Development of in situ forming implants for controlled delivery of punicalagin

Due to efficient drainage of the joint, the development of intra-articular depots for long-lasting drug release is a difficult challenge. Moreover, a disease-modifying osteoarthritis drug (DMOAD) that can effectively manage osteoarthritis has yet to be identified. The current study was undertaken to explore the potential of injectable, in situ forming implants to create depots that support the sustained release of punicalagin, a promising DMOAD. In vitro experiments demonstrated punicalagin's ability to suppress production of interleukin-1β and prostaglandin E2, confirming its chondroprotective properties. Regarding the entrapment of punicalagin, it was demonstrated by LC-MS/MS to be stable within PLGA in situ forming implants for several weeks and capable of inhibiting collagenase upon release. In vitro punicalagin release kinetics were tunable through variation of solvent, PLGA lactide:glycolide ratio, and polymer concentration, and an optimized formulation supported release for approximately 90 days. The injection force of this formulation steadily increased with plunger advancement and higher rates of advancement were associated with greater forces. Although the optimal formulation was highly cytotoxic to primary chondrocytes if cells were exposed immediately or shortly after implant formation, upwards of 70 % survival was achieved when the implants were first allowed to undergo a 24-72 h period of phase inversion prior to cell exposure. This study demonstrates a PLGA-based in situ forming implant for the controlled release of punicalagin. With modification to address cytotoxicity, such an implant may be suitable as an intra-articular therapy for OA.

Laser microgrooving and resorbable blast texturing for enhanced surface function of titanium alloy for dental implant applications

Long-term dental implant success is dependent on biocompatibility and osseointegration between the bone and the implant. Surface modifications such as laser-induced microgrooving which increase contact area can enhance osseointegration by establishing and directing a stable attachment between the implant surface and peri-implant bone. The objective of this study was to evaluate pre-osteoblast proliferation, morphology, and differentiation on titanium alloy (Ti64) surfaces-Laser-Lok^© (LL), resorbable blast textured (RBT), and machined (M)-compared to tissue culture plastic (TCP) control. We hypothesized the LL surfaces would facilitate increased cellular alignment compared to all other groups, and LL and RBT surfaces would demonstrate enhanced proliferation and differentiation compared to M and TCP surfaces. Surface roughness was quantified using a surface profilometer, and water contact angle was measured to evaluate the hydrophilicity of the surfaces. Cellular function was assessed using quantitative viability and differentiation assays and image analyses, along with qualitative fluorescent (viability and cytoskeletal) imaging and scanning electron microscopy. No differences in surface roughness were observed between groups. Water contact angle indicated LL was the least hydrophilic surface, with RBT and M surfaces exhibiting greater hydrophilicity. Cell proliferation on day 2 was enhanced on both LL and RBT surfaces compared to M, and all three groups had higher cell numbers on day 2 compared to day 1. Cell orientation was driven by the geometry of the surface modification, as cells were more highly aligned on LL surfaces compared to TCP (on day 2) and RBT (on day 3). At day 21, cell proliferation was greater on LL, RBT, and TCP surfaces compared to M, though no differences in osteogenic differentiation were observed. Collectively, our results highlight the efficacy of laser microgrooved and resorbable blast textured surface modifications of Ti64 for enhancing cellular functions, which may facilitate improved osseointegration of dental implants.

Comparison of the Capacitance of a Cyclically Fatigued Stretch Sensor to a Non-Fatigued Stretch Sensor When Performing Static and Dynamic Foot-Ankle Motions

Motion capture is the current gold standard for assessing movement of the human body, but laboratory settings do not always mimic the natural terrains and movements encountered by humans. To overcome such limitations, a smart sock that is equipped with stretch sensors is being developed to record movement data outside of the laboratory. For the smart sock stretch sensors to provide valuable feedback, the sensors should have durability of both materials and signal. To test the durability of the stretch sensors, the sensors were exposed to high-cycle fatigue testing with simultaneous capture of the capacitance. Following randomization, either the fatigued sensor or an unfatigued sensor was placed in the plantarflexion position on the smart sock, and participants were asked to complete the following static movements: dorsiflexion, inversion, eversion, and plantarflexion. Participants were then asked to complete gait trials. The sensor was then exchanged for either an unfatigued or fatigued plantarflexion sensor, depending upon which sensor the trials began with, and each trial was repeated by the participant using the opposite sensor. Results of the tests show that for both the static and dynamic movements, the capacitive output of the fatigued sensor was consistently higher than that of the unfatigued sensor suggesting that an upwards drift of the capacitance was occurring in the fatigued sensors. More research is needed to determine whether stretch sensors should be pre-stretched prior to data collection, and to also determine whether the drift stabilizes once the cyclic softening of the materials comprising the sensor has stabilized.

Effects of short-duration treatment of cartilage with punicalagin and genipin and the implications for treatment of osteoarthritis

Punicalagin (PA) not only binds type II collagen, but also blocks its MMP-13-mediated degradation, and genipin (GNP) is a collagen cross-linking agent. We hypothesized that these drugs could mitigate the loss of cartilage if administered in the early phase of osteoarthritis, and experiments were designed to provide proof-of-concept. Porcine cartilage was exposed to both drugs in a manner designed to simulate intra-articular (IA) injection. Based on penetration of PA into cartilage, the rate of drug diffusion was conservatively estimated at 2 μm per minute. GNP caused a measurable degree of cross-linking, increased compressive resistance and coefficient of friction, and substantially inhibited degradation by collagenase, but not by hyaluronidase. Pre-incubation of GNP with collagenase had no effect on enzymatic activity. PA did not cross-link collagen nor affect the mechanical properties of cartilage. It did, however, increase resistance to degradation by collagenase and hyaluronidase. Furthermore, it reacted with collagenase in solution and inhibited its subsequent enzymatic activity. Effects of PA and GNP were not additive. The chondroprotective effect of semi-weekly IA injections was investigated in the monoiodoacetate-induced model of OA in rats. Quantitative histology suggested that injection of PA decreased the amount of cartilage lost compared to saline-injected controls, and the addition of GNP made no difference. This study supports the notion that IA delivery of PA could mitigate OA-induced cartilage erosion.

Assessment of erythrocyte damage and in-line pressure changes associated with simulated transfusion of canine blood through microaggregate filters

OBJECTIVE

To determine whether passage of whole blood through a microaggregate filter by use of a syringe pump would damage canine erythrocytes.

