Functional biomaterials for cartilage regeneration

The injury and degeneration of articular cartilage and associated arthritis are leading causes of disability worldwide. Cartilage tissue engineering as a treatment modality for cartilage defects has been investigated for over 20 years. Various scaffold materials have been developed for this purpose, but has yet to achieve feasibility and effectiveness for widespread clinical use. Currently, the regeneration of articular cartilage remains a formidable challenge, due to the complex physiology of cartilage tissue and its poor healing capacity. Although intensive research has been focused on the developmental biology and regeneration of cartilage tissue and a diverse plethora of biomaterials have been developed for this purpose, cartilage regeneration is still suboptimal, such as lacking a layered structure, mechanical mismatch with native cartilage and inadequate integration between native tissue and implanted scaffold. The ideal scaffold material should have versatile properties that actively contribute to cartilage regeneration. Functional scaffold materials may overcome the various challenges faced in cartilage tissue engineering by providing essential biological, mechanical, and physical/chemical signaling cues through innovative design. This review thus focuses on the complex structure of native articular cartilage, the critical properties of scaffolds required for cartilage regeneration, present strategies for scaffold design, and future directions for cartilage regeneration with functional scaffold materials.     

Importance of the superficial tissue layer for the indentation stiffness of articular cartilage

Indentation testing is a widely used technique for nondestructive mechanical analysis of articular cartilage. Although cartilage shows an inhomogeneous, layered structure with anisotropic mechanical properties, most theoretical indentation models assume material homogeneity and isotropy. In the present study, quantitative polarized light microscopy (PLM) measurements from canine cartilage were utilized to characterize thickness and structure of the superficial, collageneous tissue layer as well as to reveal its relation to experimental indentation measurements. In addition to experimental analyses, a layered, transversely isotropic finite element (FE) model was developed and the effect of superficial (tangential) tissue layer with high elastic modulus in the direction parallel to articular surface on the indentation response was studied. The experimental indentation stiffness was positively correlated with the relative thickness of the superficial cartilage layer. Also the optical retardation, which reflects the degree of parallel organization of collagen fibrils as well as collagen content, was related to indentation stiffness. FE results indicated effective stiffening of articular cartilage under indentation due to high transverse modulus of the superficial layer. The present results suggest that indentation testing is an efficient technique for the characterization of the superficial degeneration of articular cartilage.     

Mechanical Modulation of Cartilage Structure and Function During Embryogenesis in the Chick

The mechanical behavior of cartilage is intimately related to its biochemical composition, and tissue composition is known to be influenced by its local mechanical loading environment. Although this phenomenon has been well-studied in adult cartilage, few investigations have examined such structure-function relationships in embryonic cartilage. The goal of this work was to elucidate the role of mechanical loading on the development of cartilage composition during embryogenesis. Using an embryonic chick model, cartilage from the tibiofemoral joints of immobilized embryos was compared to that of controls. The normal time course of changes in glycosaminoglycan/DNA and hydroxyproline/DNA were significantly influenced by loading history, with the most pronounced effects observed between days 9 and 14 during the period of most rapid increase in motility in control embryos. Stress-relaxation tests conducted on samples from day 14 indicate that the effects of embryonic immobilization on cartilage matrix composition have direct consequences for the mechanical behavior of the tissue, resulting in compromised material properties (e.g. 50% reduction in E(inst)). Because embryogenesis provides a unique model for identifying key factors which influence the establishment of functional biomechanical tissues in the skeleton, these data suggest that treating mechanical loading as an in vitro culture variable for tissue engineering approaches to cartilage repair is likely to be a sound approach.     

