weeks of immobilization, respectively. No bone replacement was seen in the control knees. The mean area of bone replacement increased from 0.004 ± 0.007 mm² after 2 weeks to 0.041 ± 0.036 mm²; 0.085 ± 0.077 mm²; 0.092 ± 0.056 mm² and 0.107 ± 0.051 mm² after 4, 8, 16 and 32 weeks of immobilization, respectively, (p < 0.001) largely restricted to the anterior tibial articular cartilage. Mean distance to intact articular cartilage increased from 0.89 ± 0.69 mm at 2 weeks to 1.10 ± 0.35 mm; 1.65 ± 0.77 mm; 1.48 ± 0.63 mm; and 1.78 ± 0.58 mm after 4, 8, 16 and 32 weeks of immobilization, respectively (p = 0.001). Epiphyseal bone cross-sectional area was significantly reduced following 4, 8, and 16 weeks of immobilization compare to controls (all 3 p < 0.05).

CONCLUSION

Knee immobilization in flexion resulted in bone replacement in the anterior tibial articular cartilage that began after 2 weeks and was prevalent after 4 weeks of immobilization. The bone replacement progressed in an anterior-to-posterior direction and stopped at the area of contact between tibia and femur. These findings stress the importance of mobility to maintain joint health.

Protective effect of glucosamine and risedronate (alone or in combination) against osteoarthritic changes in rat experimental model of immobilized knee

This study is aiming to investigate the protective effect of glucosamine, risedronate (alone or in combination) on articular cartilage in experimental model of immobilized rat knee. Twenty-five adult male albino rats were divided into five groups (five rats each): control group, immobilized group, glucosamine-treated group, risedronate-treated group, and group treated by a combination of glucosamine and risedronate. The articular cartilage was obtained for histological, immunohistochemical and morphometric studies. The immobilized group showed manifestations of osteoarthritis in the form of significant decrease of articular cartilage thickness with surface erosions, shrunken chondrocytes with pyknotic nuclei and marked manifested fall of chondrocyte number. There was manifested reduction of collagen contents of the articular cartilage using Masson trichrome stain. Safranin O–Fast Green revealed low proteoglycan contents. The collagen type II was also declined. The manikin score was 7.8. Risedronate improved this manifestation slightly more than glucosamine, but combination of booth drugs caused significant improvement of the damaged articular cartilage caused by immobilization. Oral administration of glucosamine and risedronate improved the degenerative changes of rat knee articular cartilage that follow immobilization. This improvement was more remarkable when both drugs were used in combination.

Effect of Dynamic Compression on in vitro Chondrocyte Metabolism

Background

Chondrocytes can detect and respond to the mechanical environment by altering their metabolism. This study was designed to explore the effects of dynamic compression on chondrocyte metabolism.

Methods

Chondrocytes were harvested from newborn Wistar rats. After 7 days of expansion, chondrocytes embedded in agarose discs underwent uniaxial unconfined dynamic compression loads at different amplitudes (5%, 10%, and 15%) and frequencies (0.5 Hz, 1.0 Hz, 2.0 Hz, and 3.0 Hz) with a duration of 24 hours. The delayed effects on the chondrocytes were studied at 1, 3, and 7 days after the experiment.

Results

The results showed that at 10% strain, higher-frequency compression pressure can enhance the proliferation of chondrocytes. The synthesis of glycosaminoglycan (GAG) increased at 10%-15% strain and a 1-Hz load. The synthesis of nitric oxide (NO) increased at the 0.5-Hz load; while decreasing at the 15% strain. With 10% strain, 1 Hz dynamic compression, the proliferation of chondrocytes and GAG synthesis increased and persisted for 7 days, and NO synthesis decreased at the third and seventh days of culture.

Conclusions

This study showed that chondrocytes respond metabolically to compressive loading, which is expected to modulate the growth and the resultant biomechanical properties of these tissue-engineered constructs during culture.

Bone replaces articular cartilage in the rat knee joint after prolonged immobilization

BACKGROUND

Lost joint range of motion (ROM) is common in chronic osteoarthritis, alters regional weight-bearing across the articular surfaces, and contributes to loss of cartilage and bone alterations. Limited data exist on the regional effects on joints subjected to chronic losses of ROM.

OBJECTIVE

To characterize the regional replacement by bone as part of articular cartilage degeneration after prolonged immobilization.

METHODS

Eleven rat knees were rigidly-immobilized in flexion for 32weeks with contralateral and sham-operated (n=6) knees as controls. Sagittal medial tibial epiphysis histological sections assessed the anterior (non-weight-bearing), middle and posterior (both weight-bearing) regions. We quantified the distribution of collagen I, collagen II, cartilage thickness, glycosaminoglycan (GAG) staining, Mankin scoring, and subchondral bone plate cross-sectional area. Using immunohistochemistry (IHC), we visualized blood vessels, osteoblasts, and mesenchymal stem cells (MSCs).

RESULTS

Immobilized cartilage had increased collagen I content in the anterior tibial region with picrosirius red staining (immobilized=61±20%; contralateral=43±12%, p=0.033; sham=20±10%, p=0.028) and collagen I IHC (immobilized=40±10%; contralateral=11±4%, p=0.003; sham=5±3%, p=0.043). Articular cartilage was thinner anteriorly (18±30μm) in immobilized knees versus contralateral (124±40μm, p<0.001) and sham (125±43μm, p=0.043). GAG staining covered 2±4% of the anterior articular area in immobilized knees versus 28±12% contralaterally (p=0.003) and 26±7% in sham (p=0.043). Mankin scores in immobilized knees were 4.7±1.7 versus 0.2±0.4 and 0±0 for contralateral and sham (p=0.003, p=0.042), respectively. The trabecular bone plate area of anterior and posterior regions showed relative loss of cross-sectional area in immobilized knees compared to controls (immobilized/contralateral area ratios of 0.67 and 0.46 respectively, both p=0.003), while the area in the middle region was preserved. Movat's pentachrome stain and CD31 staining showed chondral vascular ingrowth from subchondral bone. Osteocalcin and CD90 MSC staining were decreased in immobilized knees versus contralateral (p=0.003, p=0.036 respectively).

CONCLUSIONS

Bony replacement characterizes articular cartilage degeneration of knees immobilized for 32weeks in the anterior, non-weight bearing region of the tibia. Replacement of cartilage by bone may have been mediated by chondral vascularization, suggesting irreversible changes. These findings stress the importance of weight-bearing and joint motion to maintain cartilage structure.

Alteration of cartilage surface collagen fibers differs locally after immobilization of knee joints in rats

The purpose of this study was to examine the ultrastructural changes of surface cartilage collagen fibers, which differ by region and the length of the experimental period in an immobilization model of rat. Male Wistar rats were randomly divided into histological or macroscopic and ultrastructural assessment groups. The left knees of all the animals were surgically immobilized by external fixation for 1, 2, 4, 8 or 16 weeks (n = 5/time point). Sagittal histological sections of the medial mid-condylar region of the knee were obtained and assessed in four specific regions (contact and peripheral regions of the femur and tibia) and two zones (superficial and deep). To semi-quantify the staining intensity of the collagen fibers in the cartilage, picrosirius red staining was used. The cartilage surface changes of all the assessed regions were investigated by scanning electron microscopy (SEM). From histological and SEM observations, the fibrillation and irregular changes of the cartilage surface were more severe in the peripheral region than in the contact region. Interestingly, at 16 weeks post-immobilization, we observed non-fibrous structures at both the contact and peripheral regions. The collagen fiber staining intensity decreased in the contact region compared with the peripheral region. In conclusion, the alteration of surface collagen fiber ultrastructure and collagen staining intensity differed by the specific cartilage regions after immobilization. These results demonstrate that the progressive degeneration of cartilage is region specific, and depends on the length of the immobilization period.