SAMPLE

Blood samples obtained from 8 healthy client-owned dogs.

PROCEDURES

Whole blood was passed through a standard microaggregate filter by use of a syringe pump at 3 standard administration rates (12.5, 25, and 50 mL/h). Prefilter and postfilter blood samples were collected at the beginning and end of a simulated transfusion. Variables measured at each time point included erythrocyte osmotic fragility, mean corpuscular fragility, RBC count, hemoglobin concentration, RBC distribution width, and RBC morphology. In-line pressure when blood passed through the microaggregate filter was measured continuously throughout the simulated transfusion. After the simulated transfusion was completed, filters were visually analyzed by use of scanning electron microscopy.

RESULTS

Regardless of administration rate, there was no significant difference in mean corpuscular fragility, RBC count, hemoglobin concentration, or RBC distribution width between prefilter and postfilter samples. Additionally, there were no differences in in-line pressure during the simulated transfusion among administration rates. Echinocytes were the erythrocyte morphological abnormality most commonly observed at the end of the transfusion at administration rates of 12.5 and 25 mL/h.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that regardless of the administration rate, the microaggregate filter did not alter fragility of canine RBCs, but may have altered the morphology. It appeared that the microaggregate filter would not contribute to substantial RBC damage for transfusions performed with a syringe pump.

Effects of short- and long-term administration of nonsteroidal anti-inflammatory drugs on osteotomy healing in dogs

OBJECTIVE

To determine the influence of short-term administration of carprofen on bone healing in dogs.

STUDY DESIGN

Randomized controlled experimental study.

ANIMALS

Eighteen purpose-bred sexually mature hound dogs.

METHODS

Tibial osteotomies were performed, and dogs were divided into three groups: no carprofen (n = 6), 2-week administration of carprofen at 2.2 mg/kg twice daily (n = 6), and 8-week administration of carprofen at 2.2 mg/kg twice daily (n = 5). Bone healing was evaluated radiographically at 4 and 8 weeks postoperatively. Postmortem, fracture healing was assessed via biomechanical testing (three-point bending), histological cartilage:callus ratio, and bone mineral density (BMD) with quantitative computed tomography.

RESULTS

No biomechanical difference was detected between dogs that received no carprofen and those that received 2 weeks of carprofen or between those that received 2 weeks vs 8 weeks of carprofen. Stiffness (P = .035) and maximum stress (P = .042) were higher in dogs that received no carprofen than in those that received 8 weeks of carprofen. Radiographic healing did not differ between dogs without carprofen and those with 2-week administration of carprofen (P = .9923). However, tibias of dogs without carprofen and those with 2-week administration of carprofen were more healed compared with those in the 8-week-carprofen group at 4 and 8 weeks after surgery (P = .0011). No treatment effect was detected by cartilage:callus ratio or BMD.

CONCLUSION

Long-term administration of carprofen had a negative effect on bone healing compared with short-term or no administration of carprofen.

CLINICAL SIGNIFICANCE

Nonsteroidal anti-inflammatory drugs should be used cautiously in dogs at risk for delayed bone healing, and administration should be discontinued beyond the perioperative period in dogs with fractures or osteotomies.

A biomechanical comparison of conventional dynamic compression plates and string-of-pearls™ locking plates using cantilever bending in a canine Ilial fracture model

Background

Fracture of the ilium is common orthopedic injury that often requires surgical stabilization in canine patients. Of the various methods of surgical stabilization available, application of a lateral bone plate to the ilium is the most common method of fixation. Many plating options are available, each having its own advantages and disadvantages. The purpose of this study was to evaluate the biomechanical properties of a 3.5 mm String-of-Pearls™ plate and a 3.5 mm dynamic compression plate in a cadaveric canine ilial fracture model. Hemipelves were tested in cantilever bending to failure and construct stiffness, yield load, displacement at yield, ultimate load, and mode of failure were compared.

Results

The mean stiffness of dynamic compression plate (116 ± 47 N/mm) and String-of-Pearls™ plate (107 ± 18 N/mm) constructs, mean yield load of dynamic compression plate (793 ± 333 N) and String-of-Pearls™ plate (860 ± 207 N) constructs, mean displacement at yield of dynamic compression plate (8.6 ± 3.0 mm) and String-of-Pearls™ plate (10.2 ± 2.8 mm) constructs, and ultimate load at failure of dynamic compression plate (936 ± 320 N) and String-of-Pearls™ plate (939 ± 191 N) constructs were not significantly different. No differences were found between constructs with respect to mode of failure.

Conclusions

No significant biomechanical differences were found between String-of-Pearls™ plate and dynamic compression plate constructs in this simplified cadaveric canine ilial fracture model.

Structural and biomechanical characterizations of porcine myocardial extracellular matrix

Extracellular matrix (ECM) of myocardium plays an important role to maintain a multilayered helical architecture of cardiomyocytes. In this study, we have characterized the structural and biomechanical properties of porcine myocardial ECM. Fresh myocardium were decellularized in a rotating bioreactor using 0.1 % sodium dodecyl sulfate solution. Masson's trichrome staining and SEM demonstrated the removal of cells and preservation of the interconnected 3D cardiomyocyte lacunae. Movat's pentachrome staining showed the preservation of cardiac elastin ultrastructure and vascular elastin distribution/alignment. DNA assay result confirmed a 98.59 % reduction in DNA content; the acellular myocardial scaffolds were found completely lack of staining for the porcine α-Gal antigen; and the accelerating enzymatic degradation assessment showed a constant degradation rate. Tensile and shear properties of the acellular myocardial scaffolds were also evaluated. Our observations showed that the acellular myocardial ECM possessed important traits of biodegradable scaffolds, indicating the potentials in cardiac regeneration and whole heart tissue engineering.

A comparative biomechanical analysis of term fetal membranes in human and domestic species

OBJECTIVE

The purpose of this study was to biomechanically characterize and compare human, porcine, equine, and ovine fetal membranes.

STUDY DESIGN

Noncontact metrology was used for topographic analyses. Uniaxial tensile testing was performed to resolve specific biomechanical values. Puncture force and radial stresses were determined with biaxial puncture testing. Microstructure and surface tortuosity were analyzed histologically.

