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Topographic variation in biglycan and decorin synthesis by articular cartilage in the early stages of osteoarthritis: an experimental study in sheep.

Articular cartilage contains large molecular weight proteoglycans that aggregate with hyaluronic acid (aggrecan) and small species, particularly biglycan (dermatan sulphate proteoglycan-1) and decorin (dermatan sulphate proteoglycan-2), that do not. Mechanical stresses have been shown to profoundly influence the metabolism of aggrecan by articular chondrocytes; however, there are limited corresponding data on the metabolism of dermatan sulphate proteoglycans 1 and 2. The objective of this study was to examine the metabolism of aggrecan, biglycan, and decorin in articular cartilage from different weight-bearing areas of normal ovine stifle joints and in joints 6 months after menisectomy, a procedure that has been shown to induce early osteorthritic changes. [35S]proteoglycans synthesised by cartilage explants from eight different weight-bearing regions of unoperated and meniscectomised ovine stifle joints during 48 hours of culture were separated by size-exclusion chromatography, hydrophobic chromatography, and sodium dodecyl sulfate-polyacrylamide gel electrophoresis and were quantitated by phosphor-screen autoradiography. The synthesis and degradation of the proteoglycans were expressed relative to the DNA content of the explants. In control joints, the cartilage exposed to high contact stress synthesised significantly less proteoglycan overall and more decorin than joint regions bearing less stress. Explants from high stress regions also released significantly greater amounts of resident proteoglycans (dimethylmethylene blue positive) into media during culture. After lateral meniscectomy, the lateral tibial and femoral cartilages showed elevated biosynthesis of both 35S-dermatan sulphate proteoglycans 1 and 2. This chondrocyte biosynthetic response was accompanied by increased catabolism of aggrecan and the release of its degradation products into culture media. These experiments revealed, in normal joints, a topographic variation in proteoglycan synthesis by articular cartilage that was related to the mechanical stress to which the tissues were subjected in vivo. This biosynthetic pattern changed when the load distribution of the joint was altered by unilateral meniscectomy. These data suggest that an altered chondrocyte phenotypic expression of proteoglycans in response to abnormal mechanical loading is an early event in osteoarthritis.

Aggrecans↗

The biphasic poroviscoelastic behavior of articular cartilage: role of the surface zone in governing the compressive behavior.

Surface fibrillation of articular cartilage is an early sign of degenerative changes in the development of osteoarthritis. To assess the influence of the surface zone on the viscoelastic properties of cartilage under compressive loading, we prepared osteochondral plugs from skeletally mature steers, with and without the surface zone of articular cartilage, for study in the confined compression creep experiment. The relative contributions of two viscoelastic mechanisms, i.e. a flow-independent mechanism [Hayes and Bodine, J. Biomechanics 11, 407-419 (1978)], and a flow-dependent mechanism [Mow et al. J. biomech. Engng 102, 73-84 (1980)], to the compressive creep response of these two types of specimens were determined using the biphasic poroviscoelastic theory proposed by Mak. [J. Biomechanics 20, 703-714 (1986)]. From the experimental results and the biphasic poroviscoelastic theory, we found that frictional drag associated with interstitial fluid flow and fluid pressurization are the dominant mechanisms of load support in the intact specimens, i.e. the flow-dependent mechanisms alone were sufficient to describe normal articular cartilage compressive creep behavior. For specimens with the surface removed, we found an increased creep rate which was derived from an increased tissue permeability, as well as significant changes in the flow-independent parameters of the viscoelastic solid matrix. permeability, as well as significant changes in the flow-independent parameters of the viscoelastic solid matrix. From these tissue properties and the biphasic poroviscoelastic theory, we determined that the flow-dependent mechanisms of load support, i.e. frictional drag and fluid pressurization, were greatly diminished in cartilage without the articular surface. Calculations based upon these material parameters show that for specimens with the surface zone removed, the cartilage solid matrix became more highly loaded during the early stages of creep. This suggests that an important function of the articular surface is to provide for a low fluid permeability, and thereby serve to restrict fluid exudation and increase interstitial fluid pressurization. Thus, it is likely that with increasing severity of damage to the articular surface, load support in cartilage under compression shifts from the flow-dependent modes of fluid drag and pressurization to increased solid matrix stress. This suggests that it is important to maintain the integrity of the articular surface in preserving normal compressive behavior of the tissue and normal load carriage in the joint.

