Continuous Passive Motion and Loading System Design for the Study of Pro- and Anti-Inflamatory Mediators in Articular Cartilage

2009 ◽  
Author(s):  
Xiang Gu ◽  
Daniel Leong ◽  
Rashal Mahammud ◽  
Yong Hui Li ◽  
Hui Bin Sun ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Inflammatory Response ◽  
Knee Joint ◽  
Angular Displacement ◽  
Weight Bearing ◽  
Small Animal ◽  
Continuous Passive Motion ◽  
Mechanical Stimuli ◽  
Passive Motion

Joint diseases are common causes of disability worldwide. Physical activity and weight bearing conditions play an important role in the regulation of joint homeostasis throughout life. The parametric characterization of deleterious and beneficial joint loading regimens influencing the homeostasis of articular cartilage is of great interest from both a basic research and clinical practice point of view. The development of in vivo animal models is critical to investigate the underlying mechanisms mediating the biological response of articular joints to external mechanical stimuli. For this purpose, the design of a device capable of accurately control the joint motion and loading in a small animal is needed. In the present work, an assisted motion system was conceived to perform continuous passive motion (CPM) and continuous loaded motion (CLM) on the knee joint of a small animal in vivo. A major purpose of this system is the study of the inflammatory and anti-inflammatory response of cartilage under several biomechanical environments. Therefore, a key design criterion was to avoid any invasive intervention (i.e. intraskeletal fixators) that may produce an intrinsic inflammatory response and then obscure/mislead the assessment of the biological markers of interest. Other important design criteria include real time control of the knee joint position, angular displacement, cyclic motion frequency and custom load magnitude applied in the axial direction along the tibia.

Assessing Foot Loads in Continuous Passive Motion (CPM) and Active Knee Joint Motion Devices

2019 ◽  
Author(s):  
Benedikt Stolz ◽  
Casper Grim ◽  
Christoph Lutter ◽  
Kolja Gelse ◽  
Monika Schell ◽  
...  
Keyword(s):  
Knee Joint ◽  
Weight Bearing ◽  
Continuous Passive Motion ◽  
Full Weight Bearing ◽  
Joint Motion ◽  
Active Motion ◽  
Passive Motion ◽  
Normal Gait ◽  
Knee Joint Motion ◽  
Joint Load

Abstract Background Continuous passive motion (CPM) and active knee joint motion devices are commonly applied after various surgical procedures. Despite the growing use of active motion devices, there is a paucity of data comparing plantar loads between the different mobilization techniques. The aim of this study was to investigate foot loads during knee joint mobilization in continuous passive and active knee joint motion devices and to compare this data to the physiological load of full weight-bearing. Patients/Material and Methods Fifteen healthy participants (7 women and 8 men, 25 ± 3 years, 66 ± 6 kg, 175 ± 10 cm, BMI 21.9 ± 2) were recruited. Plantar loads were measured via dynamic pedobarography using a continuous passive motion device (ARTROMOT-K1, ORMED GmbH, Freiburg, Germany) and an active motion device (CAMOped, OPED AG, Cham, Switzerland), each with a restricted range of motion of 0-0-90° (ex/flex) and free ROM for the knee joint. For the active motion device, cycles were performed at four different resistance levels (0-III). Data were assessed using the pedar® X system (Novel Inc., Munich, Germany), which monitors loads from the foot-sole interface. Force values were compared between motion devices and normal gait, which served as the reference for conditions of full weight-bearing. P-values of < 0.05 were considered statistically significant. Results Normal gait revealed peak forces of 694 ± 96 N, defined as 100 %. The CPM device produced plantar forces of less than 1.5 N. Using the active motion device in the setting of 0-0-90° produced foot loads of < 1.5 N (resistance 0-II) and 3.4 ± 9.3 N with a resistance of III (p < 0.001). Conditions of free ROM resulted in foot loads of 4.5 ± 4.5 N (resistance 0), 7.7 ± 10.7 N (resistance I), 6.7 ± 10.4 (resistance II) and 6.7 ± 6.9 N with a resistance of III (p < 0.001), corresponding to 0.6 %, 1.1 %, 1.0 % and 1.0 % of full weight-bearing, respectively. Conclusion Motion exercises of the knee joint can be performed both with passive and active devices in accordance with strict weight-bearing restrictions, which are often recommended by surgeons. Also, active motion devices can be used when the ankle joint or foot have to be offloaded. Further studies assessing intraarticular joint load conditions have to be performed to confirm the findings obtained in this study.