An overview of cartilage tissue engineering

Articular cartilage regeneration refers to the formation of new tissue that is indistinguishable from the native articular cartilage with respect to zonal organization, biochemical composition, and mechanical properties. Due to a limited capacity to repair cartilage, scar tissue frequently has a poorly organized structure and lacks the functional characteristics of normal cartilage. The degree of success to date achieved using a purely cell- or biological-based approach has been modest. Potentially the development of a hybrid strategy, whereby, chondrocytes or chondrogenic stem cells are combined with a matrix, making cartilage in vitro, which is then subsequently transplanted, offers a route towards a new successful treatment modality. The success of this approach depends upon the material being biocompatible, processable into a suitable three-dimensional structure and eventually biodegradable without harmful effects. In addition, the material should have a sufficient porosity to facilitate high cell loading and tissue ingrowth, and it should be able to support cell proliferation, differentiation, and function. The cell-polymer-bioreactor system provides a basis for studying the structural and functional properties of the cartilaginous matrix during its development, because tissue concentrations of glycosaminoglycan and collagen can be modulated by altering the conditions of tissue cultivation.     

运动性关节软骨损伤修复材料的选择及其生物力学特征

背景：关节软骨是无血管、淋巴管和神经的组织,通常情况下软骨细胞不能进行有丝分裂,这导致自身修复能力有限。生理负荷下,关节软骨经常处在应力环境中。根据软骨自身的结构和特点,作为人工软骨的替代材料应具有良好的生物力学性能。 目的：总结运动性关节软骨损伤修复材料的应用进展及其生物替代材料的生物力学特征。 方法：以“关节软骨,生物材料,生物力学”为中文关键词,以“ tissue enginneering, articular cartilage, scaffold material, biomechanics” 为英文关键词,采用计算机检索中国期刊全文数据库、PubMed数据库1993-01/2010-10相关文章。纳入与运动有关的关节软骨损伤修复、目前常用于修复关节软骨损伤的生物材料以及生物替代材料的生物力学特征研究文章;排除重复研究或Meta分析类文章。以20篇文献为主重点对运动性关节软骨缺损修复材料的生物力学特征进行讨论。 结果与结论：关节软骨是一种各向异性、非均质、具有黏弹性并充满液体的可渗透物质,具有独特的力学性能。损伤的关节软骨在生物力学方面均与原来的软骨不同,且极易退变。骨软骨柱移植力学性能近期效果最佳;脱细胞软骨基质、小肠黏膜下基质具有一定的力学强度;普通聚乙烯醇水凝胶的最大缺陷是力学性能的不足;聚乙烯醇材料其良好的柔韧性和高弹性能,具有与人关节软骨相似的力学性能;n-HA浆料与聚酰胺66在溶剂中复合,无论在力学性能还是化学组成上都与自然骨相似。提示在众多关节软骨替代材料中,无论是人工合成材料、天然材料、复合材料其生物力学性能各有不同,且目前还无法再造与天然生成的软骨具有相同力学性能的软骨组织。      

The mechanical and material properties of elderly human articular cartilage subject to impact and slow loading

The mechanical properties of articular cartilage vary enormously with loading rate, and how these properties derive from the composition and structure of the tissue is still unclear. This study investigates the mechanical properties of human articular cartilage at rapid rates of loading, compares these with measurements at slow rates of loading and explores how they relate to the gross composition of the tissue. Full-depth femoral head cartilage biopsies were subjected to a slow, unconfined compression test followed by an impact at an energy of 78.5 mJ and velocity 1.25 m s⁻¹. The modulus was calculated from the slope of the loading curve and the coefficient of restitution from the areas under the loading and unloading curves.Tissue composition was measured as water, collagen and glycosaminoglycan contents. The maximum dynamic modulus ranged from 25 to 150 MPa. These values compared with 1–3 MPa measured during quasi-static loading. The coefficient of restitution was 0.502 (0.066) (mean (standard deviation)) and showed no site variation. Water loss was not detectable. Composition was not strongly associated with modulus; water and collagen contents together predicted about 25% of the variance in modulus.     

