The Mechanobiology of Articular Cartilage Development and Degeneration

Carter, Dennis R.; Beaupré, Gary S.; Wong, Maylene; Smith, R. Lane; Andriacchi, Tom P; Schurman, David J.

doi:10.1097/01.blo.0000144970.05107.7e

Cited by 311 publications

(224 citation statements)

References 42 publications

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“…Excessive stress exposure has been shown to cause accelerated wear of cartilage, leading to the initiation and progression of osteoarthritis [4,5]. Tibial tubercle distalization and tibial tubercle distalization with patella tendon tenodesis are effective procedures in treating patella alta.…”

Section: Discussionmentioning

confidence: 99%

Does Patella Tendon Tenodesis Improve Tibial Tubercle Distalization in Treating Patella Alta? A Computational Study

Liao

Yang

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Patellofemoral malalignment associated with patella alta may cause pain and arthritis; because of this, the condition sometimes is treated surgically. Two common procedures are tibial tubercle distalization with or without patellar tendon tenodesis. However, the biomechanical consequences of these interventions for patella alta are not clearly understood. Questions/purposes We evaluated changes in patellofemoral joint contact mechanics after tibial tubercle distalization and tibial tubercle distalization combined with patella tendon tenodesis. Specifically, we asked: (1) Are there biomechanical differences between these two types of procedures? (2) Is there an ideal range to distalize the patella? Methods Subject-specific finite-element models were created for 10 individuals with patella alta (mean InsallSalvati ratio of 1.34 ± 0.05). Input parameters for the finite-element models included subject-specific joint geometry, quadriceps muscle forces, and weightbearing patellofemoral joint kinematics. Virtual operations were conducted to simulate the two procedures. For distalization, the tibial tubercle and patella were displaced distally 4 mm to 20 mm in 4-mm increments based on the original model. At each level of distalization, the patella tendon was attached back to its original insertion to simulate the additional tenodesis procedure. Cartilage stress, contact area, and contact forces were quantified and compared between procedures and distalization levels. Results Distalization and distalization + tenodesis reduced patellofemoral joint stress compared with the baseline of 1.02 ± 0.11 MPa. Distalization led to lower cartilage stress than distalization + tenodesis, and the effect size was relatively large (0.88 ± 0. Conclusions Cartilage stress appears lower using distalization as opposed to distalization + tenodesis in this finite-element analysis simulation. An Insall-Salvati ratio of 0.95 may be an ideal level for distalization; further distalization does not show additional benefits. Clinical Relevance This study suggests that distalization may result in less stress than distalization + tenodesis,

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Section: Discussionmentioning

confidence: 99%

Does Patella Tendon Tenodesis Improve Tibial Tubercle Distalization in Treating Patella Alta? A Computational Study

Liao

Yang

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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“…13,14 In addition, by mathematical modeling, already in the late 1990s, chondropenic conditions in NWB areas in the joint were suggested. 15 Autologous chondrocyte implantation (ACI) is a widely used technique for the treatment of focal articular cartilage lesions in the knee. During a first arthroscopic procedure, a small cartilage biopsy is taken from the NWB lateral margin of the trochlea.…”

Section: Introductionmentioning

confidence: 99%

Chondrogenic Potential of Articular Chondrocytes Depends on Their Original Location

Bekkers¹,

Saris²,

Tsuchida³

et al. 2013

Tissue Engineering Part A

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Objective: This study aimed to investigate the regenerative capacity of chondrocytes derived from debrided defect cartilage and healthy cartilage from different regions in the joint to determine the best cell source for regenerative cartilage therapies. Methods: Articular cartilage was obtained from Outerbridge grade III and IV cartilage lesions and from macroscopically healthy weight-bearing and nonweight-bearing (NWB) locations in the knee. Chondrocytes isolated from all locations were either pelleted directly (P0 pellets) or after expansion (P2 pellets) and analyzed for glycosaminoglycan (GAG), DNA, and cartilage-specific gene expression. Harvested cartilage samples and cultured pellets were also analyzed by Safranin O histology and immunohistochemistry for collagen I, II, and X. Immunohistochemical stainings were quantified using a computerized pixel-intensity staining segmentation method. Results: After 4 weeks of culture, the P0 pellets derived from grade III or healthy weight-bearing chondrocytes contained more ( p < 0.015) GAG and GAG normalized per DNA compared to those from grade IV and NWB locations. After expansion, these differences were lost. Cartilage-specific gene expression was higher ( p < 0.04) in P0 pellets from grade III chondrocytes compared to grade IV chondrocytes. Semiquantitative immunohistochemistry showed a more intense ( p < 0.033) collagen I and X staining for grade IV debrided cartilage compared to grade III and weight-bearing cartilage. Also, collagen type X staining intensity was higher ( p < 0.033) in NWB cartilage compared to grade III and weight-bearing regions. Conclusion: Chondrocytes derived from debrided cartilage perform better than cells from the NWB biopsy site, however, this difference is lost upon expansion. Based thereon, the debrided defect cartilage could be a viable donor site for regenerative cartilage surgery.

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“…Testing of material blends is also most likely possible, though not undertaken as yet. In addition to measuring cell differentiation and proliferation, the readout of biomaterial screens can also be biomechanical (Tweedie et al, 2005), which will be crucial as the type and magnitude of biomechanical input to the cell-biomaterial construct, in particular the relation between hydrostatic and shear stress, will affect differentiation (Carter et al, 2004;NeidlingerWilke et al, 2009). Final identification of biomaterials or their physicochemical characteristics as regenerative will be achieved by automated multifactorial analysis of the results.…”

Section: Towards Efficient Biomaterials Designmentioning

confidence: 99%

Biomaterials for intervertebral disc regeneration: past performance and possible future strategies

Schutgens¹,

Tryfonidou²,

Smit³

et al. 2015

eCM

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Intervertebral disc (IVD) degeneration is associated with most cases of cervical and lumbar spine pathologies, amongst which chronic low back pain has become the number one cause of loss of quality-adjusted life years. In search of alternatives to the current less than optimal and usually highly invasive treatments, regenerative strategies are being devised, none of which has reached clinical practice as yet. Strategies include the use of stem cells, gene therapy, growth factors and biomaterial carriers. Biomaterial carriers are an important component in musculoskeletal regenerative medicine techniques. Several biomaterials, both from natural and synthetic origin, have been used for regeneration of the IVD in vitro and in vivo. Aspects such as ease of use, mechanical properties, regenerative capacity, and their applicability as carriers for regenerative and anti-degenerative factors determine their suitability for IVD regeneration. The current review provides an overview of the biomaterials used with respect to these properties, including their drawbacks. In addition, as biomaterial application until now appears to have been based on a mix of mere availability and intuition, a more rational design is proposed for future use of biomaterials for IVD regeneration. Ideally, high-throughput screening is used to identify optimally effective materials, or alternatively medium content comparative studies should be carried out to determine an appropriate reference material for future studies on novel materials.

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The Mechanobiology of Articular Cartilage Development and Degeneration

Cited by 311 publications

References 42 publications

Does Patella Tendon Tenodesis Improve Tibial Tubercle Distalization in Treating Patella Alta? A Computational Study

Does Patella Tendon Tenodesis Improve Tibial Tubercle Distalization in Treating Patella Alta? A Computational Study

Chondrogenic Potential of Articular Chondrocytes Depends on Their Original Location

Biomaterials for intervertebral disc regeneration: past performance and possible future strategies

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