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.

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.

Changes of articular cartilage after immobilization in a rat knee contracture model

The objective was to determine the changes of articular cartilage of the knee joint during immobilization in a rat model. The knee joints of adult male rats were immobilized at 150 degrees of flexion using an internal fixator for 3 days, and 1, 2, 4, 8, and 16 weeks. The articular cartilage from the medial midcondylar region of the knee was obtained, divided into three areas (non-contact area, transitional area, contact area), and in each area, a degree of degeneration was evaluated by gross observation, histomorphometric grading, and measurements of thickness and number of chondrocytes. Elasticity of the articular cartilage was estimated by measuring the sound speed with use of scanning acoustic microscopy. Degeneration of the articular cartilage was mainly observed in the contact and transitional areas. Matrix staining intensity by safranin-O and number of chondrocytes were decreased in these two areas. The thickness of the articular cartilage in the non-contact and contact areas was unchanged, but it was increased in the transitional area. Decrease in sound speed was observed in the transitional area of both the femoral and tibial cartilage, indicating the softening of the articular cartilage. The changes of articular cartilage became obvious as early as 1 week after immobilization. These changes may be due to a lack of mechanical stress or a lack of joint fluid circulation during immobilization. Although we do not know the reversibility of these changes of articular cartilage, early mobilization is preferable to avoid these cartilage changes.

Intra-articular injection of hyaluronan diminishes loss of chondrocytes in a rat immobilized-knee model

Joint immobilization is a useful and common treatment modality in orthopedics. However, it also causes unfavorable outcome such as articular cartilage degeneration. Intra-articular injection of hyaluronan has been accepted as a treatment of osteoarthritis, but its effects on immobilized joint remain to be clarified. Hyaluronan is a polysaccharide, distributed ubiquitously in various tissues. In this study, we examined the effect of hyaluronan on the articular cartilage in immobilized joints. The unilateral knee joints of adult male rats were immobilized at 150 degrees in flexion with an internal plate and screws for 1, 2, 4, 6, 8, 12, or 16 weeks (n = 84). Hyaluronan or saline (50 microl/each injection) was administered intra-articularly on the day of surgery and once a week. The articular cartilage from the medial midcondylar region of the knee was obtained, and divided into non-contact, contact and transitional areas (between the non-contact and the contact areas). In each area, a degree of degeneration was evaluated by histomorphometric grading, and measurements of thickness and number of chondrocytes. Histological grading scores in the hyaluronan group were smaller at 12 and 16 weeks compared with those in the saline group. The thickness of the articular cartilage increased in the transitional area in both groups. The number of chondrocytes in the contact and transitional areas gradually decreased, but their number in the hyaluronan group was greater at 12 and 16 weeks compared with that in the saline group. Hyaluronan showed chondroprotective effects on the articular cartilage in a rat immobilized-knee model.

Alteration in articular cartilage of rat knee joints after spinal cord injury

OBJECTIVE

Mechanical forces are crucial for the maintenance of the morphologic and functional integrity of articular cartilage. The alteration of the articular cartilage after spinal cord injury (SCI) has been described in relation to a suppression of mechanical forces, since the joint is unloaded and restricted in movement. However, the morphological and biochemical characteristics of the cartilage after SCI are still poorly understood. We identified the localization of cartilage alterations after SCI and verified the influence of mechanical forces on the articular cartilage.

METHOD

A total of 32 Wistar rats were used. Sixteen animals underwent an SCI and 16 animals served as control. The articular cartilage of the knee joint was assessed, respectively, at 4, 8, 10, and 12 weeks after intervention by histochemical, histomorphometric, immunohistochemical, and biochemical analyses.

RESULTS

Cartilage thickness of spinal cord-injured knees decreased at the tibial and posterior femoral (FP) regions and increased at the anterior femoral (FA) region. Spinal cord injuries decreased the number of chondrocytes at the anterior regions and decreased the cartilage matrix staining only at the tibial regions. Immunolabeling to collagen type II was noted comparably in the superficial layer but noted weakly from the middle to deep layer. Collagen type I existed excessively at the cartilage surface and the pericellular regions.

CONCLUSION

Cartilage alterations after SCI would not be explained by only a suppression of mechanical forces by unloading and immobilization, but there may be influences on the cartilage in addition to the change in mechanical forces.

Early neuromuscular electrical stimulation to optimize quadriceps muscle function following total knee arthroplasty: a case report

STUDY DESIGN

Case report.

BACKGROUND

Following total knee arthroplasty (TKA), restoration of normal quadriceps muscle function is rare. One month after surgery, quadriceps torque (force) is only 40% of preoperative values and quadriceps activation is only 82% of preoperative levels, despite initiating postoperative rehabilitation the day after surgery. Early application of neuromuscular electrical stimulation (NMES) offers a possible approach to minimize loss of quadriceps torque more effectively than traditional rehabilitation exercises alone.

CASE DESCRIPTION

A 65-year-old female underwent a right, cemented TKA. Isometric quadriceps and hamstrings muscle torque were measured preoperatively and at 3, 6, and 12 weeks after TKA. Quadriceps muscle activation was measured using a doublet interpolation technique at the same time points. The patient participated in a traditional TKA rehabilitation program augmented by NMES, which was initiated 48 hours after surgery and continued twice a day for the first 3 weeks, and once daily for 3 additional weeks.

OUTCOMES

Preoperatively, the involved quadriceps produced 75% of the torque of the uninvolved side and demonstrated only 72.9% activation. At 3, 6, and 12 weeks after TKA, quadriceps torque was greater than the preoperative values of the involved side by 16%, 29%, and 56%, respectively. Similarly, activation improved to 93.4%, 94.6%, and 93.5% at 3, 6, and 12 weeks after TKA.

DISCUSSION

Mitigating quadriceps muscle weakness immediately after TKA using early NMES may improve functional outcomes, because quadriceps weakness has been associated with numerous functional limitations and an increased risk for falls. Despite presenting preoperatively with substantial quadriceps torque and activation deficits, the patient in this case demonstrated improvements in quadriceps function at all the times measured, all of which were superior to those reported in the literature. The patient also made substantial improvements in functional outcomes, including the Knee Injury and Osteoarthritis Outcome Score (KOOS), 6-minute walk test, timed up and go (TUG) test, stair-climbing test, and the SF-36 Physical Component Score. Appropriately controlled clinical trials will be necessary to determine whether such favorable outcomes following TKA are specifically attributable to the addition of NMES to the rehabilitation program.

