Nanostructures of Phospholipids on Articular Cartilage Surface and their Functions

Phospholipids bilayers fulfill an important role in natural joint lamellar-repulsive lubrication mechanism. Low friction between surfaces coated with negatively charged the phospholipid headgroup (–PO4-) as being due to a hydration layer. Wettability of the cartilage surface depends on the number of PLs that act as a lubricant. The cartilage can be classified as a group of intelligent material, which in the wet state has a contact angle of ~0º, and the air-dry state has a contact angle of ~104º.

Quantification of Cartilage Surface Degeneration by Curvature Analysis Using 3D Scanning in a Rabbit Model

Objective Accurate analysis to quantify cartilage morphology is critical for evaluating degenerative conditions in osteoarthritis (OA). Three-dimensional (3D) optical scanning provides 3D data for the entire cartilage surface; however, there is no consensus on how to quantify it. Our purpose was to validate a 3D method for evaluating spatiotemporal alterations in degenerative cartilages in a rabbit OA model by analyzing their curvatures at various stages of progression. Design Twelve rabbits underwent anterior cruciate ligament transection (ACLT) unilaterally and were divided into 4 groups: 4 weeks control, 4 weeks OA, 8 weeks control, and 8 weeks OA. 3D scanning, India ink staining, and histological assessments were performed in all groups. In 3D curvature visualization, the surfaces of the condyles were divided into 8 areas. The standard deviations (SD) of mean curvatures from all vertices of condylar surfaces and subareas were calculated. Results Regarding the site of OA change, curvature analysis was consistent with India ink scoring. The SD of mean curvature correlated strongly with the India ink Osteoarthritis Research Society International (OARSI) score. In curvature histograms, the curvature distribution in OA was more scattered than in control. Of the 8 areas, significant OA progression in the posterolateral part of the lateral condyle (L-PL) was observed at 4 weeks. The histology result was consistent with the 3D evaluation in terms of representative section. Conclusions This study demonstrated that 3D scanning with curvature analysis can quantify the severity of cartilage degeneration objectively. Furthermore, the L-PL was found to be the initial area where OA degeneration occurred in the rabbit ACLT model.

Recent Advances in Understanding the Role of Cartilage Lubrication in Osteoarthritis

The remarkable lubrication properties of normal articular cartilage play an essential role in daily life, providing almost frictionless movements of joints. Alterations of cartilage surface or degradation of biomacromolecules within synovial fluid increase the wear and tear of the cartilage and hence determining the onset of the most common joint disease, osteoarthritis (OA). The irreversible and progressive degradation of articular cartilage is the hallmark of OA. Considering the absence of effective options to treat OA, the mechanosensitivity of chondrocytes has captured attention. As the only embedded cells in cartilage, the metabolism of chondrocytes is essential in maintaining homeostasis of cartilage, which triggers motivations to understand what is behind the low friction of cartilage and develop biolubrication-based strategies to postpone or even possibly heal OA. This review firstly focuses on the mechanism of cartilage lubrication, particularly on boundary lubrication. Then the mechanotransduction (especially shear stress) of chondrocytes is discussed. The following summarizes the recent development of cartilage-inspired biolubricants to highlight the correlation between cartilage lubrication and OA. One might expect that the restoration of cartilage lubrication at the early stage of OA could potentially promote the regeneration of cartilage and reverse its pathology to cure OA.

The Effect of Patellar Surface Morphology On Subchondral Bone Alignment When Matching Patellar Osteochondral Allografts (206)