Growth‐related structural,biochemical, and mechanical properties of the functional bone–cartilage unit

Articular cartilage and subchondral bone act together, forming a unit as a weight‐bearing loading‐transmitting surface. A close interaction between both structures has been implicated during joint cartilage degeneration, but their coupling during normal growth and development is insufficiently understood. The purpose of the present study was to examine growth‐related changes of cartilage mechanical properties and to relate these changes to alterations in cartilage biochemical composition and subchondral bone structure. Tibiae and femora of both hindlimbs from 7‐ and 13‐week‐old (each n = 12) female Sprague‐Dawley rats were harvested. Samples were processed for structural, biochemical and mechanical analyses. Immunohistochemical staining and protein expression analyses of collagen II, collagen IX, COMP and matrilin‐3, histomorphometry of cartilage thickness and COMP staining height were performed. Furthermore, mechanical testing of articular cartilage and micro‐CT analysis of subchondral bone was conducted. Growth decreased cartilage thickness, paralleled by a functional condensation of the underlying subchondral bone due to enchondral ossification. Cartilage mechanical properties seem to be rather influenced by growth‐related changes in the assembly of major ECM proteins such as collagen II, collagen IX and matrilin‐3 than by growth‐related alterations in its underlying subchondral bone structure. Importantly, the present study provides a first insight into the growth‐related structural, biochemical and mechanical interaction of articular cartilage and subchondral bone. Finally, these data contribute to the general knowledge about the cooperation between the articular cartilage and subchondral bone.     

Relationship among biomechanical, biochemical, and cellular changes associated with osteoarthritis

Articular cartilage that lines the surface of long bones is a multilayered material. The superficial layer consists of collagen fibrils and chondrocytes that run parallel to the joint surface. In the deeper layers, the collagen fibrils are more randomly arranged and support vertical units termed chondrons containing rows of chondrocytes. In the deepest layers, the collagen fibrils run almost vertically and ultimately insert into the underlying subchondral bone. Osteoarthritis (OA) is a disease that affects articular cartilage and is characterized by enzymatic and mechanical breakdown of the extracellular matrix, leading to cartilage degeneration, exposure of subchondral bone, pain, and limited joint motion. Changes in mechanical properties of articular cartilage associated with OA include decreases in modulus and ultimate tensile strength. These changes parallel the changes observed after enzymatic degradation of either collagen or proteoglycans in cartilage. Results of recent viscoelastic studies on articular cartilage suggest that the elastic modulus of collagen and fibril lengths decrease in OA and are associated with a loss of the superficial zone and a decreased ability of articular cartilage to store elastic energy during locomotion. It is suggested that osteoarthritic changes to cartilage involve enzymatic degradation of matrix components and fibril fragmentation that is promoted by subsequent mechanical loading.     

Study on Tracheal Collapsibility,Compliance, and Stress by Considering Nonlinear Mechanical Property of Cartilage

Tracheal cartilage has been widely regarded as a linear elastic material either in experimental studies or in analytic and numerical models. However, it has been recently demonstrated that, like other fiber-oriented biological tissues, tracheal cartilage is a nonlinear material, which displays higher strength in compression than in extension. Considering the nonlinearity requires a more complex theoretical frame work and costs more to simulate. This study aims to quantify the deviation due to the simplified treatment of the tracheal cartilage as a linear material. It also evaluates the improved accuracy gained by considering the nonlinearity. Pig tracheal rings were used to exam the mechanical properties of cartilage and muscular membrane. By taking into account the asymmetric shape of tracheal cartilage, the collapse behavior of complete rings was simulated, and the compliance of airway and stress in the muscular membrane were discussed. The results obtained were compared with those assuming linear mechanical properties. The following results were found: (1) Models based on both types of material properties give a small difference in representing collapse behavior; (2) regarding compliance, the relative difference is big, ranging from 10 to 40% under negative pressure conditions; and (3) the difference in determining stress in the muscular membrane is small too: <5%. In conclusion, treating tracheal cartilage as a linear material will not cause big deviations in representing the collapse behavior, and mechanical stress in the muscular part, but it will induce a big deviation in predicting the compliance, particularly when the transmural pressure is lower than −0.5 kPa. The results obtained in this study may be useful in both understanding the collapse behavior of trachea and in evaluating the error induced by the simplification of treating the tracheal cartilage as a linear elastic material.     