RESULTS

Equine and human membranes sustained larger magnitude loading, but ovine and porcine membranes exhibited stronger material properties. Biaxial puncture validated uniaxial results; human and equine groups accommodated the largest loads but lowest stresses. Equine membranes were mostly vascularized; tortuosity was highest in porcine membranes. Species' gestation length was correlated positively with membrane thickness.

CONCLUSION

The anatomy of placentation and length of species gestation show distinct relationships to membrane biomechanics. Unlike other species, human fetal membranes do not compensate for structural weakness with a thicker membrane. This finding may explain the high incidence of preterm premature rupture of membranes in humans.

Effect of a mechanical stimulation bioreactor on tissue engineered, scaffold-free cartilage

Achieving sufficient functional properties prior to implantation remains a significant challenge for the development of tissue engineered cartilage. Many studies have shown chondrocytes respond well to various mechanical stimuli, resulting in the development of bioreactors capable of transmitting forces to articular cartilage in vitro. In this study, we describe the production of sizeable, tissue engineered cartilage using a novel scaffold-free approach, and determine the effect of perfusion and mechanical stimulation from a C9-x Cartigen bioreactor on the properties of the tissue engineered cartilage. We created sizable tissue engineered cartilage from porcine chondrocytes using a scaffold-free approach by centrifuging a high-density chondrocyte cell-suspension onto an agarose layer in a 50 mL tube. The gross and histological appearances, biochemical content, and mechanical properties of constructs cultured in the bioreactor for 4 weeks were compared to constructs cultured statically. Mechanical properties were determined from unconfined uniaxial compression tests. Constructs cultured in the bioreactor exhibited an increase in total GAG content, equilibrium compressive modulus, and dynamic modulus versus static constructs. Our study demonstrates the C9-x CartiGen bioreactor is able to enhance the biomechanical and biochemical properties of scaffold-free tissue engineered cartilage; however, no additional enhancement was seen between loaded and perfused groups.

Biomechanical and molecular characteristics of hereditary equine regional dermal asthenia in Quarter Horses

Hereditary equine regional dermal asthenia (HERDA) is an autosomal recessive skin disorder that has yet to be fully characterized. HERDA is predominately expressed in Quarter Horses, with the majority of these disseminating from elite cutting horse bloodlines, leading to the increased incidence of HERDA in recent years. Affected horses have loose, hyper-extensible, fragile skin and are frequently euthanized due to poor wound healing and disfiguring scars. This study sought to better characterize HERDA by analysis of the biomechanical parameters of tensile strength, modulus of elasticity, energy to failure and thickness of skin from 10 affected and 6 unaffected horses using an Instron Universal Testing Instrument. In addition, total soluble collagen and glycosaminoglycan concentrations of skin were analysed from 13 affected and 12 unaffected horses using Sircol Soluble Collagen and Blyscan Sulfated Glycosaminoglycan assays respectively. Affected horses exhibited a two to threefold reduction in tensile strength versus unaffected horses with statistically significant differences at six of seven sample locations (P < or = 0.05). The modulus of elasticity proved to be significantly different at six of seven sample locations, energy to failure at six of seven sample locations, and skin thickness at one of seven sample locations (P < or = 0.05). Affected horses exhibited significantly higher amounts of total soluble collagen than unaffected horses (P < or = 0.05). No significant difference was demonstrated between groups for glycosaminoglycan concentration. Affected horses demonstrated uniformly weaker skin across sample locations, indicating the biomechanical properties of HERDA are not regionally confined to specific areas of the horses' skin.

Vasoactive agents alter the biomechanical properties of aortic heart valve leaflets in a time-dependent manner

BACKGROUND AND AIM OF THE STUDY

Although the vasoactive agents, angiotensin II (Ang II) and 5-hydroxytryptamine (5-HT) are implicated in aortic heart valve disease, it is unclear how these compounds alter the biomechanical properties of valve leaflet tissue. The study aim was to characterize temporal changes in the elastic modulus of tissues incubated with these compounds.

METHODS

Valve leaflets were excised from fresh porcine aortic heart valves. Leaflet tissue was incubated with 10(-6) M 5-HT, or 10(-6) M Ang II. The stress and elongation of the tissue in the circumferential and radial directions was measured using a stepper motor-driven micromechanical testing machine at 0.5, 6, and 24 h, followed by calculations of strain and elastic modulus of each sample.

RESULTS

Tissue samples incubated with Ang II showed a significant increase in stiffness with time in the radial direction, but not in the circumferential direction. Regression analysis showed a correlation between time and elastic modulus for the tissue (R2 = 0.84). Conversely, leaflets incubated in 5-HT did not show any significant change in elastic modulus over time in the radial direction; however, significant increases in stiffness were observed after 24 h in the circumferential direction. A strong correlation between the elastic modulus in the circumferential direction and time was also noted (R2 = 0.99).

CONCLUSION

The study results showed that vasoactive agents are capable of increasing the elastic modulus of aortic valve tissue in a time-dependent manner. Furthermore, the biomechanical changes induced by vasoactive agents are direction-specific, indicating different modes of action.

Production of hyaline-like cartilage by bone marrow mesenchymal stem cells in a self-assembly model

A scaffoldless or self-assembly approach to cartilage tissue engineering has been used to produce hyaline cartilage from bone marrow-derived mesenchymal stem cells (bMSCs), but the mechanical properties of such engineered cartilage and the effects the transforming growth factor (TGF) isoform have not been fully explored. This study employs a cell culture insert model to produce tissue-engineered cartilage using bMSCs. Neonatal pig bMSCs were isolated by plastic adherence and expanded in monolayer before being seeded into porous transwell inserts and cultured for 4 or 8 weeks in defined chondrogenic media containing either TGF-beta1 or TGF-beta3. Following biomechanical evaluation in confined compression, colorimetric dimethyl methylene blue and Sircol dye-binding assays were used to analyze glycosaminoglycan (GAG) and collagen contents, respectively. Histological sections were stained with toluidine blue for proteoglycans and with picrosirius red to reveal collagen orientation, and immunostained for detection of collagen types I and II. Neocartilage increased in thickness, collagen, and GAG content between 4 and 8 weeks. Proteoglycan concentration increased with depth from the top surface. The tissue contained much more collagen type II than type I, and there was a consistent pattern of collagen alignment. TGF-beta1-treated and TGF-beta3-treated constructs were similar at 4 weeks, but 8-week TGF-beta1 constructs had a higher aggregate modulus and GAG content compared to TGF-beta3. These results demonstrate that bMSCs can generate functional hyaline-like cartilage through a self-assembling process.