Objectives: Recent research has shown that implanting a patellar osteochondral allograft with a non-matched surface morphology (i.e., Wiberg classification) does not create increased chondral surface deviation or circumferential step-off in the donor plug compared to the native patella. While much of the research on patellar osteochondral allografts has been focused on chondral surface matching, little has been done to determine if the subchondral bone alignment at the donor:native interface plays a role in graft healing, local force distribution, and long term success of the allograft transplant. Previous work in our lab demonstrated that even when the patellar cartilage surface was well matched, notable differences in subchondral bone alignment were observed. The purpose of this study was therefore to use surface contour mapping of subchondral bone to determine if differences in Wiberg classification play a role in the ability of donor patellar osteochondral allograft subchondral bone to align with the native patellar subchondral bone when treating osteochondral defects of the patellar apex. The hypothesis was that patellar surface morphology would have an effect on subchondral bone surface height deviation and circumferential step-off when performing osteochondral allograft transplants of the patellar apex. Methods: Sixty fresh frozen human patellae were acquired from a national donor procurement company. Twenty (10 Wiberg I and 10 Wiberg II/III) patellae were designated as the recipient and then nano-CT scanned. Each recipient was size-matched (within ±2mm tibial width) to both a Wiberg I and a Wiberg II/III patellar donor. A 16mm circular osteochondral “defect” centered on the central ridge of the patella was then created in the recipient patella. A randomly-ordered donor Wiberg I or Wiberg II/III plug was harvested from a homologous location and transplanted into the recipient. The recipient was then nano-CT scanner, digitally reconstructed, and superimposed on the initial nano-CT scan of the native recipient patella. After careful atraumatic removal of the first donor plug, the process was repeated using the other allograft plug. MATLAB was used to determine the root mean square (RMS) surface height deviation between the native and donor subchondral bone surfaces. Dragonfly 3D imaging software was used to measure the RMS subchondral bone step-off height at 3° increments around the circumference of the graft. Surface height deviation and circumferential step-off height were analyzed for the whole surface and by quadrant to determine if there were local differences. ANOVA was used to compare surface deviation and step-off heights between matched and unmatched grafts. Sidak’s multiple comparison test was used to complete sub-analysis between patellar graft quadrants. Comparisons were made between matched and unmatched grafts in terms of the RMS surface height deviation and step-off, as well as in the percentage of measurements that were more than 0.5mm, 1mm, and 2mm proud or sunken relative to the native surface. Results: There were no significant differences in RMS subchondral bone surface height deviation between matched and unmatched Wiberg plugs as a whole or by quadrant (RMS range = 0.69 to 0.97mm, p = 0.45 – 1.0). There was a significant difference in RMS circumferential step-off height between matched (1.14 ± 0.52mm) and unmatched (1.38 ± 0.49mm) Wiberg plugs ( p=0.015). The majority of these increased step-off measurements occurred in the lateral quadrant with lateral quadrant RMS step-off of 0.89 ± 0.43mm in matched grafts and 1.60 ± 0.78mm in unmatched grafts ( p=0.007). There was also a significant difference in the percent of step-off measurements greater than 2mm sunken in the lateral quadrant between matched and unmatched grafts (5.17 ± 20.87% matched, 24.5 ± 36.39% unmatched, p=0.028). There were no significant differences between matched and unmatched grafts for any other comparison using 0.5, 1, or 2mm cut-offs for circumferential step-off or surface height deviation. Combining all allografts, the respective proportion of surface deviation and circumferential step-off height measurements that were above the stated thresholds were as follows: 31% and 34% for a 0.5mm threshold, 15% and 21% for a 1mm threshold, and 2% and 8% for a 2mm threshold. Conclusions: While unmatched Wiberg patella osteochondral allograft implantation did not result in significantly different subchondral bone surface height deviations, there were significant differences in circumferential subchondral bone step-off heights. The majority of step-off height differences between Wiberg matched and unmatched osteochondral allografts occurred in the lateral quadrant. In comparison to previous data evaluating differences in the cartilage surface match in these patellar OCA transplants, the deviations and step-off heights in the subchondral bone identified in the current study were approximately 0.5mm greater than the differences in the cartilage surface. These findings therefore suggest there is greater variability in the alignment of the subchondral bone in these patellar osteochondral allografts than there is in the cartilage surface. Further investigation using finite element analysis modeling will help determine the implications of subchondral bone surface deviation and circumferential step-off on local cartilage:bone compression and shear force distribution. These studies may shed light on the mechanisms of failure in patellar osteochondral transplants and may help to better understand the contribution of subchondral bone alignment in OCA healing and long-term outcome.

Factors Contributing to Graft Matching in a Patellar Osteochondral Allograft Selection Model (211)

Objectives: Patellar osteochondral allograft (OA) transplantation has been shown to be a successful treatment in patients with isolated patellar cartilage injury. Currently, there is minimal guidance in anatomic and sizing factors that portend similar patellar surface topography. The most commonly utilized patellar sizing criteria to match the donor and recipient is radiographic tibial width. Our hypothesis is that specific patella anatomic factors will better predict surface topography matching. To our knowledge, no prior study has investigated the topography of the patella and what intrinsic factors of the graft and the recipient affect matching of the chondral and osseous layers between the graft and defect. Methods: Computed tomography (CT) images of the specimens were acquired and three-dimensional (3D) CT models of the patella were then created and exported into point-cloud models using a 3D reconstruction software program. Circular articular cartilage and subchondral bone defect models were created in each point-cloud model of the recipient patella with a diameter of 18 mm and 22.5 mm at 3 locations: the medial, central, and lateral portions of the patellar surface. Circular articular cartilage and subchondral bone graft models were created on all possible locations on the articular cartilage surface models of the donor patellae (Figure 1). The graft models were virtually placed on the surface of the defect model. Orientation of the graft model was adjusted so that its axis matched that of the defect site. Least distances between the graft and the defect articular surface models were calculated and were defined as the shortest distance from the point in question to the corresponding point in space. A mean value of the least distances was calculated for each position of the graft model. The mean least distance of subchondral bone surface in each point was calculated simultaneously. The graft model was then rotated 360° around the axis perpendicular to the articular cartilage surface in 1° increments, and the least distance of articular cartilage surface and the resulting least distance of subchondral bone surface were calculated at each rotating angle. This procedure was repeated for all points in the articular surface model of the donor patella. Step-off was then calculated as the least mean square difference between the defect and graft along the periphery. Stepwise linear regression was used for each defect location to analyze which variables predict degree of mismatch in millimeters. Results: A total of 16 patella were utilized in analysis. Comparison of cartilage least mean square distances between locations demonstrated that the lateral location had significantly less surface incongruity compared to the other two locations (vs medial: p = .0038, vs central: p = .0046). In addition, significant differences in subchondral bone distances were observed between the locations (lateral vs medial: p = .0007, lateral vs central: p < .0001, medial vs central: p < .0001) (Table 1). The associations of six anatomic and morphologic variables with cartilage mismatch, bone mismatch, and step-off for 18 mm and 22.5 mm defects are presented in Tables 2 and Table 3. All variables were analyzed as the difference in value between the recipient and donor. For both lesion sizes, cartilage step-off was the most susceptible to variable differences. Compared to the 18 mm defect group, the 22.5 mm defects were more affected (higher coefficients) by the same differences in variables. Differences in tibial width were associated mismatch for central lesions (eg. 22.5mm defect coefficient: -0.026, p < .001), while cartilage width was associated with mismatch for lateral lesions. (eg. 22.5 mm defect coefficient: -0.034, p < .023). Conclusions: Multiple clinically relevant factors were found to affect graft and defect chondral mismatch and to a lesser extent osseous mismatch. For all three locations at both defect sizes, step-off was the most susceptible to differences in patellar morphology between the donor and recipient. In addition, differences in tibial width, a commonly used metric for patellar graft matching, did not significantly predict chondral mismatch for lateral and medial sized lesions. These findings should be considered when selecting and preparing the graft in a patella osteochondral allograft procedure.