Contrasting alterations of apposed and unapposed articular cartilage during joint contracture formation

OBJECTIVE

To quantify histologic articular cartilage alterations after immobilization, distinguishing between apposed and unapposed sites in an animal model of joint contracture.

DESIGN

Experimental controlled trial.

SETTING

Laboratory, in vivo study.

ANIMALS

Adult male Sprague-Dawley rats (N=128).

INTERVENTIONS

One hundred seventeen animals had 1 knee internally immobilized or sham-operated for 2, 4, 8, 16, or 32 weeks. One knee in 11 nonoperated animals served as controls. Main outcome measures On standardized sections, we identified femur and tibia cartilage sites that were apposed or that were unapposed. We quantified 4 characteristics: number of chondrocytes in the superficial and deep cartilage; matrix staining intensity to toluidine blue; surface irregularity of articular cartilage; and thickness of cartilage.

RESULTS

Immobilized knees harbored fewer chondrocytes in the superficial cartilage at apposed sites and in the deep cartilage at unapposed sites. Matrix staining decreased only at unapposed sites. Cartilage surface became significantly more irregular at both sites but cartilage thickness remained unchanged. Noncartilaginous tissues appeared only at unapposed sites in the superficial and deep cartilage.

CONCLUSIONS

Immobilization led to contrasting patterns of cartilage degeneration at apposed sites compared with unapposed sites. These results suggest distinct pathogenetic pathways for cartilage alterations, possibly through absence of mechanical forces (negative mechanotransduction) at unapposed sites and cyclic pressure at apposed sites. Considering the limited potential for cartilage self-repair, these results support the need for early diagnosis and aggressive mobilization of joints that are developing contractures.

Feasibility of Polysaccharide Hybrid Materials for Scaffolds in Cartilage Tissue Engineering: Evaluation of Chondrocyte Adhesion to Polyion Complex Fibers Prepared from Alginate and Chitosan

The ideal cell-carrier material for cartilage regeneration should be one that closely mimics the natural environment in a living articular cartilage matrix. In the current study, we considered that alginate-based chitosan hybrid biomaterials could provide excellent supports for chondrocyte adhesion. To test this hypothesis, we investigated the adhesion behavior of rabbit chondrocytes onto an alginate polymer versus the adhesion of the chondrocytes onto some alginate-based chitosan hybrid polymer fibers in vitro. We demonstrated that the alginate-based chitosan hybrid polymer fibers showed much improved adhesion capacity with chondrocytes in comparison with alginate polymer fiber. Additionally, morphologic studies revealed maintenance of the characteristic round morphology of the chondrocyte and the dense fiber of the type II collagen produced by the chondrocytes in the hybrid polymer. On the basis of these results, we conclude that an alginate-based chitosan hybrid polymer fiber has considerable potential as a desirable biomaterial for cartilage tissue scaffolds.

Dynamic compression of cartilage constructs engineered from expanded human articular chondrocytes

Recent works have shown that mechanical loading can alter the metabolic activity of chondrocytes cultured in 3D scaffolds. In this study we determined whether the stage of development of engineered cartilaginous constructs (expanded adult human articular chondrocytes/Polyactive foams) regulates the effect of dynamic compression on glycosaminoglycan (GAG) metabolism. Construct maturation depended on the culture time (3-14 days) and the donor (4 individuals). When dynamic compression was subsequently applied for 3 days, changes in GAG synthesized, accumulated, and released were significantly positively correlated to the GAG content of the constructs prior to loading, and resulted in stimulation of GAG formation only in the most developed tissues. Conversely, none of these changes were correlated with the expression of collagen type II mRNA, indicating that the response of chondrocytes to dynamic compression does not depend directly upon the stage of cell differentiation, but rather on the extracellular matrix surrounding the cells.

Experimental induction of anterior disk displacement of the rabbit craniomandibular joint: an immuno-electron microscopic study of collagen and proteoglycan occurrence in the condylar cartilage

BACKGROUND

Results from our previous studies suggest that surgical induction of anterior disk displacement (ADD) in the rabbit craniomandibular joint (CMJ) leads to histopathological alterations consistent with osteoarthritis. In addition, molecular changes in collagens and glycosaminoglycans (GAGs) were observed using immunohistochemistry. The purpose of the present study was to further characterize those molecular changes in collagens and GAGs using immuno-electron microscopy.

METHODS

The right joint of 15 rabbits was exposed surgically and all discal attachments were cut except for the posterior attachment (the bilaminar zone). The disc was then repositioned anteriorly and sutured to the zygomatic arch. The left joint was used as a sham-operated control. Ten additional joints were used as non-operated controls. Mandibular condyles were removed 2 weeks following surgery and processed for light and immuno-electron microscopy using colloidal gold-labeled antibodies against collagen type I, II, VI and IX and against keratan sulfate, chondroitin-4 and -6-sulfate, and link protein.

RESULTS

Light microscopic results showed osteoarthritic changes. Immuno-electron microscopy of osteoarthritic cartilage demonstrated a decline in type II collagen, the abnormal presence of type I collagen and loss of type VI and IX collagens. Quantitative colloidal gold immuno-electron microscopy confirmed the depletion of keratan sulfate, chondroitin-4 and -6-sulfate, and link protein in osteoarthritic cartilage.

CONCLUSION

Anterior disk displacement leads to molecular alterations in both the collagen and the proteoglycans of rabbit condylar cartilage characteristic of osteoarthritis in other synovial joints. These alterations are consistent with loss of the shock absorber function of the cartilage and injury of the underlying bone.

Serum keratan sulphate as a cartilage metabolic marker in horses: the effect of exercise

Keratan sulphate (KS) concentration in sera from resting horses and horses training daily on a racetrack was measured by an inhibition enzyme-linked immunosorbent assay (ELISA) using anti-equine KS antibody 1/14/16H9. For the in-training horses, serum KS concentrations in 2-year-old-horses was significantly higher than 3- or 4-year-old-horses. A higher concentration of serum KS was found in the in-training group than in the long-term resting group in 2-year-old-horses. Serum KS concentration increased remarkably immediately after training in healthy horses, and at 1, 5, 9 and 24 h after training remained at similar levels to the pre-training concentration. The results suggest that serum KS concentration could represent the situation of joint loading, induced by daily racetrack training, affecting the metabolic activities in joint cartilage.

Tissue adaptation to physical stress: a proposed "Physical Stress Theory" to guide physical therapist practice, education, and research

The purpose of this perspective is to present a general theory--the Physical Stress Theory (PST). The basic premise of the PST is that changes in the relative level of physical stress cause a predictable adaptive response in all biological tissue. Specific thresholds define the upper and lower stress levels for each characteristic tissue response. Qualitatively, the 5 tissue responses to physical stress are decreased stress tolerance (eg, atrophy), maintenance, increased stress tolerance (eg, hypertrophy), injury, and death. Fundamental principles of tissue adaptation to physical stress are described that, in the authors' opinion, can be used to help guide physical therapy practice, education, and research. The description of fundamental principles is followed by a review of selected literature describing adaptation to physical stress for each of the 4 main organ systems described in the Guide to Physical Therapist Practice (ie, cardiovascular/pulmonary, integumentary, musculoskeletal, neuromuscular). Limitations and implications of the PST for practice, research, and education are presented.