Effect of collagen hydrolysate on chondrocyte-seeded agarose constructs

The mechanical properties of engineered cartilage are strongly dependent on collagen content, but the collagen to glycosaminoglycan ratio in engineered cartilage is often much lower than that of the native tissue. Therefore culture medium supplements which increase collagen production by chondrocytes are of interest. It had previously been reported that collagen hydrolysate stimulated type II collagen biosynthesis in short-term, high density monolayer chondrocyte cultures. It was hypothesized that collagen hydrolysate added to the culture medium of three dimensional chondrocyte-agarose constructs would enhance their mechanical properties. Porcine articular chondrocytes were embedded in 2% agarose and cultured for up to 6 weeks with and without 1 mg/ml collagen hydrolysate. The instantaneous compressive modulus and equilibrium compressive modulus were significantly lower in the collagen hydrolysate-treated constructs, consistent with the finding of lower collagen and GAG content. Contrary to our hypothesis, our results indicate that 1 mg/ml collagen hydrolysate may actually inhibit macromolecule biosynthesis and be detrimental to the mechanical properties of long term chondrocyte-agarose constructs.

Effect of Cytoskeletal Disruption on Mechanotransduction of Hydrostatic Pressure by C3H10T1/2 Murine Fibroblasts

Cyclic hydrostatic pressure of physiological magnitude (< 10 MPa) stimulates chondrogenic differentiation of mesenchymal stem cells, but mechanotransduction mechanisms are not well understood. It was hypothesized that an intact cytoskeleton would be required for uninhibited mechanotransduction of hydrostatic pressure. Therefore we examined the effects of drugs which selectively interfere with actin and tubulin polymerization on pressure-induced upregulation of aggrecan and col2a1 (type II collagen) mRNA expression. C3H10T1/2 cells were cultured as pellets in either 4µM cytochalasin D or 4µM nocodazole and subjected to 3 days of cyclic hydrostatic compression (1 Hz, 5 MPa, 2 h per day). Phalloidin staining and indirect immunostaining with anti α-tubulin antibody confirmed disruption of microfilament and microtubule assemblies, respectively. Real time RT-PCR revealed that both drugs substantially lowered the basal level of aggrecan and col2a1 mRNA, but that neither drug prevented a pressure-stimulated increase in gene expression relative to the altered basal state. Thus upregulation of macromolecular gene expression by cyclic hydrostatic pressure did not require a completely intact cytoskeleton.

Variation of diameter distribution, number density, and area fraction of fibrils within five areas of the rabbit patellar tendon

The purpose of this investigation is to show microstructural information at various regions within the rabbit patellar tendon. The properties of the rabbit patellar tendon are well documented mechanically, but detailed information at the microscopic level is not available. Increasing attention has been directed to soft tissue microscopy as the demand for development of biologically inspired materials increases. Microstructural examination of the tendon fibrils is performed to provide further insight into understanding of the structure to function relations within the rabbit patellar tendon. Limited studies on rabbit patellar tendon collagen fibrils at the microscopic level have been computed. Furthermore, evaluation of structure-function relations in multiple regions of any given specimen of a particular tissue type has not been conducted. In this study the number density, area fraction, and diameter distribution of collagen fibrils have been determined. Overall, this examination showed considerable variation within each section of the tendon. Correlating these structural results with mechanical tests of the tendon portions in the various regions could provide additional information on the mechanics of the rabbit tendon as well as insight into development of artificial tissue constructs.

The anisotropic compressive mechanical properties of the rabbit patellar tendon

In this study, we examine the transverse and longitudinal compressive mechanical behavior of the rabbit patellar tendon. The anisotropic compressive properties are of interest, because compression occurs where the tendon attaches to bone and where the tendon wraps around bone leading to the development of fibro-cartilaginous matrices. We quantified the time dependent viscoelastic and anisotropic behavior of the tendon under compression. For both orientations, sections of patellar tendon were drawn from mature male white New Zealand rabbits in preparation for testing. The tendons were sequentially compressed to 40% strain at strain rates of 0.1, 1 and 10% strain(s) using a computer-controlled stepper motor driven device under physiological conditions. Following monotonic loading, the tendons were subjected to stress relaxation. The tendon equilibrium compressive modulus was quantified to be 19.49+/-11.46 kPa for the transverse direction and 1.11+/-0.57 kPa for the longitudinal direction. The compressive modulus at applied strain rates of 0.1, 1 and 10% strain(s) in the transverse orientation were 13.48+/-2.31, 18.24+/-4.58 and 20.90+/-8.60 kPa, respectively. The compressive modulus at applied strain rates of 0.1, 1 and 10% strain/s in the longitudinal orientation were 0.19+/-0.11, 1.27+/-1.38 and 3.26+/-3.49 kPa, respectively. The modulus values were almost significantly different for the examination of the effect of orientation on the equilibrium modulus (p=0.054). Monotonic loading of the tendon showed visual differences of the strain rate dependency; however, no significant difference was shown in the statistical analysis of the effect of strain rate on compressive modulus. The statistical analysis of the effect of orientation on compressive modulus showed a significant difference. The difference shown in the orientation analysis validated the anisotropic nature of the tendon.

Influence of hydrostatic and distortional stress on chondroinduction

Undifferentiated connective tissue that arises during embryonic development and some healing processes contains pluripotent mesenchymal stem cells. It is becoming increasingly evident that the mechanical environment is an important differentiation factor for these cells. In our laboratory, we have focused on the potential for mechanical signals to induce chondrogenic differentiation of mesenchymal stem cells. Using C3H10T1/2 cells as a model, we have investigated the influence of hydrostatic pressure, equibiaxial contraction, and centrifugal pressure on chondroinduction. Cells responded to cyclic hydrostatic compression (5 MPa at 1 Hz) and cyclic contractile strain (15% at 1 Hz) by upregulating aggrecan and collagen type II gene expression. In addition, a preliminary study of the effects of centrifugal pressure (4.1 MPa for 30 min) suggests that it may increase cell proliferation and stimulate proteoglycan and collagen type II production. We speculate that compression, whether it is distortional or hydrostatic in nature, applied to undifferentiated connective tissue triggers differentiation toward a chondrocyte-like phenotype and production of a less permeable extracellular matrix which is capable of sustaining increasingly higher hydrostatic fluid pressure for compressive load support.