Attenuation of Osteoarthritis Progression via a Combination of Intra-articular Injection of Synovial Membrane-derived MSCs (SMMSCs), Platelet Rich Plasma (PRP) and Conditioned Medium (Secretome)

Introduction: Osteoarthritis (OA) as a progressive destructive disease of articular cartilage is the most common joint disease characterized by reduction of joint cartilage thickness, demolition of cartilage surface and new bone formation. To overcome these problems, the purpose of the current research was to evaluate and compare the in vivo effects of Synovial membrane-derived MSCs (SMMSCs), platelet rich plasma (PRP) and conditioned medium (secretome) on collagenase II-induced rat knee osteoarthritis (KOA) remedy. Methods: For the first step, SMMSCs were isolated and characterized. Also, secretome was collected from SMMSCs culture. Furthermore, PRP was collect from the rat heart venous blood. Second, two injection of collagenase II with an interval of 3 days was performed in the knee intra- articular space to induce osteoarthritis. Two weeks later, animals were randomly divided into 6 groups. Control group without treatment, positive group: taken an intra-articular Hyalgan injection (0.1 cc), treatment groups taken an intra-articular injection of; treatment 1: SMMSCs (5 × 106), treatment 2: SMMSCs (5 × 106) + secretome (50 µl), treatment 3: SMMSCs (5 × 106) + PRP (50 µl), and treatment 4: SMMSCs (5 × 106) + secretome (50 µl) + PRP (50 µl). Three months later, rats were sacrificed and the following assessments were executed: radiography, histopathology, and immunohistochemistry. Results: Our findings represented that a combination of the SMMSCs with PRP and secretome had a considerable effect on GAGs and collagen II contents, articular cartilage preservation, compared with other groups. In addition, combination of the SMMSCs with PRP and secretome showed the lowest expression of mmp3, while SOX9 had the highest expression in comparision with other groups. Also, SMMSCs -injected groups demonstrated better results compared with positive and control groups. Conclusions: Injection a combination of the SMMSCs with PRP and secretome resulted in better efficacy in terms of joint space width, articular cartilage surface continuity and integrity, sub chondral bone and ECM constituents such as collagen II. Indeed, transplantation of this combination could be considered as a promising therapy for patients with KOA.

CELL METABOLISM UNDER DIFFERENT INTENSITY EXERCISES IN SPORTS MEDICINE

ABSTRACT Introduction: Articular cartilage is an essential structure for joint weight-bearing and movement. If it is always under a specific mechanical stimulation, it will cause osteoarthritis (OA) and even involve the articular cartilage. Sports can affect articular cartilage thickness, cartilage surface morphology, and cartilage cell metabolism. Objective: This thesis studies the cell metabolism of knee cartilage tissue with exercises of different intensities. Methods: We divided 40 rats into four groups according to exercise intensity. The control group exercised freely, while the experimental group exercised with different intensities. After eight weeks of exercise, we extracted the knee joint cartilage to observe its cell metabolism. Results: We found that the cartilage surface of the rats was complete after exercise, and the thickness of the cartilage layer was significantly greater than that of rats without exercise. Conclusion: Exercises of different intensities have different effects on the metabolism of cartilage cells in the knee joint of rats. Level of evidence II; Therapeutic studies - investigation of treatment results.