Inadequate placement of osteochondral plugs may induce abnormal stress-strain distributions in articular cartilage --finite element simulations

The transplantation of osteochondral (cartilage-bone) plugs is an alternative approach to treat local, full thickness cartilage defects in young patients. It is technically difficult to control the amount of the press fit tolerance and the position of the osteochondral (OC) plug in the recipient hole. Inadequate placement of the OC plugs may produce abnormal stress and strain distributions within the cartilage, and thus influence the regeneration of the injured cartilage site and the maintenance of opposing, healthy cartilage surfaces. In the present study, the influence of press fit tolerance and the placement of the OC plug on the joint contact mechanics was simulated using finite element methods. The joint was assumed to be axi-symmetric with a spherical femur and tibia and a cylindrical OC plug. Our simulations showed that small misplacements of the OC plug induced abnormal tension in the articular cartilage of the opposing, healthy cartilage surface. Such tension might induce unpredictable adaptations, or possibly degenerations, in the opposing cartilage layer. The contact stress profiles in the joint were predicted to change discontinuously across the plug/recipient interface, even when the plug was perfectly placed in the recipient hole, i.e., the plug's surface was aligned with the recipient surface. For a fixed coefficient of friction and a fixed fit tolerance, the maximal sliding force was predicted to vary with the size of the plug and reached a maximum at a specific plug diameter. The present simulations should be helpful for the design of instruments for osteochondral transplantation and placement of OC plugs, for understanding articular cartilage adaptation following osteochondral repair, and for providing insight into the mechanics at the transplant/recipient interface where proper integration of the plug into the joint is most problematic.

Altered swelling behavior of femoral cartilage following joint immobilization in a canine model

Periods of reduced joint loading have been shown to induce changes in the biochemical composition. metabolism and mechanics of articular cartilage. In this study, changes in cartilage swelling behavior were studied following a 4-week period of joint immobilization, using a recently developed osmotic loading technique [J. Biomech, 32 (1999) 401-408]. The magnitude and distribution of swelling strains were measured in cartilage-bone samples equilibrated in physiological and hypotonic saline, relative to a hypertonic reference NaCl solution. Physicochemical parameters (glycosaminoglycan fixed charge density and water volume fraction) were determined in site-matched cartilage samples. The experimental data for swelling strains, fixed charge density and water volume fraction were used with a triphasic mechano-chemical theory [J. Biomech. Eng. 113 (1991) 245-258] to determine the effect of joint immobilization on the tensile modulus of the cartilage solid matrix. Four weeks of immobilization resulted in a significant increase in the magnitude of swelling-induced strains, and a significant decrease in fixed charge density in cartilage, as compared with the contralateral controls. Joint immobilization also resulted in decreases in values for the modulus of cartilage, as compared with the contralateral controls. Our results suggest that 4 weeks of joint immobilization had a significant effect on cartilage mechanical function that may be linked to collagen changes in the cartilage extracellular matrix.

Extracellular matrix composition of full-thickness defect repair tissue is little influenced by exercise in rat articular cartilage

Full-thickness articular cartilage defects in the femoral condyles of adult rats were examined four and eight weeks after injury. Quantitative polarized light microscopic analysis showed that birefringence of the tissue in the central repair area increased more in rats exercised on a treadmill. Glycosaminoglycan content in the repair tissue was also higher than in the intermittent active motion group at four weeks after injury, but by eight weeks the levels were similar in both groups. No normal-looking articular cartilage was formed in the lesions, and only in one animal type II collagen was observed in the superficial zone of repair tissue. No 3B3(-) antigenicity of the proteoglycans was seen during repair. In conclusion, exercise minimally modified the repair of full-thickness articular cartilage defects in adult rats. The repair in the exercised group may occur slightly faster in the early stages but no difference was seen at the eight week time interval between the exercised and the intermittently active group.

Altered mechanics and histomorphometry of canine tibial cartilage following joint immobilization

Joint immobilization is associated with altered cartilage biosynthesis and catabolism that may affect cartilage mechanics and joint function. In this study, the mechanical behavior of articular cartilage was studied in an experimental model of joint immobilization, in which the canine knee was cast-immobilized at 90 degrees of flexion for 4 weeks. Articular cartilage from the medial tibial plateau was tested in compression and in shear. Biochemical assays for water and glycosaminoglycan content and histomorphometric grading were performed on site-matched samples. Significant decreases in the equilibrium and dynamic shear moduli, but not compressive moduli, were observed in cartilage after 4 weeks of joint immobilization as compared to cartilage from a separate control population. Importantly, there was also evidence of a decrease in the compressive and shear moduli of tibial cartilage from the contralateral knee joints compared to control joints that were not immobilized. No significant effect of immobilization on the biochemical parameters or histomorphometric scores was detected, expect for a significant loss of proteoglycan staining following immobilization. These findings for changes in the tibial cartilage following cast immobilization are consistent with a mild form of cartilage degeneration.

Compressive strains at physiological frequencies influence the metabolism of chondrocytes seeded in agarose

Articular cartilage is subjected to dynamic compressive loading that is known to influence chondrocyte metabolism. While the exact signalling mechanisms are unclear, it has been proposed that cell deformation plays a role and may stimulate a metabolic response through distinctive pathways. In this study, a well characterized model system in which chondrocytes are embedded in agarose was used to study the effect of dynamic cellular strain on three key metabolic processes, namely the synthesis of glycosaminoglycan, of DNA, and of total protein. Using a specially designed apparatus, 15% compressive strain amplitude was applied to agarose-chondrocyte cylinders statically or dynamically over a range of frequencies (0.3-3 Hz). Static and low-frequency strain (0.3 Hz) inhibited the synthesis of glycosaminoglycan, while a frequency of 1 Hz stimulated synthesis. Static strain reduced the level of thymidine uptake, whereas dynamic strain at all frequencies induced an increase in chondrocyte proliferation. Incorporation of tritiated proline was suppressed by all strain regimens tested. The three parameters investigated were each influenced by the dynamic strain regimens in a distinct manner, implying that the signalling mechanisms involved are uncoupled.

Characterization of cartilage metabolic response to static and dynamic stress using a mechanical explant test system

A new mechanical explant test system was used to study the metabolic response (via proteoglycan biosynthesis) of mature, weight-bearing canine articular cartilage subjected to static and dynamic compressive stresses. Stresses ranging from 0.5 to 24 MPa were applied sinusoidally at 1 Hz for intervals of 2-24 h. The explants were loaded in unconfined compression and compared to age-matched unloaded explants. Both static and dynamic compressive stress significantly decreased proteoglycan biosynthesis (range 25-85%) for all loading time intervals. The inhibition was proportional to the applied stress but was independent of loading time. After rehydration upon load removal, the measured water content of the loaded explants was not different from the unloaded explants for all test variables. Autoradiographic and electron microscopic analysis of loaded explants showed viable chondrocytes throughout the matrix. Our results suggest that the decreased metabolic response of cyclically loaded explants may be dominated by the static component (RMS) of the dynamic load. Furthermore, the observed decreased metabolism may be more representative of the in situ tissue response than that of unloaded explants, in which we found an increasing rate of metabolism for up to 6 days after explant removal.