关节软骨力学特征研究进展

骨关节炎(osteoarthritis OA)是一种以关节疼痛和僵硬为特征的慢性退行性关节疾患,好发于老年人群。OA发病缓慢,病程较长,早期临床表现和组织学改变均不明显,限制了疾病的早期诊断与治疗。关节软骨微观结构决定了软骨宏观力学特性。软骨微观结构具有区域差异性,导致软骨的力学性能也具有区域依赖性,从软骨浅表区到深区软骨抗负荷、抗形变能力逐渐增加。然而,在OA病程发展过程中,软骨微观构成改变导致OA软骨抗负荷、抗形变能力降低。通过检测关节软骨的微观构成可以推测软骨的力学特性,反之检测软骨的力学指标可以了解软骨早期的微观改变,从而有助于了解OA的病程发展,便于疾病的早期诊断。综述近年来关节软骨在正常和急慢性损伤状态下力学性能的相关研究文献,阐述软骨结构与力学性能之间的关系,为OA的病程发展、早期诊断与治疗提供进一步理论依据。     

New structural concepts of articular cartilage demonstrated with a physical model

The construction and function of a model of articular cartilage based on a system of deformable elements trapped within a three-dimensional network of fibrils is described. The network is generated from a radial array of elements appropriately crosslinked along their length. The model demonstrates in a qualitative sense how a soft composite tissue structure such as articular cartilage developed from a specific arrangement of two primary components exhibiting totally contrasting mechanical properties, i.e. tension resisting collagen fibrils and highly deformable hydrated proteoglycans, can have dimensional stability in its unloaded state and mechanical resilience under a wide range of loading conditions.     

软骨细胞力学信号转导在骨性关节炎中的作用

异常力学负荷是骨关节炎发生的主要危险因素,可导致胶原降解、糖胺聚糖丢失和软骨细胞凋亡,引起软骨和软骨下骨破坏.然而,由于对软骨细胞力学传导认识不足,以及各种软骨修复再生手段的效果并不理想,故迫切需要了解软骨细胞力学传导过程以及软骨机械性损伤发生机制,以期望为研究软骨损伤修复和再生提供参考.详细介绍力学信号如何从细胞外经...     

Bioreactor cultivation and remodelling simulation for cartilage replacement material

For the development of articular cartilage replacement material, it is essential to study the dependence between mechanical stimulation and cell activity in cellular specimens. Bioreactor cultivation is widely used for this purpose, however, it is hardly possible to obtain a quantitative relationship between collagen type II production and applied loading history. For this reason, a bioreactor system is developed, measuring applied forces and number of loading cycles by means of a load cell and a forked light barrier, respectively. Parallel to the experimental study, a numerical model by means of the finite element method is proposed to simulate the evolution of material properties during cyclic stimulation. In this way, a numerical model can be developed for arbitrary deformation cases.     

含裂纹缺损关节软骨的单轴准静态拉伸性能

背景:关节软骨一旦出现裂纹缺损其力学性能会发生改变,而先前研究中针对受损关节软骨的探究多集中在压缩,对于拉伸性能的研究较少。目的:预先在软骨层试样上制造裂纹缺损,测试其单轴准静态拉伸性能。方法:选取新鲜成年猪膝关节的关节软骨,制备含裂纹缺损的软骨试样,在不同应力率下(0.001,0.01,和0.1 MPa/s)测试其拉伸性能,在不同恒定应力下(1,2,3 MPa)测试其蠕变性能。结果与结论:①不同应力速率下的拉伸实验中,随着应力速率的增加,达到相同应变所需的应力逐渐增大,且试件的杨氏模量随应力率的增加而增加;②不同应力速率下含裂纹缺损关节软骨的拉伸应力-应变曲线不重合,说明含裂纹缺损关节软骨的拉伸性能具有率相关性;③不同恒定拉应力水平下的蠕变实验中,蠕变应变随着拉应力水平的提高而增大,蠕变柔量随拉应力水平的提高而降低,并且随着蠕变时间的推移蠕变应变先快速增加后缓慢增加;④结果表明,不同应力率和不同恒定应力对含裂纹缺损关节软骨的拉伸力学性能影响较大,该实验结果可为缺损关节软骨的修复提供力学参考。     