Animals↗

Softening of the lateral condyle articular cartilage in the canine knee joint after long distance (up to 40 km/day) running training lasting one year.

The effects of long distance running training (up to 40km/day) on the biomechanical properties of young canine articular cartilage were investigated using in situ indentation creep technique. The stiffness of articular cartilage was determined in the form of instantaneous and equilibrium shear moduli. The rate of cartilage deformation was also computed. Microspectrophotometric and polarized light microscopic analyses were made for determination of local glycosaminoglycan content and collagen organization, respectively. During a period of one year, the runner dogs (n = 10) underwent a gradually increased treadmill exercise up to 40 km/day, while the littermate control dogs (n = 10) lived normally in their cages. The equilibrium shear modulus of articular cartilage decreased significantly by 12 to 14% (p < 0.05) in the lateral, but not in the medial, condyles of femur and tibia. In the lateral condyles of the runner dogs, the deformation rate of cartilage increased by 16% (p < 0.05). Consequently, the articular cartilage response to running training was site-dependent. The simultaneous changes of the equilibrium shear modulus or the retardation time spectrum and the glycosaminoglycan content confirm the key role of proteoglycans in modulating the cartilage equilibrium stiffness and creep rate. The changes in the instant shear modulus appeared to be predominantly related to the alterations in the organization of the superficial collagen network. Although the running training did not create cartilage damage, we assume that the softening of the cartilage may with time jeopardize the ability of articular cartilage to maintain its normal structural and functional properties.

Animals↗

Staphylococcus aureus stimulates inducible nitric oxide synthase in articular cartilage.

OBJECTIVE: To determine if Staphylococcus aureus stimulates the L-arginine-nitric oxide (NO) synthase pathway in articular cartilage. METHODS: A heat-killed and sonicated (denatured) S. aureus preparation was added to cultures of bovine articular cartilage. NO production was measured as accumulated nitrite in the culture medium and by the NO synthase-dependent conversion of 3H-L-arginine to 3H-L-citrulline in cartilage homogenates. Inducible NO synthase (iNOS) messenger RNA (mRNA) expression was analyzed by Northern blot. Proteoglycan synthesis was measured by 35SO4 incorporation into glycosaminoglycan. RESULTS: Nitrite accumulation and 3H-L-citrulline formation in cartilage were elevated by denatured S. aureus (compared with unstimulated control cartilage) and inhibited by the NO synthase inhibitor N(G)-monomethyl-L-arginine. Northern blot analysis revealed increased iNOS mRNA expression in bovine chondrocytes in response to denatured S. aureus stimulation. Denatured S. aureus suppressed the accumulation of 35SO4-labeled macromolecules representing newly synthesized proteoglycans in bovine articular cartilage. The suppressed proteoglycan synthesis was due to the presence of NO. CONCLUSION: These findings support the hypothesis that a component of S. aureus can stimulate iNOS in articular cartilage, and that NO generated from this enzyme down-regulates cartilage matrix proteoglycan synthesis.

Animals↗

Immunolocalization of carboxy-terminal type II procollagen peptide in regenerated articular cartilage of osteoarthritic knees after reduction of mechanical stress.