Hydrostatic pressure influences mRNA expression of transforming growth factor-beta 1 and heat shock protein 70 in chondrocyte-like cell line

The present study investigated the influence of hydrostatic pressure on the expression of cytokines and heat shock protein 70 in a chondrocyte-like cell line. Chondrocyte-like cells (HCS-2/8) were exposed to hydrostatic pressure by a special pressure apparatus. Total RNA for cytokines (interleukin-1 beta, basic fibroblast growth factor, insulin-like growth factor-I, and transforming growth factor-beta 1) and for heat shock protein 70 was extracted and was analyzed by a polymerase chain reaction method and Northern blotting. An assay for incorporation of [35S]sulfate was performed to assess proteoglycan synthesis. The expression of transforming growth factor-beta 1 mRNA was enhanced after exposure to 5-MPa of hydrostatic pressure and was reduced after 50 MPa, whereas the expression of heat shock protein 70 was enhanced following exposure to 50 MPa of hydrostatic pressure. The incorporation of [35S]sulfate into the cultured cells increased following exposure to 1-5 MPa of hydrostatic pressure and decreased following 10-50 MPa of pressure. These results suggest that hydrostatic pressure at physiologic levels enhances the expression of transforming growth factor-beta 1 mRNA in addition to increasing proteoglycan synthesis in chondrocytes and that excessively high hydrostatic pressure reduces the expression of transforming growth factor-beta 1 mRNA and increases the expression of heat shock protein 70 mRNA while decreasing proteoglycan synthesis.

Mechanical behavior and biochemical composition of canine knee cartilage following periods of joint disuse and disuse with remobilization

The mechanical behavior and biochemical composition of articular cartilage were studied in an experimental model of joint disuse, in which the canine knee was immobilized in a sling at 90 degrees of flexion. Articular cartilage from the surface zone of the femur was tested in an isometric tensile test and full-thickness cartilage on the tibial plateau was tested in a compressive indentation test. Water, proteoglycan and collagen contents were measured in site-matched samples. Site-specific increases in the tensile moduli (approximately 88% above control values in distal femoral groove) were observed in cartilage after 8 weeks of joint disuse, and after 3 weeks of remobilization following either 4 (approximately 140%, distal and proximal femoral groove) or 8 weeks (approximately 140%, distal femoral groove) of joint disuse. In contrast, the compressive properties of cartilage determined in the indentation test exhibited no change from control values with joint disuse or disuse followed by remobilization. Water contents increased at some sites on the tibia after 8 weeks of joint disuse (approximately 6% of tissue wet weight, posterior site), but not in the surface zone tissue of the femur. Proteoglycan/collagen and cartilage thickness were not found to change with disuse or disuse followed by remobilization. Reduced values for the ratio of proteoglycan:water were observed in the surface zone tissue of the femur (approximately 23%, distal femoral groove) and in the full-thickness tissue of the tibia (approximately 21%, anterior and posterior sites) after periods of joint disuse. In this study, the measured material properties suggest that the articular surface remains intact following periods of disuse or disuse with remobilization. This finding suggests one important difference between this model of joint disuse and other experimental models in which cartilage changes are both progressive and degenerative, such as surgically-induced joint instability.

Histochemical and immunohistochemical studies of the effects of experimental anterior disc displacement on sulfated glycosaminoglycans, hyaluronic acid, and link protein of the rabbit craniomandibular joint

PURPOSE

The purpose of this study was to determine the effects of surgically induced anterior disc displacement (ADD) on sulfated glycosaminoglycans (GAGs) such as keratan sulfate (KS), chondroitin-4-sulfate (C4S), and chondroitin-6-sulfate (C6S), hyaluronic acid (HA), and link protein (LP) of the rabbit craniomandibular joint (CMJ) using histochemical and immunohistochemical techniques.

MATERIALS AND METHODS

The right joint of 20 rabbits was exposed surgically, and all discal attachments were severed except for the posterior attachment. The disc was then repositioned anteriorly and sutured to the zygomatic arch. The left joint served as a sham-operated control. Ten additional joints were used as nonoperated controls. Deeply anesthetized rabbits were perfused with 2% buffered formalin 2 weeks (10 rabbits) or 6 weeks (10 rabbits) after surgery. Discs, bilaminar zones, condyles, and articular eminences were excised. Condyles and articular eminences were decalcified in ethylenediaminetetraacetic acid (EDTA). All tissues were sectioned at 10 microns in a cryostat. Sections were incubated with alcian blue and monoclonal antibodies directed against KS, C4S, C6S, HA, or LP. After incubation in the appropriate fluorescein isothiocyanate (FITC)-labeled secondary antibodies, tissue sections were studied under the fluorescence microscope.

RESULTS

The results showed a reduction in alcian blue staining and KS, C4S, C6S, HA, and LP immunostaining in the disc and articular surfaces at 2 weeks after induction of ADD. This reduction was followed by an increase in their immunostaining at 6 weeks. Also, there was a progressive increase in alcian blue staining, and KS, C4S, C6S, and HA immunostaining in the bilaminar zone at 2 and 6 weeks.

CONCLUSION

It was concluded that surgical induction of ADD in the rabbit CMJ leads to alterations in KS, C4S, C6S, HA, and LP content, consistent with similar changes accompanying osteoarthritis of other synovial joints.

Expression of interleukin-6 in osteoarthritic chondrocytes and effects of fluid-induced shear on this expression in normal human chondrocytes in vitro

This study tested the effect of fluid-induced shear on interleukin-6 expression in normal human articular chondrocytes in vitro. As determined by Northern blot analysis, interleukin-6 mRNA expression occurs in chondrocytes from osteoarthritic cartilage but not in normal chondrocytes. Applying fluid-induced shear stress to primary high density cultures of chondrocytes increased interleukin-6 mRNA signal 4-fold at 1 hour and 10 to 15-fold at 48 hours compared with unsheared control cultures. At 48 hours, fluid-induced shear stress increased interleukin-6 protein levels in the culture medium 9 to 10-fold compared with unsheared controls. mRNA signals for interleukin-1alpha, interleukin-1beta, and tumor necrosis factor-alpha in RNA from sheared or control chondrocytes were not detected by Northern blotting. Transforming growth factor-beta mRNA signal was detectable but was not affected by shear. In contrast, human lung fibroblasts (WI-38) responded to fluid-induced shear with increased signal for transforming growth factor-beta, but not interleukin-6, mRNA. Both cell types did respond to interleukin-1alpha with increased interleukin-6 mRNA signal. These data demonstrated that distortional forces, such as fluid-induced shear stress, alter interleukin-6 levels in normal chondrocytes in vitro and suggest that increased interleukin-6 expression in osteoarthritic cartilage may result, in part, from alterations in the mechanical loading of the tissue.

