Detecting early osteoarthritis through changes in biomechanical properties – A review of recent advances in indentation technologies in a clinical arthroscopic setup

Cykowska, Anna; Danalache, Marina; Bonnaire, Florian Christof; Feierabend, Martina; Hofmann, Ulf Krister

doi:10.1016/j.jbiomech.2022.110955

Cited by 8 publications

(6 citation statements)

References 103 publications

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“…Better techniques are, therefore, still warranted to further improve guideline‐based intraoperative decision‐making. Possible candidates for such evaluations could be, for example, micro‐ultrasound evaluations, optical coherence tomography‐based air‐jet indentation, or biomechanic testings, such as fiber Bragg grating (reviewed by Cykowska et al 27 …”

Section: Discussionmentioning

confidence: 99%

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Reliability and Accuracy of the Outerbridge Classification in Staging of Cartilage Defects

Mederake,

Scheibe,

Dalheimer

et al. 2024

Orthopaedic Surgery

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ObjectiveThe decision on whether or not and how to treat a local cartilage defect is still made intraoperatively based on the visual presentation of the cartilage and findings from indentations with an arthroscopic probe. The treatment decision is then usually based on grading according to established classifications systems, which, therefore, need to have high reliability and accuracy. The aim of the present study was to evaluate the reliability and accuracy of the Outerbridge classification in staging cartilage defects.MethodsWe performed an observer arthroscopic study using the Outerbridge classification on seven fresh‐frozen human cadaveric knees, which collectively exhibited nine cartilage defects. To evaluate accuracy, defect severity was verified through histological examination. Interrater and intrarater reliabilites were calculated using Cohen's kappa and the intra‐class correlation coefficient (ICC 3.1).ResultsThe interrater and intrarater reliability for the Outerbridge classification ranged from poor to substantial, with 0.24 ≤ κ ≤ 0.70 and κ = 0.55 to κ = 0.66, respectively. The accuracy evaluated by comparison with the histological examination was 63% overall. The erroneous evaluations were, however, still often at the discrimination of grade 2 and 3. We did not find any relationship between higher experience and accuracy or intraobserver reliability. Taken together, these results encourage surgeons to further use diagnostic arthroscopy for evaluating cartilage lesions. Nevertheless, especially in grade 2 and 3, deviations from the histology were observed. This is, however, the point where a decision is made on whether to surgically address the defect or not.ConclusionDiagnostic arthroscopy is the standard for cartilage lesion assessment, yet interobserver reliability is fair to substantial. Caution is warranted in interpreting varied observer results. The accuracy of the “simpler” Outerbridge classification is insufficient compared to histological examinations, highlighting the need for improved techniques in guideline‐based intraoperative decision‐making.

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Section: Discussionmentioning

confidence: 99%

“…Possible candidates for such evaluations could be, for example, micro‐ultrasound evaluations, optical coherence tomography‐based air‐jet indentation, or biomechanic testings, such as fiber Bragg grating (reviewed by Cykowska et al . 27 ).…”

Section: Discussionmentioning

confidence: 99%

Reliability and Accuracy of the Outerbridge Classification in Staging of Cartilage Defects

Mederake,

Scheibe,

Dalheimer

et al. 2024

Orthopaedic Surgery

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“…To date, diagnosis of OA has remained in the late stages of the disease, but advanced OA can already cause irreversible damage to joints and even more distant tissues. AFM can distinguish normal cells from inflammatory cells by the morphological and mechanical properties of chondrocytes, and thus can be a promising tool for early diagnosis of OA (Cykowska et al, 2022).…”

Section: Osteoarthritismentioning

confidence: 99%

Atomic force microscopy in disease‐related studies: Exploring tissue and cell mechanics

Liu,

Han,

Kong

et al. 2023

Microscopy Res & Technique

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Despite significant progress in human medicine, certain diseases remain challenging to promptly diagnose and treat. Hence, the imperative lies in the development of more exhaustive criteria and tools. Tissue and cellular mechanics exhibit distinctive traits in both normal and pathological states, suggesting that “force” represents a promising and distinctive target for disease diagnosis and treatment. Atomic force microscopy (AFM) holds great promise as a prospective clinical medical device due to its capability to concurrently assess surface morphology and mechanical characteristics of biological specimens within a physiological setting. This review presents a comprehensive examination of the operational principles of AFM and diverse mechanical models, focusing on its applications in investigating tissue and cellular mechanics associated with prevalent diseases. The findings from these studies lay a solid groundwork for potential clinical implementations of AFM.Research HighlightsBy examining the surface morphology and assessing tissue and cellular mechanics of biological specimens in a physiological setting, AFM shows promise as a clinical device to diagnose and treat challenging diseases.

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“…Clinically, in situ quantitative evaluation of articular cartilage stiffness during arthroscopy provides valuable information on identifying the early stage of OA. Various indentation technologies have been developed for deciphering early changes in mechanical properties of the cartilage in a clinical arthroscopic setup (for detail see review [ 9 ]). With the help of these techniques, there were growing evidences pointing out the relationship between cartilage stiffness and OA progression.…”

Section: Introductionmentioning

confidence: 99%

Alteration in cartilage matrix stiffness as an indicator and modulator of osteoarthritis

Song,

Zeng,

et al. 2024

Bioscience Reports

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Osteoarthritis (OA) is characterized by cartilage degeneration and destruction, leading to joint ankylosis and disability. The major challenge in diagnosing OA at early stage is not only lack of clinical symptoms but also the insufficient histological and immunohistochemical signs. Alteration in cartilage stiffness during OA progression, especially at OA initiation, has been confirmed by growing evidences. Moreover, the stiffness of cartilage extracellular matrix (ECM), pericellular matrix (PCM) and chondrocytes during OA development are dynamically changed in unique and distinct fashions, revealing possibly inconsistent conclusions when detecting cartilage matrix stiffness at different locations and scales. In addition, it will be discussed regarding the mechanisms through which OA-related cartilage degenerations exhibit stiffened or softened matrix, highlighting some critical events that generally incurred to cartilage stiffness alteration, as well as some typical molecules that participated in constituting the mechanical properties of cartilage. Finally, in vitro culturing chondrocytes in various stiffness-tunable scaffolds provided a reliable method to explore the matrix stiffness-dependent modulation of chondrocyte metabolism, which offers valuable information on optimizing implant scaffolds to maximally promote cartilage repair and regeneration during OA. Overall, this review systematically and comprehensively elucidated the current progresses in the relationship between cartilage stiffness alteration and OA progression. We hope that deeper attention and understanding in this researching field will not only develop more innovative methods in OA early detection and diagnose, but also provide promising ideas in OA therapy and prognosis.

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Detecting early osteoarthritis through changes in biomechanical properties – A review of recent advances in indentation technologies in a clinical arthroscopic setup

Cited by 8 publications

References 103 publications

Reliability and Accuracy of the Outerbridge Classification in Staging of Cartilage Defects

Reliability and Accuracy of the Outerbridge Classification in Staging of Cartilage Defects

Atomic force microscopy in disease‐related studies: Exploring tissue and cell mechanics

Alteration in cartilage matrix stiffness as an indicator and modulator of osteoarthritis

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