OBJECTIVE: The purpose of this study was to investigate the immunolocalization of carboxy-terminal type II procollagen peptide (pCOL-II-C) in the regenerated articular cartilage grown 1-2 years after reduction of mechanical stress by correction of varus deformity with high tibial osteotomy (HTO) for knees with medial compartmental osteoarthritis. DESIGN: The series included 24 knees of 16 patients with a mean age of 70 (56-79) years. Synovial fluid and tissue specimens of the regenerated articular cartilage were obtained at the time of plate removal with arthrotomy. Tissue specimens were decalcified and stained with toluidine blue, safranin O, anti-type I and type II collagen and anti-pCOL-II-C. Pineda's histological grading of articular cartilage repair and Okada's grade of immunostaining were employed to assess the regenerated articular cartilage. RESULTS: In knees with regeneration of articular cartilage, there was a positive linear correlation between the grade of immunostaining and the concentration of synovial fluid pCOL-II-C (r=0.652; P< 0.001). Similarly, a positive linear correlation was observed between the grade of immunostaining and the histological grading score (r=0.683; P< 0.001). CONCLUSIONS: The immunostaining and synovial fluid concentration of pCOL-II-C decreased in accordance with the progression of articular cartilage regeneration observed after reduction of mechanical stress by correction of deformity with HTO.

Aged↗

The treatment of isolated articular cartilage lesions in the young individual.

The treatment of isolated articular cartilage defects is an evolving field in orthopaedic surgery today. We have summarized the basic science and clinical date on the treatment of isolated articular cartilage defects. Further long-term controlled studies are required in order to compare definitively the efficacy of treatments in this difficult clinical area. In future studies, inclusion/exclusion criteria must be detailed, and classification systems need to be standardized Comparative analysis can then be performed to assess the efficacy of various techniques.

Adolescent↗

A biphasic viscohyperelastic fibril-reinforced model for articular cartilage: formulation and comparison with experimental data.

Experiments in articular cartilage have shown highly nonlinear stress-strain curves under finite deformations, nonlinear tension-compression response as well as intrinsic viscous effects of the proteoglycan matrix and the collagen fibers. A biphasic viscohyperelastic fibril-reinforced model is proposed here, which is able to describe the intrinsic viscoelasticity of the fibrillar and nonfibrillar components of the solid phase, the nonlinear tension-compression response and the nonlinear stress-strain curves under tension and compression. A viscohyperelastic constitutive equation was used for the matrix and the fibers encompassing, respectively, a hyperelastic function used previously for the matrix and a hyperelastic law used before to represent biological connective tissues. This model, implemented in an updated Lagrangian finite element code, displayed good ability to follow experimental stress-strain equilibrium curves under tension and compression for human humeral cartilage. In addition, curve fitting of experimental reaction force and lateral displacement unconfined compression curves showed that the inclusion of viscous effects in the matrix allows the description of experimental data with material properties for the fibers consistent with experimental tensile tests, suggesting that intrinsic viscous effects in the matrix of articular cartilage plays an important role in the mechanical response of the tissue.

Animals↗

Effects of hyaluronan on periosteal grafts for large full-thickness defects in rabbit articular cartilage.

We studied the effects of hyaluronan (HA) on chondrogenesis in periosteal grafts in rabbit knees to elucidate the effects of this agent in the repair of articular cartilage. Large full-thickness defects of the articular cartilage were created in the anteromedial part of the femoral articular surface of bilateral knee joints. Periosteal grafts were then harvested and sutured onto the defects. HA was injected in the right knee immediately after the operation and then once a week for 4 weeks (HA group). The same volume of saline was injected in the left knee in the control group. The animals were killed 2, 5, 8, and 12 weeks after the operation. Macroscopic and histological findings of the regenerated tissue were evaluated with a semiquantitative histological grading system. The total histological scores of the HA group were better than those in the control group at each time examination point. At 12 weeks, in particular, the scores for surface regularity and integration to adjacent articular cartilage were significantly better in the HA group than in the control group (P < 0.05). No significant differences were observed between the two groups in regard to the area healed (%). HA may have beneficial effects on the repair of large full-thickness defects of the articular cartilage with autologous periosteal grafts.