The development and characterization of an in vitro system to study strain-induced cell deformation in isolated chondrocytes

A model system has been developed to investigate cell deformation of chondrocytes in vitro. Chondrocytes were isolated from bovine articular cartilage by enzymatic digestion and seeded in agarose (type VII) at a final concentration of 2 x 10(6) cells.ml-1 in 3% agarose. Mechanical evaluation of the system showed no change in the tangent modulus of agarose/chondrocyte cultures over a 6-d culture period. The resulting agarose/chondrocyte cultures were subjected to compressive strains ranging from 5-20%. Cell shape was assessed by measuring the dimensions of the cell both perpendicular (x) and parallel (y) to the axis of compression and deformation indices (I = y/x) calculated. Cell deformation increased with the level of strain applied for freshly isolated chondrocytes. The cultures were maintained in medium that inhibits or stimulates matrix production (DMEM and DMEM + 20% FCS, respectively) in order to assess the effect of cartilaginous matrix on chondrocyte deformation. Matrix elaborated by the cells markedly influenced levels of cell deformation, an increase in matrix leading to a decrease in cell deformation. Freshly isolated deep zone chondrocytes were found to deform significantly more than surface zone chondrocytes, although this effect was lost after 6 d in culture. The elaborated matrix also altered the recovery characteristics of the chondrocytes following constant compressive strain of 15% for 24 h. Cells that had elaborated matrix took several hours to return to unloaded shape, while cells without matrix returned to the unloaded shape instantly.

Mechanical responses of the rabbit patello-femoral joint to blunt impact

Various studies suggest impact trauma may initially soften cartilage, damage subchondral bone, or a combination thereof. The initial damages are commonly thought due to excessive contact pressure generated on cartilage and the underlying bone. The objective of this research was to develop a small animal model for studying post-traumatic OA and to correlate contact pressure with tissue damage. Blunt insult was graded by dropping a rigid mass onto the hyperflexed hind limb of rabbits. Contact pressure in the patello-femoral joint was measured with pressure sensitive film. One, 3, 6, and 14 days later the animals were euthanized. Damage to cartilage and the underlying bone was assessed visually and in microscopic sections. Indentation experiments were performed on the patellar cartilage with a rigid, flat probe. Contact pressures were nonuniform over the articular surfaces and a high frequency of surface fissures were generated on the lateral facet in severe insults. The appearance of surface fissures correlated better with the magnitude of contact pressure gradients in the damage zone than the magnitude of contact pressures on the facet, per se. Blunt trauma causing surface fissures resulted in a measurable degree of softening in the patellar cartilage, especially close to the defects. Surgical intervention of the joint to insert pressure sensitive film, however, also resulted in significant softening of the cartilage.

Glycosaminoglycan synthesis in the rat articular disk in response to mechanical stress

The mechanism by which compressive mechanical stress affects glycosaminoglycan synthesis in the articular disk was investigated with a modified organ culture technique. Forty-eight male Sprague-Dawley rats were divided into three experimental groups and one control group of 12 animals each, aged 7 and 9 weeks. The experimental groups followed different regimens of stress applied for 25%, 75%, or 100% of the time during the total test period of 24 hours. Articular disks were stressed with flexible bottomed dishes (Flex I dishes, Flexcell Corp., McKeesport, Pa.) using the Flexercell Strain Unit (Flexcell Corp., McKeesport, Pa.) and incubated with [3H]-glucosamine for 24 hours. Samples were then collected, digested with Pronase-E, and after precipitation with cetylpyridinium chloride (CPC) and ethanol, the different glycosaminoglycans (GAGs) were separated by using cellulose acetate electrophoresis. The significant GAG types with stress were chondroitin6sulfate (C6S), hyaluronic acid (HA), and dermatan sulfate (DS). There was no significant relationship in the experimental groups between age and regimen of stress applied in either age. Higher stress regimens showed significantly higher proportions of C6S when compared with the controls, whereas HA appeared to decrease slightly and DS was not affected. Since C6S is the major component of hyaline cartilage, the results of this study suggest that compressive forces in the articular disk may stimulate the development of more cartilagenous-like properties with respect to GAG content.

Tissue-engineered growth of cartilage: the effect of varying the concentration of chondrocytes seeded onto synthetic polymer matrices

Ninety-six synthetic bioresorbable cell-delivery devices (10 x 10 x 0.5 mm) were seeded, varying the concentrations of living chondrocytes (2, 10, 20, 100 million cells/cc) isolated from shoulders of freshly killed calves and implanted subcutaneously on the dorsum of nude mice after 1 week of in vitro culture. This resulted in the formation of new cartilage in 95.6% of the implants. Twenty-four control implants (0 cells seeded) did not show cartilage formation. During 12 weeks of in vivo implantation, the wet weight and the thickness of the specimens (10, 20, 100 million cells/cc) increased significantly. Histologic analysis revealed cells appearing in their own lacunar structures surrounded by basophilic matrix. The increase in sulfated glycosaminoglycan content indicated the maturation of the extracellular matrix. The ability to manipulate the growth of new cartilage on biocompatible polymer scaffolds by varying the cell density before in vivo implantation will allow engineering to optimize the utilization of chondrocytes in relation to the desired shape, thickness, and quality of the new cartilage.

The effect of growth on collagen and glycosaminoglycans in the articular disc of the rat temporomandibular joint

Newly synthesized collagen and glycosaminoglycans (GAG) were studied in the temporomandibular discs of male Sprague-Dawley rats of 3-13 weeks of age. Each age group had eight animals and [14C]glycine or [3H]glucosamine were used to determine the proportion of newly synthesized type III to type I collagens or the proportion of different types of newly synthesized GAGs during 4 h of labelling in organ culture. Separation of newly synthesized collagen bands from rat disc by sodium dodecyl sulphate-polyacrylamide gel electrophoresis showed a peak in type III at the ages of 7 and 8 weeks. Type III collagen synthesis and the rate of mandibular growth were strongly related through all ages studied. GAG chains were separated by cellulose-acetate electrophoresis. Calculation of disintegrations/min per mg of wet disc tissue for each GAG peak showed that hyaluronic acid (HA), chondroitin-6-sulphate and keratan sulphate/chondroitin-4-sulphate (KS/C4S) were the predominant molecules synthesized in the disc. There was also a steady increase in newly synthesized HA and C6S synthesis up to 6 and 7 weeks respectively. Proportions of newly synthesized C4S/KS, HA and C6S were significantly higher than those of other GAGs with respect to ageing. From these observations it appears that the articular disc shows more of the characteristics of cartilage, as evidenced by the increased amounts of C6S and KS/C4S during the mandibular growth spurt at the ages of 6 and 7 weeks, similar to that of type III collagen. There were also increased amounts of HA, suggesting that during 5-7 weeks of age the rat disc is undergoing more active remodelling. This study provides baseline data for further analysis of the effects of mechanical loading and trauma on articular disc responses.

Adaptation of canine femoral head articular cartilage to long distance running exercise in young beagles

OBJECTIVE

To study the effects of long term (one year), long distance (up to 40 km/day) running on the metabolism of articular cartilage the biosynthesis of proteoglycans was examined by in vitro labelling of anterior (weight bearing) and posterior (less weight bearing) areas of the femoral head from young beagles.

METHODS

Total sulphate incorporation rates were determined and distribution of the incorporated sulphate was localised by quantitative autoradiography. Concentration and extractability of the proteoglycans were determined, and proteoglycan structures were investigated by gel filtration chromatography, agarose gel electrophoresis, and chemical determinations.