scholarly journals Continuous Passive Motion, Early Weight Bearing, and Active Motion following Knee Articular Cartilage Repair

Cartilage ◽  
2010 ◽  
Vol 1 (4) ◽  
pp. 276-286 ◽  
Author(s):  
Jennifer S. Howard ◽  
Carl G. Mattacola ◽  
Spencer E. Romine ◽  
Christian Lattermann
Keyword(s):  
Articular Cartilage ◽  
Cartilage Repair ◽  
Weight Bearing ◽  
Continuous Passive Motion ◽  
Articular Cartilage Repair ◽  
Active Motion ◽  
Early Weight Bearing ◽  
Passive Motion

scholarly journals Kinematic Analysis of Cpm Machine Supporting to Rehabilitation Process after Surgical Knee Arthroscopy and Arthroplasty

2014 ◽  
Vol 19 (4) ◽  
pp. 841-848 ◽  
Author(s):  
R. Trochimczuk ◽  
T. Kuźmierowski
Keyword(s):  
Knee Joint ◽  
Kinematic Analysis ◽  
Knee Arthroscopy ◽  
Arthroscopic Surgery ◽  
Computer Application ◽  
Continuous Passive Motion ◽  
Rehabilitation Process ◽  
Passive Motion ◽  
Novel Structure

Abstract Existing commercial solutions of the CPM (Continuous Passive Motion) machines are described in the paper. Based on the analysis of existing solutions we present our conceptual solution to support the process of rehabilitation of the knee joint which is necessary after arthroscopic surgery. For a given novel structure we analyze and present proprietary algorithms and the computer application to simulate the operation of our PCM device. In addition, we suggest directions for further research.

The Knee Loading Apparatus: Axial, Anterior, and Compressive Loading With Magnetic Resonance Imaging

2013 ◽  
Vol 135 (2) ◽  
Author(s):  
Jessica C. Küpper ◽  
Ion Robu ◽  
Richard Frayne ◽  
Janet L. Ronsky
Keyword(s):  
Magnetic Resonance ◽  
Knee Joint ◽  
Weight Bearing ◽  
Compressive Loading ◽  
Hydraulic Loading ◽  
Additional Information ◽  
Knee Loading ◽  
Loading System ◽  
Main Components

When magnetic resonance (MR) images are collected while applying a load to the knee joint, additional information about the joint response to loading can be acquired such as cartilage deformation, whole joint and ligament stiffness, or physiological estimates of weight-bearing joint positions. To allow load application and controlled lower limb movement in supine MR imaging, the knee loading apparatus (KLA) was designed to apply safe and physiologically relevant controlled loads to the knee joint, position the knee through a range of flexion angles, and operate successfully in a magnetic environment. The KLA is composed of three main components: a remotely operated custom hydraulic loading system, a logic system that interfaces with the user, and modular non ferromagnetic positioning frames. Three positioning frames are presented for application to anterior tibial loading, tibiofemoral compression, and patellofemoral compression at multiple knee flexion angles. This system design makes improvements over current devices. Safe remotely applied loads (hydraulic loading system) can be applied by either subject or tester and in multiple locations simultaneously. Additionally, loads can be altered at any time in a continuous manner without electrical interference. Transportability was improved due to a smaller footprint. The KLA has the flexibility to attach any positioning frame with many possible loading scenarios without changing the loading mechanism or logic systems, and allows force values over time to be output rather than estimated. An evaluation of the load repeatability (within 7% of applied load) and accuracy (0.5–14.9%) demonstrates the feasibility of this design for investigations into in vivo knee joint responses to loading.

Estimation of In-Vivo Quadriceps Forces of the Knee: A Combined In-Vivo Patellofemoral Joint Kinematics Measurement and Finite Element Prediction

2011 ◽  
Author(s):  
Koichi Kobayashi ◽  
Guoan Li
Keyword(s):  
Knee Joint ◽  
Load Transfer ◽  
Weight Bearing ◽  
Knee Oa ◽  
Moment Arms ◽  
Joint Reaction Forces ◽  
Joint Contact ◽  
Reaction Forces ◽  
Knee Pathology

The load transfer mechanics across the patellofemoral (PF) joint during weight-bearing conditions is important for treatment of the knee pathology, such as knee OA, ACL deficiency as well as TKA. Many studies have characterized the PF joint reaction forces using equilibriums of the quadriceps and ground reaction forces at the knee joint [1,2,3]. However, this simplification does not consider other muscle function as well as 3D knee joint contact location when calculate moment arms of the involved forces.

scholarly journals Silk fibroin hydrogel scaffolds incorporated with chitosan nanoparticles repair articular cartilage defects by regulating TGF-β1 and BMP-2