Adjuvants, Immunologic↗

Artefacts in the mechanical characterization of porcine articular cartilage due to freezing.

Many experimental protocols for investigating articular cartilage mechanics have involved the use of a freeze-thaw cycle for storage or tissue manipulation. It was hypothesized that mechanical properties are altered due to freeze-thaw cycling. The aim of this study, therefore, was to examine the possibility of protocol-induced artefacts in the mechanical properties of porcine articular cartilage specimens related specifically to freeze-thaw events. Twenty-eight osteochondral specimens [14 from the femoral condyles (FCs) and 14 from the patella-femoral (PF) groove] were tested in confined compression before and after being frozen at -20 degrees C for 7 days. The fluid-independent and fluid-dependent mechanical properties (aggregate modulus of the solid phase and the half-life of stress relaxation respectively) were determined and compared. The aggregate modulus decreased by 13.5 per cent and 20.1 per cent for the PF and FC regions respectively (p = 0.002) and the half-life of the stress relaxation at 10 per cent strain decreased by 6.4 per cent and 12.6 per cent for the PF and FC specimens respectively (p = 0.0341). In conclusion, it has been shown that the protocol used, which involved freezing to -20 degrees C and thawing after 7 days, caused artefacts in the mechanical properties of porcine osteochondral specimens. It is suggested that protocols requiring freezing must be critically reviewed to eliminate such artefacts.

Animals↗

Dendritic cells in rheumatoid synovial membrane after total removal of the hyaline articular cartilage.

OBJECTIVE: To investigate the effect of total removal of the hyaline articular cartilage on dendritic cells in synovial membrane in rheumatoid arthritis (RA) or ankylosing spondylitis (AS). PATIENTS AND METHODS: Immunohistochemical staining for two dendritic cell markers, CD35 and RFD1, was carried out on synovial membrane specimens from arthritis patients undergoing primary (n=10) or revision (n=8) total hip replacement (THR). The results are expressed as the number (mean+/-standard deviation) of positive cells per 1000 total cells. RESULTS: CD35-(112+/-9) and RFD1-(27+/-5) positive cells were found in all primary RA synovial membrane, while only two out of eight synovial membrane samples from revision THR contained CD35-positive follicular dendritic cells (nine and 12 cells), and no revision samples contained any RFD1-positive interdigitating dendritic cells. CONCLUSION: Removal of the hyaline articular cartilage reduces the infiltration and functional differentiation of dendritic cells in synovial membrane. Our findings suggest that the antigen driving chronic arthritis/synovitis is contained in the hyaline articular cartilage.

Adult↗

Osteochondritis dissecans of the knee: value of MR imaging in determining lesion stability and the presence of articular cartilage defects.

Osteochondritis dissecans is a lesion of articular surfaces that is of uncertain etiology. These lesions are seen on radiographs as a bony defect or fragmentation of the subchondral bone. A bony defect may be an actual surface hole or the defect may be filled with fibrous tissue or fibrocartilage. Similarly, the apparent bone fragments may be only partially attached so they are unstable and prone to displacement or they may be firmly attached with fibrous tissue. Knowledge of fragment stability and the presence of an articular cartilage defect is useful in deciding on treatment. This information cannot be determined on plain films or clinical examination. We correlated MR examinations with arthroscopic findings in 21 patients with osteochondritis dissecans of the knee to see if MR imaging could be used to predict lesion stability and articular cartilage defects. A high-signal interface between the lesion and the femur was used as evidence of lesion instability and was found in 15 lesions. One of these lesions was questionably stable at surgery; the remainder were unstable and partially attached. The other six patients had displaced fragments with large articular defects that were clearly visualized on the MR examinations. We conclude that MR imaging is useful in evaluating articular surface defects and lesion stability in patients with osteochondritis dissecans.

Adolescent↗

Effect of physical exercise on indentation stiffness of articular cartilage in the canine knee.

