The critical size of focal articular cartilage defects is associated with strains in the collagen fibers

Heuijerjans, Ashley; Wilson, W.; Ito, Keita; Donkelaar, Corrinus C. van

doi:10.1016/j.clinbiomech.2017.09.015

Cited by 22 publications

(16 citation statements)

References 41 publications

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“…This is also where rim stress concentrations were reported experimentally . Deeper in the tissue deviatoric strains increased, in agreement with previous studies . Kock et al reported that contact pressures surrounding defects can be 190% of the contact pressures in the healthy state, dependent on gait phase, and on defect and implant size, which could be ameliorated by mosaicplasty or a metal osteochondral resurfacing implant .…”

Section: Discussionsupporting

confidence: 89%

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Osteochondral resurfacing implantation angle is more important than implant material stiffness

Heuijerjans

Wilson

Ito

et al. 2018

Journal Orthopaedic Research

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Osteochondral resurfacing implants are a promising treatment for focal cartilage defects. Several implant-factors may affect the clinical outcome of this treatment, such as the implant material stiffness and the accuracy of implant placement, known to be challenging. In general, softer implants are expected to be more accommodating for implant misalignment than stiffer implants, and motion is expected to increase effects from implant misalignment and stiffness. 3D finite element models of cartilage/cartilage contact were employed in which implantation angle (0°, 5°, 10°) and implant material stiffness (E = 5 MPa, 100 MPa, 2 GPa) were varied. A creep loading (0.6 MPa) was simulated, followed by a sliding motion. Creep loading resulted in low maximum collagen strains of 2.5% in the intact case compared to 11.7% with an empty defect. Implants mostly positively affected collagen strains, deviatoric strains, and hydrostatic pressures in the adjacent cartilage, but these effects were superior for correct alignment (0°). The main effect of implant misalignment was bulging of opposing cartilage tissue into the gap caused by the misalignment. This increased collagen strains and hydrostatic pressures. Deviatoric strains were increased adjacent to the gap. Subsequent sliding initially increased strains for a stiff, misaligned implant, but generally sliding decreased strains. In conclusion, implants can decrease the detrimental effect of defects, but correct implant alignment is crucial, more than implant material stiffness. Implant misalignment causes a gap, causing potentially damaging cartilage deformation during prolonged loading, for example, standing, even for soft implants. Mild motion may positively affect the cartilage. © 2018 The Authors. Journal of Orthopaedic Research® published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society. J Orthop Res 9999:1-12, 2018.

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Section: Discussionsupporting

confidence: 89%

“…At the rim of the defect, superficial collagen fiber strains increased significantly compared to the intact situation, similar to previous numerical models . This is also where rim stress concentrations were reported experimentally .…”

Section: Discussionsupporting

confidence: 89%

Osteochondral resurfacing implantation angle is more important than implant material stiffness

Heuijerjans

Wilson

Ito

et al. 2018

Journal Orthopaedic Research

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“…Previously, the prevalence and progression of chondral lesions as well as alterations in cartilage biomechanics in in vitro models of cartilage lesions have been investigated . In vitro models and strain‐based degeneration algorithm have, for example, been able to reproduce experimentally found cartilage degeneration in terms of proteoglycan loss under similar levels of strain as reported here .…”

Section: Discussionmentioning

confidence: 63%

Computational evaluation of altered biomechanics related to articular cartilage lesions observed in vivo

Myller¹,

Korhonen²,

Töyräs³

et al. 2019

Journal Orthopaedic Research

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Chondral lesions provide a potential risk factor for development of osteoarthritis. Despite the variety of in vitro studies on lesion degeneration, in vivo studies that evaluate relation between lesion characteristics and the risk for the possible progression of OA are lacking. Here, we aimed to characterize different lesions and quantify biomechanical responses experienced by surrounding cartilage tissue. We generated computational knee joint models with nine chondral injuries based on clinical in vivo arthrographic computed tomography images. Finite element models with fibril-reinforced poro(visco)elastic cartilage and menisci were constructed to simulate physiological loading. Systematically, the lesions experienced increased peak values of maximum principal strain, maximum shear strain, and minimum principal strain in the surrounding chondral tissue (p < 0.01) compared with intact tissue. Depth, volume, and area of the lesion correlated with the maximum shear strain (p < 0.05, Spearman rank correlation coefficient r ¼ 0.733-0.917). Depth and volume of the lesion correlated also with the maximum principal strain (p < 0.05, r ¼ 0.767, and r ¼ 0.717, respectively). However, the lesion area had non-significant correlation with this strain parameter (p ¼ 0.06, r ¼ 0.65). Potentially, the introduced approach could be developed for clinical evaluation of biomechanical risks of a chondral lesion and planning an intervention. Statement of Clinical Relevance:In this study, we computationally characterized different in vivo chondral lesions and evaluated their risk of cartilage degeneration. This information is vital in decision-making for intervention in order to prevent post-traumatic

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“…Also, collagen damage progression was not taken into account, because we assumed that the damage in the ground substance and the subsequent FCD loss appear before the disorganization of the collagen network, which has been observed previously, especially at a relatively short follow-up period 21 . Future efforts will be focused on combining the adaptation of the collagen content and fibril orientation 23 , 72 as well as inflammatory responses 5 , 73 with the studied degeneration mechanisms after a traumatic joint injury. For those, more experimental data are required.…”

Section: Discussionmentioning

confidence: 99%

A novel mechanobiological model can predict how physiologically relevant dynamic loading causes proteoglycan loss in mechanically injured articular cartilage

Orozco

Tanska

Florea

et al. 2018

Sci Rep

132

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Cartilage provides low-friction properties and plays an essential role in diarthrodial joints. A hydrated ground substance composed mainly of proteoglycans (PGs) and a fibrillar collagen network are the main constituents of cartilage. Unfortunately, traumatic joint loading can destroy this complex structure and produce lesions in tissue, leading later to changes in tissue composition and, ultimately, to post-traumatic osteoarthritis (PTOA). Consequently, the fixed charge density (FCD) of PGs may decrease near the lesion. However, the underlying mechanisms leading to these tissue changes are unknown. Here, knee cartilage disks from bovine calves were injuriously compressed, followed by a physiologically relevant dynamic compression for twelve days. FCD content at different follow-up time points was assessed using digital densitometry. A novel cartilage degeneration model was developed by implementing deviatoric and maximum shear strain, as well as fluid velocity controlled algorithms to simulate the FCD loss as a function of time. Predicted loss of FCD was quite uniform around the cartilage lesions when the degeneration algorithm was driven by the fluid velocity, while the deviatoric and shear strain driven mechanisms exhibited slightly discontinuous FCD loss around cracks. Our degeneration algorithm predictions fitted well with the FCD content measured from the experiments. The developed model could subsequently be applied for prediction of FCD depletion around different cartilage lesions and for suggesting optimal rehabilitation protocols.

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The critical size of focal articular cartilage defects is associated with strains in the collagen fibers

Cited by 22 publications

References 41 publications

Osteochondral resurfacing implantation angle is more important than implant material stiffness

Osteochondral resurfacing implantation angle is more important than implant material stiffness

Computational evaluation of altered biomechanics related to articular cartilage lesions observed in vivo

A novel mechanobiological model can predict how physiologically relevant dynamic loading causes proteoglycan loss in mechanically injured articular cartilage

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