The integration of chitosan-coated titanium in bone: an in vivo study in rabbits

PROCEDURE

Much research is directed at surface modifications to enhance osseointegration of implants. A new potential coating is the biopolymer, chitosan, the deacetylated derivative of the natural polysaccharide, chitin. Chitosan is biocompatible, degradable, nontoxic, and exhibits osteogenic properties. The aim of this research was to investigate the hypothesis that chitosan-coated titanium supports bone formation and osseointegration.

MATERIALS AND METHODS

Chitosan (1 wt% of 92.3% deacetylated chitosan in 1% acetic acid) was solution cast and bonded to rough ground titanium pins (2-mm diameterx4-mm long) via silane reactions. Calcium phosphate sputter-coated titanium and uncoated titanium pins were used as controls. Two chitosan-coated pins, and 1 each of calcium phosphate coated and uncoated pins were implanted unilaterally in the tibia of 16 adult male New Zealand white rabbits. At 2, 4, 8, and 12 weeks, undecalcified sections were histologically evaluated for healing and bone formation.

RESULTS

Histological evaluations of tissues in contact with the chitosan-coated pins indicated minimal inflammatory response and a typical healing sequence of fibrous, woven bone formation, followed by development of lamellar bone. These observations were similar to those for tissues interfacing the control calcium phosphate-coated and uncoated titanium implants. Quantitative comparisons of the bone-implant interface were not possible since 31% of the implants migrated into the tibial marrow space after implantation due to insufficient cortical bone thickness to hold pins in place during healing.

CONCLUSION

These data support the hypothesis that chitosan-coatings are able to develop a close bony apposition or the osseointegration of dental/craniofacial and orthopedic implants.

Characterization of chitosan films and effects on fibroblast cell attachment and proliferation

Chitosan has been researched for implant and wound healing applications. However, there are inconsistencies in reports on the tissue and fibroblast responses to chitosan materials. These inconsistencies may be due to variations in chitosan material characteristics. The aim of this study was to correlate fibroblast responses with known chitosan material characteristics. To achieve this aim, chitosan was characterized for degree of deacetylation (DDA), molecular weight (MW), residual protein and ash contents, and then solution cast into films and characterized for hydrophilicity by water contact angle. The films were seeded with normal human dermal fibroblasts and the number of attached cells was evaluated for after 30 min. Cell proliferation was evaluated over 5 days. This study found no relationship between DDA, contact angle, cell attachment, and or proliferation. General trends were observed for increasing proliferation with increasing residual ash content and decreasing residual protein. These data indicate that chitosan characteristics other than DDA may be important to their biological performance.

Chondrocyte response to cyclic hydrostatic pressure in alginate versus pellet culture

Cells are often cultured at high density (e.g., confluent monolayer and as pellets) to promote chondrogenic differentiation and to maintain the chondrocyte phenotype. They are also frequently suspended in hydrogels such as agarose or alginate for the same purposes. These culture techniques differ markedly with respect to frequency of direct contact between cells and overall intercellular spacing. Because these factors may significantly affect mechanotransduction, the purpose of this study was to determine if the response of articular chondrocytes to cyclic hydrostatic pressure would depend on the culture condition. Primary articular chondrocytes from young and mature pigs were cultured either as pellets or suspended in alginate beads. Both groups were exposed to dynamic hydrostatic pressure (4 MPa, 1 Hz, 5400 cycles per day) for 7 days. Cell proliferation was unaffected by pressure, but pressurized chondrocytes in pellet culture had significantly greater sGAG content and incorporated [3H]proline at a higher rate than nonpressurized controls. Electron microscopy revealed a fibrous extracellular matrix (ECM) surrounding pellets, but not cells in alginate. In addition, expression of Connexin 43 (Cx43) mRNA was slightly lower in alginate than in pellet cultures and was not significantly altered by loading. Thus, metabolic response of chondrocytes to dynamic hydrostatic pressure was affected by culture technique; chondrocytes cultured as pellets exhibited the classical anabolic response to dynamic hydrostatic pressure, but those in alginate did not. Although cell-ECM interaction could be important, the differential response is not likely attributable to differential expression of Cx43 mRNA.

Influence of cyclic hydrostatic pressure on fibrocartilaginous metaplasia of achilles tendon fibroblasts

The goal of this study was to demonstrate whether cyclically imposed hydrostatic pressure, compressive in nature, could induce fibrocartilaginous metaplasia in a purely tendinous cell source in vitro. The effect of short-duration cyclic hydrostatic pressure on tendon fibroblasts (tenocytes) expanded from rat Achilles tendon was studied. Total RNA was isolated either immediately after loading or 24 h later. The mRNA expression of tendon and cartilage specific markers - Collagen types I and II, Sox9, and Aggrecan was quantified by real-time reverse transcription polymerase chain reaction over multiple biological samples (n=6). For immediately isolated RNA samples, there were statistically significant increases in mRNA expression of Aggrecan and Collagen type II, while Collagen type I significantly decreased. Noticeably, for RNA samples isolated 24 h later, there were further increases in mRNA expression of Aggrecan and Collagen type II, whereas Collagen type I increased roughly three-fold relative to the non-loaded control. These findings support the hypothesis that cyclic hydrostatic pressurization can induce fibrocartilaginous metaplasia in tenocytes by upregulation of cartilaginous gene expression. Also, it was demonstrated that changes in mRNA expression as a result of single 2 h pressurization persist even up to 24 h.

The role of negative intra-articular pressure in the maintenance of shoulder joint stability in dogs

The objective of this study was to evaluate the effect of negative intra-articular pressure on shoulder joint stability in canine cadavers. Cadaver forelimbs from 12 mature dogs were used. The forelimbs were placed in a testing frame and axially preloaded with 4 kg of weight. Shoulder joint stability was tested in flexion, extension, and neutral position before and after venting of the joint capsule. Humeral translation relative to the glenoid was induced by applying a 3 kg load in three different directions (cranial, lateral, and medial) and quantitatively measured by use of an electromagnetic motion tracking system. Peak translational data were compared in each joint position before and after venting of the joint capsule. After venting the shoulder joint capsule, a significant increase in translation was observed in the cranial direction with the joint in neutral position and in the medial direction with the joint in extension. The horizontal translations measured after venting of the joint capsule were likely not clinically relevant. Negative intra-articular pressure is not a major contributor to shoulder stability in dogs during weight-bearing.