Using the indentation method, we investigated the effects of physical exercise (treadmill running 4 km/day for 15 weeks) on stiffness of the articular cartilage in the canine knee. Considering cartilage to be an elastic material with homogeneity and isotropy, we calculated elastic moduli for femoral, tibial, and patellar cartilages using instant and 15-s deformations after load application. Although the elastic moduli do not represent, because of the non-equilibrium condition, true elastic properties of articular cartilage, they characterize, together with the retardation time spectrum, the integrated response of articular cartilage during the first 15 s after load application. The moderate loading used in our training program caused no macroscopic changes on the articular surface. In running dogs, the mean stiffness of articular cartilage increased by 6% as compared with the controls. Stiffening, which was attributed to the decreased fluid flow in the cartilage, was significant (P less than 0.05) on the patellar surface of the femur and on the tibial condyles. In general, stiffness increased more (approximately 10%) in the cartilage areas, which were repeatedly heavily loaded during running exercise. This alteration in the biomechanical property as well as an increase (approximately 11%) in thickness were considered to be typical responses of articular cartilage to an increased, but physiologic loading pattern.

Animals↗

Silicone rubber: an alternative for repair of articular cartilage defects.

Silicone-rubber implants were used to fill full-thickness articular cartilage in the trochlea area of the knee joint in rabbits, for the purpose of studying the long-term influence of silicone-rubber implant on surrounding articular cartilage. Forty eight weeks after surgery, the silicone rubbers were still fitted tightly into the defects; surrounding cartilage showed mild degeneration, better than the control group. Our results showed silicone-rubber implantation for repairing local articular cartilage defects can effectively delay the pathogenetic progression of osteoarthritis.

Animals↗

Acoustic properties of articular cartilage under mechanical stress.

Mechano-acoustic and elastographic techniques may provide quantitative means for the in vivo diagnostics of articular cartilage. These techniques assume that sound speed does not change during tissue loading. As articular cartilage shows volumetric changes during compression, acoustic properties of cartilage may change affecting the validity of mechano-acoustic measurements. In this study, we examined the ultrasound propagation through human, bovine and porcine articular cartilage during stress-relaxation in unconfined compression. The time of flight (TOF) technique with known cartilage thickness (true sound speed) as well as in situ calibration method [Suh, Youn, Fu, J. Biomech. 34 (2001), 1347-1353] were used for the determination of sound speed. Ultrasound speed and attenuation decreased in articular cartilage during ramp compression, but returned towards the level of original values during relaxation. Variations in ultrasound speed induced an error in strain and compressive moduli provided that constant ultrasound speed and time-of-flight data was used to determine the tissue thickness. Highest errors in strain (-11.8 +/- 12.0%) and dynamic modulus (15.4 +/- 17.9%) were recorded in bovine cartilage. TOF and in situ calibration methods yielded different results for changes in sound speed during compression. We speculate that the variations in acoustic properties in loaded cartilage are related to rearrangement of the interstitial matrix, especially to that of collagen fibers. In human cartilage the changes, are, however relatively small and, according to the numerical simulations, mechano-acoustic techniques that assume constant acoustic properties for the cartilage will not be significantly impaired by this phenomenon.

Adult↗

Articular cartilage transplantation. Clinical results in the knee.

Between December 1983 and August 1991, 55 consecutive patients (55 knees) who underwent articular cartilage transplantation to their damaged knees were enrolled in the study. Average followup was 75 months (range, 11-147 months). Eight-two percent were younger than 45 years of age. Patients were evaluated through an 18-point scale, with 6 points each allocated to pain, range of motion, and function. An excellent knee was pain free, had full range of motion, and permitted unlimited activity. A good knee allowed full time employment and moderate activity. Eleven of 15 (73%) allografts transplanted 10 or more years ago were still good or excellent at the time of last followup. Overall, 45 of 55 (76%) knees that received the transplants were rated good or excellent. Specifically, 36 of 43 (84%) patients with unipolar transplants regained normal use of their resurfaced knee. The results after bipolar resurfacing were less encouraging, with only six of 12 (50%) knees rated good or excellent. The described technique of osteochondral shell allograft resurfacing of the knee capitalize on the different healing potentials of bone and cartilage by transplanting the viable articular cartilage organ in its entirety along with just enough of the underlying bone to allow for graft incorporation through creeping substitution. The results support the use of fresh osteochondral shell allograft transplantation for the treatment of large, full thickness articular cartilage defects to the medial or lateral femoral condyles and to the patella.