滚压载荷下成年和幼年软骨的棘轮行为

文题释义： 非接触数字相关技术：非接触式测量方法以前主要有光学式和气动式两种,实验采用光学式图像采集系统。图像测量技术作为一种新兴的非接触测量方法有着独特的优越性,它通过把被测对象的图像作为检测和传递信息的手段,从图像中提取有用信息进而获得待测参数,研究通过图像采集点的坐标变化从而计算出受载前后软骨的应变。 棘轮效应：材料受到拉伸或压缩时,如果力大于材料的屈服强度,那么材料就会发生塑性变形。在非对称应力控制循环加载下,材料反向变形大小就会小于初始变形,进而产生了残余应变,如此反复而产生的沿应力方向上塑性变形累积的现象,这种现象即称为棘轮效应。 背景：国内外学者对关节软骨在不同力学环境及循环压缩载荷下的受力情况做了不少研究,但均集中在循环压缩载荷对软骨的作用,有关软骨年龄因素对软骨力学特性影响的研究和软骨在复杂受力环境下的特性研究不深入。                                                      目的：研究不同滚压载荷条件对成年和幼年关节软骨棘轮行为的影响。 方法：以成年猪股骨软骨和幼年猪股骨软骨为实验对象,在不同实验条件下(压缩量：10%,20%,30%;滚压速率：1.66,3.44,6.68 mm/s;缺损宽度：1,2,4 mm)采用滚压加载装置施加载荷,同时使用非接触数字相关技术对加载过程中的试样进行图像采集,通过分析处理图像,研究循环滚压载荷作用下成年及幼年关节软骨的棘轮行为。 结果与结论：①在滚压载荷下,随着滚压循环载荷的进行,成年软骨和幼年软骨的棘轮应变都呈现先快速增加后缓慢增加的趋势;②随着压缩量的增加,成年软骨和幼年软骨的棘轮应变都增加;在相同压缩量下,幼年软骨的棘轮应变大于成年软骨,并且他们的棘轮应变沿着软骨深度从表层到深层逐渐降低;③随着滚压速率的增加,成年软骨和幼年软骨的棘轮应变减小;④1 mm微型缺损关节软骨的棘轮应变数值和趋势与完整无缺损软骨大致相同。在2,4 mm缺损状态下,缺损软骨的棘轮应变值均比同样条件下完整软骨的棘轮应变值要高。 ORCID: 0000-0003-3586-1073(李凯);0000-0002-7288-6686(高丽兰) 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

Effects of growth and exercise on composition, structural maturation and appearance of osteoarthritis in articular cartilage of hamsters

Articular cartilage composition and structure are maintained and remodeled by chondrocytes under the influence of loading. Exercise‐induced changes in the composition, structure, mechanical properties and tissue integrity of growing and aging hamster articular cartilage were investigated. Articular cartilage samples (n = 191) were harvested from the proximal tibiae of hamsters aged 1, 3, 6, 12 and 15 months. The hamsters were divided into runners and controls. The runners had free access to a running wheel between 1 and 3 months (runner groups 3‐, 12‐ and 15‐month‐old hamsters) or 1 and 6 months (runner group 6‐month‐old hamsters) of age. Control animals were subjected to a sedentary lifestyle. Mechanical indentation tests and depth‐wise compositional and structural analyses were performed for the cartilage samples. Furthermore, the integrity of articular cartilage was assessed using histological osteoarthritis grading. Exercise affected the collagen network organization after a 5‐month exercise period, especially in the middle and deep zones. However, no effect on the mechanical properties was detected after exercise. Before the age of 12 months, the runners showed less osteoarthritis than the controls, whereas at 15 months of age the situation was reversed. It is concluded that, in hamsters, physical exercise at a young age enhances cartilage maturation and alters the depth‐wise cartilage structure and composition. This may be considered beneficial. However, exercise at a young age demonstrated adverse effects on cartilage at a later age with a significant increase in the incidence of osteoarthritis.     

Cartilage and diarthrodial joints as paradigms for hierarchical materials and structures.