Cyclic hydrostatic compression stimulates chondroinduction of C3H/10T1/2 cells

While the potential for intermittent hydrostatic pressure to promote cartilaginous matrix synthesis is well established, its potential to influence chondroinduction remains poorly understood. This study examined the effects of relatively short- and long-duration cyclic hydrostatic compression on the chondroinduction of C3H/10T1/2 murine embryonic fibroblasts by recombinant human bone morphogenetic protein-2 (rhBMP-2). Cells were seeded at high density into round bottom wells of a 96-well plate and supplemented with 25 ng/ml rhBMP-2. Experimental cultures were subjected to either 1,800 cycles/day or 7,200 cycles/day of 1 Hz sinusoidal hydrostatic compression to 5 MPa (applied 10 min on/10 min off) for 3 days. Non-pressurized control and experimental cultures were maintained in static culture for an additional 5 days. Cultures were then analyzed for alcian blue staining intensity, DNA and sulfated glycosaminoglycan (sGAG) content, and for the rate of collagen synthesis. Whereas cultures subjected to 1,800 pressure cycles exhibited no significant differences (statistical or qualitative) compared to controls, those subjected to 7,200 cycles stained more intensely with alcian blue, contained nearly twice as much sGAG, and displayed twice the rate of collagen synthesis as non-pressurized controls. This study demonstrates the potential for cyclic hydrostatic compression to stimulate chondrogenic differentiation of the C3H/10T1/2 cell line in a duration-dependent manner.

Contact angle, protein adsorption and osteoblast precursor cell attachment to chitosan coatings bonded to titanium

Chitosan, a derivative of the bio-polysaccharide chitin, has shown promise as a bioactive material for implant, tissue engineering and drug-delivery applications. The aim of this study was to evaluate the contact angle, protein adsorption and osteoblast precursor cell attachment to chitosan coatings bonded to titanium. Rough ground titanium (Ti) coupons were solution cast and bonded to 91.2% de-acetylated chitosan (1 wt% chitosan in 0.2% acetic acid) coatings via silane reactions. Non-coated Ti was used as controls. Samples were sterilized by ethylene oxide gas prior to experiments. Contact angles on all surfaces were measured using water. 5 x 10(4) cells/ml of ATCC CRL 1486 human embryonic palatal mesenchyme (HEPM) cells, an osteoblast precursor cell line, were used for the cell attachment study. SEM evaluations were performed on cells attached to all surfaces. Contact angles and cell attachment on all surfaces were statistically analyzed using ANOVA. The chitosan-coated surfaces (76.4 +/- 5.1 degrees) exhibited a significantly greater contact angle compared to control Ti surfaces (32.2 +/- 6.1 degrees). Similarly, chitosan-coated surfaces exhibited significantly greater (P < 0.001) albumin adsorption, fibronectin adsorption and cell attachment, as compared to the control Ti surfaces. Coating chitosan on Ti surfaces decreased the wettability of the Ti, but increased protein adsorption and cell attachment. Increased protein absorption and cell attachment on the chitosan-coated Ti may be of benefit in enhancing osseointegration of implant devices.

Role of the tendons of the biceps brachii and infraspinatus muscles and the medial glenohumeral ligament in the maintenance of passive shoulder joint stability in dogs

OBJECTIVE

To objectively evaluate the effect of transecting the tendon of the biceps brachii muscle (BBT), tendon of the infraspinatus muscle (IFS), or medial glenohumeral ligament (MGHL) on shoulder joint stability in canine cadavers.

SAMPLE POPULATION

81 forelimbs from mature dogs.

PROCEDURE

Cadaver forelimbs were placed in a testing frame and axially preloaded with 4 kg of weight. Shoulder joint stability was tested in neutral joint position, flexion, and extension before and after transection of the BBT (n = 37), IFS (37), or MGHL (7). Humeral translation relative to the glenoid was induced by applying a 3-kg load in each of 3 directions (cranial, lateral, and medial) and quantitatively measured by use of an electromagnetic motion tracking system. Peak translational data were compared in each joint position before and after transection of the BBT, IFS, or MGHL.

RESULTS

When tested in neutral position, the cranial, lateral, and medial translation of the humerus was significantly increased after BBT transection. In the flexed position, translation of the humerus in the cranial and lateral directions was significantly increased after BBT transection. In the extended position, the medial translation of the humerus was significantly increased after BBT transection. Complete medial luxation of all humeral heads occurred following transection of the MGHL.

CONCLUSIONS AND CLINICAL RELEVANCE

The BBT contributes to passive shoulder joint stability in dogs, particularly in the neutral and flexed positions. It also provides medial stability during shoulder joint extension. Complete luxation of the joint occurs when the MGHL is transected.

Effects of pico-tesla electromagnetic field treatment on wound healing in rats

OBJECTIVE

To evaluate the effects of a pico-tesla electromagnetic field (PTEF) on healing of sutured and open skin wounds and clinicopathologic variables in rats.

ANIMALS

64 male Fischer-344 rats.

PROCEDURE

An incision made in the dorsal aspect of the neck was sutured (n = 32) or left open to heal (32). In each group, 16 rats were not PTEF-treated (controls). Wound treatment consisted of exposure to a PTEF once daily. Rats in each group were euthanatized at days 2, 4, 7, and 14. Wounds were evaluated via tensiometry (sutured wounds), digital planimetry (open wounds), laser Doppler perfusion imaging, bacteriologic culture, and histologic examination. Blood samples were collected from all rats for analysis.

RESULTS

At day 14, sutured wounds in PTEF-treated rats were stronger (ultimate stress) and tougher (strain energy) than were sutured wounds in control rats. Open wounds in PTEF-treated rats contracted more quickly at days 2 and 4 than did those in control rats. Compared with control wounds, histologic changes (indicative of improved healing) in sutured and open wounds in PTEF-treated rats were detected as early as day 4. Laser Doppler perfusion measurements, results of CBCs, serum biochemical analyses, and bacteriologic cultures were not different between groups.