RESULTS

In the less weight bearing area the amount of extractable proteoglycans was decreased (p < or = 0.02), simultaneously with an increased concentration of residual glycosaminoglycans in the tissue after 4 M GuCl extraction (p < or = 0.05). In control animals proteoglycan synthesis was most active in the deep zone of the cartilage, whereas exercise increased synthesis in the intermediate zone. There was a tendency to a lower keratan: chondroitin sulphate ratio in the running dogs. No macroscopical or microscopical signs of articular degeneration or injury were visible in any of the animals.

CONCLUSION

The articular cartilage of the femoral head showed a great capacity to adapt to the increased mechanical loading. The reduced proteoglycan extractability in the less weight bearing area changed it similar to the weight bearing area, suggesting that the low extractability of proteoglycans reflects the long term loading history of articular cartilage. The congruency of the femoral head with acetabulum seems to protect the cartilage from the untoward alterations that occur in the femoral condyles subjected to a similar running programme.

Effects of long-term running exercise on canine femoral head articular cartilage

After long-term running program (40 km/day) anterior and posterior tissue samples from canine femoral head were labeled ex vivo in the presence of 35S-SO4. Sulfate incorporation rates did not differ between runner and control groups. The statistically significant changes in runners included a decreased uronic acid concentration (p < or = 0.02) and proportion of extractable proteoglycans (p < or = 0.05) as well as increased concentration of tissue uronic acid after 4 M GuCl extraction (p < or = 0.05) in the posterior area. These results support an idea of strengthened cartilage tissue after this kind of motion and load.

A retrospective evaluation of stifle osteoarthritis in dogs with bilateral medial patellar luxation and unilateral surgical repair

The effects of surgical and nonsurgical therapy on the development of osteoarthritis were compared in 12 dogs with bilateral medial patellar luxation and unilateral surgical repair. Evaluations included severity of lameness and patellar luxation, ligamentous stability, range of motion, and radiographic evidence of osteoarthritis before surgery and at a mean of 33 months after surgery. Stifles without surgical treatment served as controls for the contralateral stifles with surgery. All stifles treated surgically had reduced patellofemoral joints, normal range of motion, and improved limb use. Osteoarthritis progressed significantly and comparably in both groups of stifles. Progression of osteoarthritis was not correlated with luxation grade, body weight, or interval from surgery to follow-up. Age at surgery was correlated positively with severity of osteoarthritis in the stifles treated surgically.

Rabbit knee immobilization: bone remodeling precedes cartilage degradation

This study analyzed processes underlying osteoporosis and osteoarthrosis after short-term immobilization of the right hind limb of postadolescent (2.8 kg) and mature (4.0 kg) rabbits. After 3 weeks, the lateral posterior aspect of the lateral tibial plateau and the lateral femoral condyle of the immobilized limb exhibited prominent subchondral vascular eruptions. Femoral metaphyseal bone density decreased 27 and 18% in the immobilized limbs of postadolescent and mature rabbits, respectively. Calcein green fluorescence increased 1.9-fold (p less than 0.001) in the metaphyseal trabeculae of immobilized femurs. With immobilization, sulfate incorporation into femoral cartilage glycosaminoglycan increased, although total cartilage glycosaminoglycan and hydroxyproline levels were unchanged. Thymidine incorporation into DNA increased four- to fivefold in tibial and femoral cartilage of the immobilized limb. In this study, bone loss and remodeling preceded erosive cartilage degradation.

Proteoglycan alterations following immobilization and remobilization in the articular cartilage of young canine knee (stifle) joint

The distribution of proteoglycans (PGs) at 11 sites on the knee (stifle joint) cartilage of young female beagle dogs was studied following cast immobilization for 11 weeks in 90 degrees flexion and after a subsequent remobilization for 15 weeks. Immobilization induced a reduction in PG uronic acid at all sites (mean of -38%), but the greatest depletion (-64%) occurred at the anterior and posterior extremes of the femoral condyles, i.e., at locations where the immobilized cartilage lost contact to the opposing cartilage. Following remobilization, the content of uronic acid remained lower than in the age-matched controls (-18% on average), particularly at the minimum contact sites most affected by immobilization (-33%). The chondroitin-6-sulfate to chondroitin-4-sulfate ratio was reduced by immobilization in most locations (average of -14%) and returned to control values after remobilization. There was no consistent change in the percentage of aggregating PGs observed in Sephacryl S-1000 gel filtration after immobilization or remobilization. However, following remobilization, the aggregating PGs showed an enhanced proportion of the slower mobility band in agarose gel electrophoresis, indicative of a larger monomer size. In the contralateral, load-bearing knee joint, both the uronic acid content and PG monomer type distribution were identical to those observed in the experimental joint, suggesting that the state reached after the remobilization period was due to factor(s) influencing both sides. The results suggest that contact forces between articulating surfaces are required to maintain normal PG content and that the control mechanism works locally at each cartilage site. Restriction of joint mobility and loading in young animals is concluded to cause persistent changes in cartilage matrix. Furthermore, the use of the contralateral joint as the sole control in this kind of studies, although experimentally convenient, seems not to be appropriate.

Chondrons from articular cartilage (II): Analysis of the glycosaminoglycans in the cellular microenvironment of isolated canine chondrons

A chondron rich preparation was isolated from mature canine tibial cartilage using low-speed homogenization techniques. Proteoglycans were extracted from this preparation by exhaustive treatment with 4M guanidine-HCl. A significant proportion of the total proteoglycan, measured as uronic acid, was resistant to extraction and represented 27.9% in intact cartilage chips and 18.6% in the chondron fraction. Histochemical examination of chondrons confirmed that extraction resistant proteoglycans remained within the capsule of the chondron after 4M guanidine-HCl treatment. Electrophoretic analysis of the glycosaminoglycans extracted from intact cartilage chips and the chondron fraction showed approximately equivalent amounts of chondroitin sulphate (79.3%), keratan sulphate (16.3%) and hyaluronic acid (4.3%) present. In contrast, the extraction resistant residue in the chondron fraction was significantly enriched for hyaluronic acid (10.5%, p less than 0.05) but was depleted of chondroitin sulphate (70.9%, p less than 0.05). The major chondroitin sulphate isomer in the resistant fraction was chondroitin 6-sulphate while in the soluble fraction, the quantities of the two isomers were approximately equivalent. Comparison with previously published data suggests a role for minor collagens in the retention of proteoglycans in the cellular microenvironment.

Levels of chondroitin-6-sulfate and nonaggregating proteoglycans at articular cartilage contact sites in the knees of young dogs subjected to moderate running exercise

The levels and types of proteoglycans in articular cartilage of the knees of young beagle dogs were studied after 15 weeks of running exercise, at 4 km/day. Running increased the levels of proteoglycans in the cartilage of the patella, the superior patellofemoral groove, and the summit of the medial condyle of the femur, all of which are considered contact sites subject to enhanced loading caused by running. The elevated content of uronic acid at the femoral sites proved to be due to proteoglycans that were unable to aggregate with hyaluronic acid. There was no change in the content of aggregating proteoglycans. Analysis of chondroitinase AC-derived disaccharides at the same sites showed an increase in chondroitin-6-sulfate content as compared with chondroitin-4-sulfate levels. We believe that this modulation of the proteoglycan matrix reflects enhanced tissue maturation and physiologic adjustment to higher local contact pressures.

