Osteoarthritis-Related Degeneration Alters the Biomechanical Properties of Human Menisci Before the Articular Cartilage

Abstract

An exact understanding of the interplay between the articulating tissues of the knee joint in relation to the osteoarthritis (OA)-related degeneration process is of considerable interest. Therefore, the aim of the present study was to characterize the biomechanical properties of mildly and severely degenerated human knee joints, including their menisci and tibial and femoral articular cartilage (AC) surfaces. A spatial biomechanical mapping of the articulating knee joint surfaces of 12 mildly and 12 severely degenerated human cadaveric knee joints was assessed using a multiaxial mechanical testing machine. To do so, indentation stress relaxation tests were combined with thickness and water content measurements at the lateral and medial menisci and the AC of the tibial plateau and femoral condyles to calculate the instantaneous modulus (IM), relaxation modulus, relaxation percentage, maximum applied force during the indentation, and the water content. With progressing joint degeneration, we found an increase in the lateral and the medial meniscal instantaneous moduli (p < 0.02), relaxation moduli (p < 0.01), and maximum applied forces (p < 0.01), while for the underlying tibial AC, the IM (p = 0.01) and maximum applied force (p < 0.01) decreased only at the medial compartment. Degeneration had no influence on the relaxation percentage of the soft tissues. While the water content of the menisci did not change with progressing degeneration, the severely degenerated tibial AC contained more water (p < 0.04) compared to the mildly degenerated tibial cartilage. The results of this study indicate that degeneration-related (bio-)mechanical changes seem likely to be first detectable in the menisci before the articular knee joint cartilage is affected. Should these findings be further reinforced by structural and imaging analyses, the treatment and diagnostic paradigms of OA might be modified, focusing on the early detection of meniscal degeneration and its respective treatment, with the final aim to delay osteoarthritis onset.

Knee Joint Menisci Are Shock Absorbers: A Biomechanical In-Vitro Study on Porcine Stifle Joints

“…Normal menisci have a highly anisotropic structure that is mainly composed of water (75%), collagen (23%), water-binding glycosaminoglycans (1%), and other matrix components leading to a time-dependent viscoelastic behavior ( Herwig et al, 1984 ; Pereira et al, 2014 ; Seitz et al, 2021 ). While under static equilibrium conditions ( Tibesku et al, 2004 ; Martin Seitz et al, 2013 ; Schwer et al, 2020 ) and repetitive loading ( Kessler et al, 2006 ), the menisci exhibit considerable axial deformation, high impact, or shock loads, as seen, e.g., during jump landings, leading to an increase in their stiffness, and thus, to a decrease in the ability to reduce the transmitted stresses.…”

The efficacy of platelet rich plasma in treating symptomatic cases with MRI-confirmed degenerative medial meniscal lesions

“…With the increase of age, degenerative injury appears inside meniscus which is mainly manifested by the change of its internal structures, and horizontal tear is the main type of injury on MRI images [2]. Degenerative lesion of menisci is considered of the early stage of the knee osteoarthritis [3,4]. And literature statistics showed that 90% of symptomatic osteoarthritis patients' had positive meniscus lesions on their MRI pictures [5] and osteoarthritis-related medial gonarthrosis is much more frequent than the lateral [3].…”

Mechanotransduction in meniscus fibrochondrocytes: What about caveolae?

“…Several groups have identified a relationship between meniscal degeneration and the progression of KOA. Seitz et al (2021) recently demonstrated that the biomechanical alterations and degeneration associated with KOA were first detectable in menisci and occurred before degeneration of the articular cartilage. Together, these findings suggest that the mechanobiology of the meniscus plays a key role in the pathogenesis of KOA.…”

“…If this mechanism were to be identified, this information could lead to a breakthrough discovery that would have important implications for meniscus research including studies on knee osteoarthritis (KOA). KOA is a degenerative disease of the knee joint that poses a huge annual socioeconomic burden (Seitz et al, 2021) and is characterized by progressive pain, joint immobility, and a reduced quality of life (Thomas et al, 2017). It is well established that biomechanical dysfunctions of the knee joint are contributing factors to the initiation and progression of the disease (Egloff et al, 2012).…”

“…KOA is a degenerative disease of the knee joint that poses a huge annual socioeconomic burden (Seitz et al, 2021) and is characterized by progressive pain, joint immobility, and a reduced quality of life (Thomas et al, 2017). It is well established that biomechanical dysfunctions of the knee joint are contributing factors to the initiation and progression of the disease (Egloff et al, 2012).…”