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Yuan Li ◽  
Yanping Liu ◽  
Qiang Guo
Keyword(s):  
Articular Cartilage ◽  
Knee Joint ◽  
Silk Fibroin ◽  
Cartilage Defects ◽  
Joint Cartilage ◽  
Hydrogel Scaffolds ◽  
Articular Cartilage Defects ◽  
Tgf Β1

AbstractCartilage defects frequently occur around the knee joint yet cartilage has limited self-repair abilities. Hydrogel scaffolds have excellent potential for use in tissue engineering. Therefore, the aim of the present study was to assess the ability of silk fibroin (SF) hydrogel scaffolds incorporated with chitosan (CS) nanoparticles (NPs) to repair knee joint cartilage defects. In the present study, composite systems of CS NPs incorporated with transforming growth factor-β1 (TGF-β1; TGF-β1@CS) and SF incorporated with bone morphogenetic protein-2 (BMP-2; TGF-β1@CS/BMP-2@SF) were developed and characterized with respect to their size distribution, zeta potential, morphology, and release of TGF-β1 and BMP-2. Bone marrow stromal cells (BMSCs) were co-cultured with TGF-β1@CS/BMP-2@SF extracts to assess chondrogenesis in vitro using a cell counting kit-8 assay, which was followed by in vivo evaluations in a rabbit model of knee joint cartilage defects. The constructed TGF-β1@CS/BMP-2@SF composite system was successfully characterized and showed favorable biocompatibility. In the presence of TGF-β1@CS/BMP-2@SF extracts, BMSCs exhibited normal cell morphology and enhanced chondrogenic ability both in vitro and in vivo, as evidenced by the promotion of cell viability and the alleviation of cartilage defects. Thus, the TGF-β1@CS/BMP-2@SF hydrogel developed in the present study promoted chondrogenic ability of BMSCs both in vivo and in vitro by releasing TGF-β1 and BMP-2, thereby offering a novel therapeutic strategy for repairing articular cartilage defects in knee joints.

scholarly journals Discoidin Domain Receptors 1 Inhibition Alleviates Osteoarthritis via Enhancing Autophagy

2020 ◽  
Vol 21 (19) ◽  
pp. 6991 ◽  
Author(s):  
Hsin-Chaio Chou ◽  
Chung-Hwan Chen ◽  
Liang-Yin Chou ◽  
Tsung-Lin Cheng ◽  
Lin Kang ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Cruciate Ligament ◽  
Weight Bearing ◽  
Mammalian Target Of Rapamycin ◽  
Terminal Differentiation ◽  
Cartilage Degradation ◽  
Chondrocyte Apoptosis ◽  
Differentiation Markers ◽  
Discoidin Domain Receptors

We recently reported that the chondrocyte-specific knockout of discoidin domain receptors 1 (Ddr1) delayed endochondral ossification (EO) in the growth plate by reducing the chondrocyte hypertrophic terminal differentiation, and apoptosis. The biologic and phenotypic changes in chondrocytes in the articular cartilage with osteoarthritis (OA) are similar to the phenomena observed in the process of EO. Additionally, autophagy can promote chondrocyte survival and prevent articular cartilage from degradation in OA. On this basis, we explored the effect of Ddr1 inhibition on OA prevention and further investigated the roles of autophagy in treating OA with a Ddr1 inhibitor (7 rh). The anterior cruciate ligament transection (ACLT)–OA model was used to investigate the role of 7 rh in vivo. Forty 8-week-old mice were randomly assigned to four groups, including the sham group, ACLT group, and two treated groups (ACLT with 7 rh 6.9 nM or 13.8 nM). According to the study design, normal saline or 7 rh were intra-articular (IA) injected into studied knees 3 times per week for 2 weeks and then once per week for 4 weeks. The results showed that 7 rh treatment significantly improved the functional performances (the weight-bearing ability and the running endurance), decreased cartilage degradation, and also reduced the terminal differentiation markers (collagen type X, Indian hedgehog, and matrix metalloproteinase 13). Moreover, 7 rh decreased chondrocyte apoptosis by regulating chondrocyte autophagy through reducing the expression of the mammalian target of rapamycin and enhancing the light chain 3 and beclin-1 expression. These results demonstrated that the IA injection of 7 rh could reduce the chondrocyte apoptosis and promote chondrocyte autophagy, leading to the attenuation of cartilage degradation. Our observations suggested that the IA injection of 7 rh could represent a potential disease-modifying therapy to prevention OA progression.

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