Prevention of ligament and meniscus atrophy by active joint motion in a non-weight-bearing model

This study describes the effect of active joint motion on the maintenance of ligament and meniscus mass in a non-weight-bearing model of disuse. Denervation and fixation models of immobilization have shown that resorption of isotope and atrophy of mass occurred for hard tissue (bone) and soft tissues (ligament, tendon, or meniscus). A unilateral ankle disarticulation model of disuse that maintains active knee motion without weight bearing was studied for 8 weeks in dogs that were chronically prelabeled with three different isotopes. The effects of non-weight-bearing without denervation or fixation were analyzed for the resorption of isotopes, and net atrophy of bone mass (femur or tibia) and soft-tissue mass (collateral or cruciate ligaments, menisci). A large and similar loss of all three isotopes, as well as collagen and calcium mass occurred for whole femur and tibia; this indicated that mass loss was equivalent to bone resorption and suggests little replacement with new bone. No loss of isotope or mass per whole tissue occurred for the collateral and cruciate ligaments or menisci. The strength of the femur-anterior cruciate ligament-tibia complex was analyzed by a tensile failure test when a fast rate of deformation was applied; the results did not differ qualitatively or quantitatively between control and experimental limbs. The absence of weight bearing for 8 weeks resulted in marked bone atrophy without resorption or atrophy of soft tissues, or decrease of the mechanical strength for the femur-ligament-tibia complex.

Biosynthetic response of cartilage explants to dynamic compression

The biosynthetic response of calf articular cartilage explants to dynamic compression was examined over a wide range of amplitudes, waveforms, and frequencies. Glycosaminoglycan synthesis was assessed by 35S-sulfate incorporation, and amino acid uptake and protein synthesis were assessed by 3H-proline incorporation. Two culture chambers were designed to allow uniaxial radially unconfined compression and mechanical testing of cartilage disks: one chamber was used inside a standard incubator; the other was used with a mechanical spectrometer and allowed load and displacement to be monitored during compression. Dynamic stiffness measurements of 3-mm diameter disks identified a characteristic frequency [0.001 Hz (cycles/sec)] that separated low- and high-frequency regimes in which different flow and deformation phenomena predominated; e.g., at 0.0001-0.0001 Hz, significant fluid was exuded from cartilage disks, whereas at 0.01-1 Hz, hydrostratic pressure increased within disks. At the higher frequencies, oscillatory strains of only approximately 1-5% stimulated 3H-proline and 35S-sulfate incorporation by approximately 20-40%. In contrast, at the lower frequencies (a) compressions of less than 5% had no effect, consistent with the dosimetry of biosynthetic inhibition by static compression (approximately 25% compression caused a approximately 20% inhibition of radiolabel incorporation), and (b) higher amplitudes (cycling between disk thicknesses of 1.25 and 0.88-1.00 mm) stimulated 3S-sulfate incorporation by approximately 20-40%, consistent with the kinetics of response to a single 2-h compression and release. None of the compression protocols was associated with detectable alterations in (e.g., compression-induced depletion of) total glycosaminoglycan content. This study provides a framework for identifying both the physical and biological mechanisms by which dynamic compression can modulate chondrocyte biosynthesis. In addition, the culture and compression methodology potentially allows in vitro evaluation of clinical strategies of continuous passive motion therapy to stimulate cartilage remodeling.

Biomechanical properties of the canine knee articular cartilage as related to matrix proteoglycans and collagen

The instant, creep and equilibrium responses of canine knee articular cartilages were determined after a constant load application with an in situ indentation creep test and related to the chemical composition of the tissue. Instantly, the cartilage stiffness correlated inversely with the proportion of proteoglycans (PGs) extractable with guanidium chloride. The tibial cartilage, rich in PGs but relatively poor in collagen, showed a low resistance to instant rearrangement of the solid matrix after load application. However, the resistance of the tibial cartilage to water flow during creep deformation was similar or even higher than in the femur. The rate of creep correlated inversely with the PG content. The equilibrium modulus of the femoral cartilage (0.40 MPa), 29 per cent higher than in the tibia (0.31 MPa), was related to the content of PGs, while in the tibia the direct correlation between PGs and modulus was not observed. Our results suggest that while PGs control the fluid flow in articular cartilage, a high PG content alone does not guarantee high stiffness of the cartilage. Instead, the properties of the collagen network are suggested to control particularly the instant shape alterations of the articular cartilage under compression.

Densitometric assay of nanogram quantities of proteoglycans precipitated on nitrocellulose membrane with Safranin O

Proteoglycan (PG) and glycosaminoglycan (GAG) samples corresponding to a minimum of 10 ng of uronic acid were reliably quantified as precipitates with the cationic dye Safranin O, collected by vacuum-aided filtration onto a cellulose acetate/nitrate membrane in a standard 96-well dot assay apparatus. The reflectances of the precipitation dots were measured by automatic densitometric scanning of the membrane sheets. Standard GAGs produced reflectance values which were related to the number of anionic groups per unit disaccharide; hyaluronate and keratan sulfate gave lower values while heparin yielded values higher than those of chondroitin sulfates. The presence of 8 M urea, 1% Triton X-100, 30% sucrose, 0.02% NaN3, or mixtures of proteinase inhibitors and various buffers did not markedly influence the reflectances, while 4 M guanidinium chloride and 3 M CsCl reduced the sensitivity of the assay to 30-50 ng. Samples containing sodium dodecyl sulfate (SDS) were not applicable because SDS precipitated with Safranin O. Proteins showed virtually no response, while nucleic acids gave significant although smaller reflectances than GAGs. Owing to its marked sensitivity and convenience the method is particularly suitable for the detection of PGs during their preparative purification and fractionation as well as in various analytical assays.

Effects of joint loading on articular cartilage collagen metabolism: assay of procollagen prolyl 4-hydroxylase and galactosylhydroxylysyl glucosyltransferase

The degree of joint loading on the femoral head cartilage was experimentally altered in dogs by splinting of the knee joint for 11 weeks (n = 9), and making another group (n = 6) to run on a treadmill with 15 degrees uphill inclination during a period of 15 weeks (4 km/day, 5 days a week). A third group (n = 9) served as controls. The influence of these altered loading conditions on articular cartilage collagen synthesis was measured by assaying the activity of procollagen prolyl 4-hydroxylase (PPH) and galactosylhydroxylysyl glucosyltransferase (GGT) in chondrocytes. The average activity of PPH was 11-13% elevated in the runner and contralateral (more loaded) cartilages, while the splinted (unloaded) cartilages showed a significant (53%) increase of PPH. In some samples of the runner, splinted and contralateral cartilages the activity of GGT was also high, but the differences did not reach statistical significance. The increase of the activity of PPH, combined with unaltered total content of collagen, indicates that the synthesis of collagen and probably also its turnover, are enhanced in the cartilage atrophied due to reduced weight-bearing, but only slightly, if at all in the cartilages subjected to moderately elevated loading.