Adolescent↗

The collagenous architecture of articular cartilage. Correlation of scanning electron microscopy and polarized light microscopy observations.

The localization and directional orientation of collagen fibers in articular cartilage is demonstrated by scanning electron microscopy and polarized light microscopy. Vertical sections of articular cartilage show different directional orientations of collagen fibers through all zones of cartilage depending upon whether the sections are parallel or perpendicular to the cleft pattern produced when the surface of articular cartilage is pierced with a round pointed awl. Sections parallel to the cleft axis show a significant population of oblique collagen fibers which are not seen in sections perpendicular to the clefts. These oblique fiber groups show a progression from nearly radial to nearly tangential orientation from deep to more superficial zones, with the most abrupt directional change seen through the transitional zone. Within the transitional zone there is a narrow band having no vertical or horizontal collagen fibers and in which collagen fibers intersect predominantly at angles ranging between 45 and 135 degrees. The number of chondrocyte lacunae per unit area is greater in sections parallel to the cleft axis compared to perpendicular sections by a factor of approximately 1.6:1. There is therefore a greater relative number of chondrocytes in the plane of section having the greatest abundance of oblique collagen fibers, suggesting a cellular basis for the collagenous architecture observed. The results are consistent with published biophysical data relating tensile and swelling properties of all zones of articular cartilage to the cleft axis.

Animals↗

The effect of synovial tissue on the synthesis of proteoglycan by the articular cartilage of young pigs.

Explants of pig articular cartilage were grown in organ culture in the presence of synovial tissue; controls consisted of paired explants that were cultivated in isolation. To find whether the synovial tissue affected synthesis of sulfated proteoglycan by the cartilage, 35SO4 was added to the medium and its incorporation into the cartilage examined by both biochemical assay and autoradiography. The synovial tissue severely inhibited the uptake of 35SO4, but if the synovium was removed after 8 days cultivation and the cartilage was grown in isolation for a further 4 days, incorporation of 35SO4 equalled and sometimes surpassed that of controls which had been grown without synovium continuously for 12 days. Synovium did not prevent the formation of new cartilage on the cut surfaces of the explants, but it reduced the incidence of newly formed cartilage.

Animals↗

Articular cartilage proteoglycans from normal and osteoarthritic mice.

Articular cartilage proteoglycans from an osteoarthritic mouse strain, STR/IN, were labeled in vivo with 35S-sulfate and characterized with respect to extractability, ability to aggregate, size of monomer and glycosaminoglycan chains, sulfation of glycosaminoglycans, relative amounts of chondroitin-4 sulfate and chondroitin-6 sulfate, and link proteins. The proportion of 35S-labeled proteoglycans extractable by 0.4M guanidine hydrochloride was the same in control and osteoarthritic animals. However, a greater proportion was extractable by 4M guanidine hydrochloride in the STR/IN animals as compared with the control mice. The ability of the 35S-proteoglycans to aggregate was comparable in controls and osteoarthritic mice, as judged by their exclusion on Sepharose CL-2B. Monomers from both controls and osteoarthritic animals eluted from Sepharose CL-2B with a KAV of 0.47. Glycosaminoglycans from control and osteoarthritic animals eluted from Sepharose CL-6B with a KAV of 0.63, and no differences in sulfation or chondroitin-4 sulfate content were found. Aggregates were immunoprecipitated with link protein-specific antiserum, and only link protein 2 was found in aggregates from control and osteoarthritic animals.

Animals↗