CONCLUSIONS AND CLINICAL RELEVANCE

Exposure to the PTEF caused no adverse effects on clinicopathologic, histologic, or bacteriologic variables tested in this study. It appears that PTEF is a safe form of adjuvant treatment for wounds and improves strength of sutured wounds and speeds contraction of open wounds.

Postoperative integrity of veterinary surgical gloves

A multicenter, prospective study was performed to document the incidence of defective gloves postoperatively in veterinary surgery and to correlate defects with a variety of influencing factors. Gloves were collected after surgical procedures performed by the small animal clinical services at two veterinary teaching hospitals and one institution's student surgery laboratories. Gloves were evaluated for defects using electrical resistance testing. The overall incidence of glove defects was 23.3%. Significantly more defects occurred in gloves used for nonsoft-tissue procedures and in gloves worn on the nondominant hand. Eighty-four percent of all defects occurred in procedures lasting >60 minutes. No differences were detected in the brands of gloves used nor among surgeons of different experience levels. The individuals performing the surgery were not able to accurately predict the presence of a defect in their gloves. Surgeons should remain alert for possible glove defects and consider measures such as changing gloves every 60 minutes or double-gloving to minimize potential complications.

Conditioned medium of mechanically compressed chick limb bud cells promotes chondrocyte differentiation

Previous studies have demonstrated that chondrocyte differentiation can be stimulated by cyclic mechanical compression of chick limb bud cell-agarose constructs. This study reveals that medium collected from these compressed cultures promotes chondrocyte differentiation of non-compressed cells to approximately the same extent as compression alone. In micromass cultures of chick limb bud cells, incubation with medium from compressed cells significantly enhanced cell proliferation and the average rate of proteoglycan synthesis in a dose-dependent manner. These findings indicate that the response of undifferentiated chick limb bud cells to mechanical loading involves the secretion of one or more soluble differentiation factors. The chondrogenic activity of the conditioned medium was substantially inhibited by passage through a filter with a nominal molecular-weight cutoff (MWCO) of 10 kDa but not inhibited when using a MWCO of 30 kDa, suggesting that at least one of these factors has a molecular mass between 10 and 30 kDa.

Potential use of chitosan as a cell scaffold material for cartilage tissue engineering

One of the most important factors in any tissue-engineering application is the cell substrate. The purpose of this study was the initial evaluation of chitosan, a derivative of the abundant, naturally occurring biopolymer chitin, as a cell scaffold for cartilage tissue engineering. Chitosan scaffolds having an interconnecting porous structure were easily fabricated by simple freezing and lyophilization of a chitosan solution. After rehydration of scaffolds, porcine chondrocytes were seeded onto scaffolds and cultured for up to 28 days in a rotating-wall bioreactor. Chitosan scaffolds supported cell attachment and maintenance of a rounded cell morphology. After 18 days, cells within the scaffolds had synthesized extracellular matrix in which proteoglycan and type II collagen were detected by toluidine blue staining and immunohistochemistry, respectively. Abundant extracellular matrix was found almost exclusively in the periphery of the scaffolds, as scaffold microstructure prevented cells from penetrating to interior regions. Nonetheless, the results suggest that chitosan scaffolds may be a useful alternative to synthetic cell scaffolds for cartilage tissue engineering.

A device for imposing cyclic strain to cells growing on implant alloys

The objective of this study was to develop a unique device for applying well-characterized cyclic, strain to cells growing on implant alloys. The device is based on the four-point bending principle and utilizes an electric motor, belt, and cam system to cyclically deflect a commercially pure titanium plate with cell culture wells in the middle of the plate. Analyses demonstrated that 182 +/- 3, 366 +/- 9, and 984 +/- 7 microstrain may be cyclically generated in culture areas from 0.5 to 10 Hz for up to 72 h. UMR-106 osteoblast-like cells growing on the titanium plate were subjected to these strain magnitudes at 1.5 Hz for periods of 4 or 24 h. Cells were checked for viability, total protein as a general indicator of cell number, and alkaline phosphatase activity (ALP) as an indicator of bone cell func-tion. Cells strained at 984 +/- 7 microstrain exhibited 21%-24% more protein but 45%-49% less ALP activity than cells strained at 182 +/- 2 or 366 +/- 9 microstrain. Decreased ALP activity may indicate impaired mineralization. Results indicate the device is suitable for applying known, cyclic strain to cells growing on implant alloys and evaluating cellular responses to strain while growing on implant alloys.

Energetics of nanocrystalline TiO2

The energetics of the TiO(2) polymorphs (rutile, anatase, and brookite) were studied by high temperature oxide melt drop solution calorimetry. Relative to bulk rutile, bulk brookite is 0.71 +/- 0.38 kJ/mol (6) and bulk anatase is 2.61 +/- 0.41 kJ/mol higher in enthalpy. The surface enthalpies of rutile, brookite, and anatase are 2.2 +/- 0.2 J/m(2), 1.0 +/- 0.2 J/m(2), and 0.4 +/- 0.1 J/m(2), respectively. The closely balanced energetics directly confirm the crossover in stability of nanophase polymorphs inferred by Zhang and Banfield (7). An amorphous sample with surface area of 34,600 m(2)/mol is 24.25 +/- 0.88 kJ/mol higher in enthalpy than bulk rutile.

Chondrocyte differentiation is modulated by frequency and duration of cyclic compressive loading

As part of a program of research aimed at determining the role of mechanical forces in connective tissue differentiation, we have developed a model for investigating the effects of dynamic compressive loading on chondrocyte differentiation in vitro. In the current study, we examined the influence of cyclic compressive loading of chick limb bud mesenchymal cells to a constant peak stress of 9.25 kPa during each of the first 3 days in culture. Cells embedded in agarose gel were subjected to uniaxial, cyclic compression at 0.03, 0.15, or 0.33 Hz for 2 h. In addition, load durations of 12, 54, or 120 min were evaluated while holding frequency constant at 0.33 Hz. For a 2 h duration, there was no response to loading at 0.03 Hz. A significant increase in chondrocyte differentiation was associated with loading at 0.15 Hz, and an even greater increase with loading at 0.33 Hz. Holding frequency constant at 0.33 Hz, a loading duration of 12 min elicited no response, whereas chondrocyte differentiation was enhanced by loading for either 54 or 120 min. Although not statistically significant from the 120 min response, average cartilage nodule density and glycosaminoglycan synthesis rate were highest in the 54 min duration group. This result suggests that cells may be sensitive to the level of cumulative (nonrecoverable) compressive strain, as well as to the dynamic strain history.

Effect of compressive loading on chondrocyte differentiation in agarose cultures of chick limb-bud cells

It is well established that mechanical loading is important to homeostasis of cartilage tissue, and growing evidence suggests that it influences cartilage differentiation as well. Whereas the effect of mechanical forces on chondrocyte biosynthesis and gene expression has been vigorously investigated, the effect of the mechanical environment on chondrocyte differentiation has received little attention. The long-term objective of this research is to investigate the regulatory role of mechanical loading in cell differentiation. The goal of this study was to determine if mechanical compression could modulate chondrocyte differentiation in vitro. Stage 23/24 chick limb-bud cells, embedded in agarose gel, were subjected to either static (constant 4.5-kPa stress) or cyclic (9.0-kPa peak stress at 0.33 Hz) loading in unconfined compression during the initial phase of commitment to a phenotypic lineage. Compared with nonloaded controls, cyclic compressive loading roughly doubled the number of cartilage nodules and the amount of sulfate incorporation on day 8, whereas static compression had little effect on these two measures. Neither compression protocol significantly affected overall cell viability or the proliferation of cells within nodules. Since limb-bud mesenchymal cells were seeded directly into agarose, an assessment of cartilage nodules in the agarose reflects the proportion of the original cells that had given rise to chondrocytes. Thus, the results indicate that about twice as many mesenchymal cells were induced to enter the chondrogenic pathway by cyclic mechanical compression. The coincidence of the increase in sulfate incorporation and nodule density indicates that the primary effect of mechanical compression on mesenchymal cells was on cellular differentiation and not on their subsequent metabolism. Further studies are needed to identify the primary chondrogenic signal associated with cyclic compressive loading and to determine the mechanism by which it influences commitment to or progression through the chondrogenic lineage, or both.

A new optical system for the determination of deformations and strains: calibration characteristics and experimental results

Many types of optical strain measurement systems have been used for the determination of deformations and strains in soft biological tissues. The purpose of this investigation is to report a new optical strain measurement system developed in our laboratory which offers distinct advantages over systems developed in the past. Our optical strain system has demonstrated excellent performance in calibration and experimental tests. Calibration tests illustrate the system's accuracy to 0.05% strain at 3.52% strain and 0.18% strain at 11.74% strain. Further, this system can measure strains to within 2% measurement error for strains in a 0-11.74% range when 100 microns increments of motion are used for calibration. The resolution of our system appears to be at least as good as the linear micrometer (2 microns) used as a calibrating standard. Errors in strain measurement due to whole specimen rotation or translation are quantified. Rotations about an in-plane axis perpendicular to the direction of strain and translations in/out of the plane of focus result in the largest sources of error. Finally, in an in vitro biomechanical study of the rabbit Achilles tendon, experimental failure strains are 4.3 +/- 0.9% using this system.

Revision arthroplasty facilitated by ultrasonic tool cement removal. An evaluation of whole bone strength in a canine model

Ultrasonic driven tools have been developed to facilitate the removal of bone cement during revision arthroplasty. The effect on whole bone strength of cement removal by ultrasonic tools was examined in a canine femur model. Paired, fresh-frozen canine femora were divided into two groups. In group A, one femur from each pair was subjected to cement extraction with ultrasonic tools. In group B, one femur from each pair was subjected to manual cement extraction. Contralateral femora from each pair served as controls to determine the strength of intact femora. Torsional fractures were produced using a servocontrolled hydraulic testing machine (Minneapolis Testing System, Minneapolis, MN). Maximum torque, maximum angle, and energy capacity to failure were determined. Results were recorded as a reduction in percent value of the tested specimen versus the contralateral control. When comparing femora with cement removal by ultrasonic tools to the contralateral control femur, there were no statistical differences in ultimate torque (P = .83), maximum angle (P = .89), and energy capacity (P = .74) by analysis of variance. In addition, there were no significant differences between the group with ultrasonic tool cement removal and the group with manual tool removal. The authors conclude that in this canine model, removal of cement with ultrasonically driven tools has no adverse effects on whole bone strength.

Screw-augmented fixation of acetabular components. A mechanical model to determine optimal screw placement

Sixteen embalmed hemipelves were used to determine the optimal acetabular screw placement to provide maximal screw pull-out strength in unicortical and bicortical screw fixation. The anterior column, superior ilium, posterior column, ischium, and pubis regions of the pelvis were tested using 6.5-mm titanium alloy screws and a hydraulic servo-controlled 1321 Instron testing machine. Force vs displacement data were acquired. Bicortical fixation was stronger than unicortical fixation in the four zones compared. This difference was significant in the superior ilium, posterior column, and ischium. The anterior column could not accept unicortical screws due to inadequate bone depth, which ranged between only 6 mm and 10 mm. Bicortical fixation was significantly greater in the superior ilium, posterior column, and ischium than in the anterior column or pubis. Unicortical fixation was greatest in the superior ilium. This information may aid decisions concerning the positioning of screws to augment acetabular component fixation.

The impact of supportive intervention after second trimester termination of pregnancy for fetal abnormality

The reactions of women who had had a termination of pregnancy for fetal abnormality in the second trimester have been studied retrospectively using a semi-structured questionnaire. The severity of the grief reaction was measured and the outcome at 6 months was compared with the findings from a previous study in South Wales which had led to the introduction of skilled support from genetic fieldworkers and formal genetic counselling after the termination. Of the 69 women interviewed, 55 (80 per cent) experienced an acute grief reaction and 17 (25 per cent) had not resolved their grief 6 months after the termination, compared with 37 (77 per cent) and 22 (46 per cent) out of 48 respectively in the previous study. Fifty-seven (83 per cent) women had found the fieldworker's intervention useful or very useful, some describing her support as essential. An association between poor resolution of the grief reaction with increasing maternal age and with poor perceived support from partners was noted. Improved follow-up support and counselling have lessened the adverse emotional consequences and support should therefore be offered to all women undergoing termination for fetal malformation.