The anatomic forms of diarthrodial joints are important structural features which provide and limit the motions required for the joint. Typically, the length scale of topographic variation of anatomic forms ranges from 0.5 to 15 cm. Articular cartilage is the thin layer of hydrated soft tissue (0.5-5.0 mm thick) covering the articulating bony ends in diarthrodial joints. This tissue has a set of unique mechanical and physicochemical properties which are responsible for its load-carrying capabilities and near-frictionless qualities. The mechanical properties of articular cartilage are determined at the tissue-scale level and these properties depend on the composition of the tissue, mainly collagen and proteoglycan, and their molecular and ultrastructural organization (ultra-scale: 10(-8)-10(-6) m). Because proteoglycans possess a high density of fixed negative charges, articular cartilage exhibits a significant Donnan osmotic pressure effect. This physicochemically derived osmotic pressure is an important component of the total swelling pressure; the other component of the total swelling pressure stems from the charge-to-charge repulsive force exerted by the closely spaced (1-1.5 nm) negative charge groups along the proteoglycan molecules. Thus these interactions take place at a nano-scale level: 10(-10)-10(-9) m. Finally, cartilage biochemistry and organization are maintained by the chondrocytes which exist at a micro-scale level (10(-7)-10(-6) m). Significant mechanoelectrochemical transduction occurs within the extracellular matrix at the micro-scale level which affects and modulates cellular anabolic and catabolic activities. At present, the exact details of these transduction mechanisms are unknown. In this review, we present a summary of the hierarchical features for articular cartilage and diarthrodial joints and tables of known material properties for cartilage. Also we summarize how the multi-scale interactions in articular cartilage provide for its unique material properties and tribological characteristics.     

运动性关节软骨缺损支架材料的选择及其生物相容性

背景：骨软骨支架是用于承载细胞,供细胞黏附、生长、增殖、分化的载体。 目的：总结运动性关节软骨缺损支架材料的应用进展及其生物替代材料的生物相容性。 方法：以“关节软骨,生物材料,工程软骨,支架材料,生物相容性”为中文关键词,以“ tissue enginneering ,articular cartilage,scaffold material”为英文关键词,采用计算机检索维普数据库、PubMed数据库1993-01/2010-11相关文章。纳入与有关修复关节软骨损伤、生物材料、支架材料、生物相容性等相关的文章。以20篇文献为重点对运动性关节软骨缺损修复用的生物材料的生物相容性进行了讨论。 结果与结论：天然软骨支架材料因其具有细胞识别信号,故生物相容性好,细胞黏附率高,但力学性能较差。有些人工合成材料生物相容性不理想、亲水性差、对细胞吸附不足,人工合成高分子聚合物生物相容性良好。复合支架利用不同生物材料的优点克制材料的局限性制备理想的复合支架,其混合比例、混合技术还有待进一步研究。目前尚无一种材料完全满足组织工程的要,通过材料制备技术的改进或将几种不同材料的复合,材料的性能会不断的提高。     

Mechanical quality of tissue engineered cartilage: results after 6 and 12 weeks in vivo

Traumatic events are a primary cause for local lesions of articular cartilage. If treated early, restoration of the initial joint geometry and integrity may be achieved. In large defects, sufficient material is not available to bridge the affected area. Heterologeous transplantation is not well accepted due to the risk of infection and immune response. Alternatives are cartilage-like structures, which may be cultured in vitro and transplanted into the defect site. Critical to the success of these new tissues are their mechanical properties. Goals of this study were to generate a hyaline-like cartilage structure, to evaluate its performance in vivo and to verify that its cellular and material properties meet those of native cartilage. Hyaline-like cartilage specimens were generated in vitro and implanted in the backs of nude mice. Specimens were explanted after 6 and 12 weeks, mechanically tested using an indentation test and histologically examined. In mechanical testing, stiffness and failure load significantly increased between weeks 6 and 12. At 12 weeks, mechanical properties of the hyaline-like cartilage were comparable to those of native nasal septal cartilage. Compared to native articular cartilage, the engineered tissue achieved up to 30-50% in strength and mechanical stiffness. In histological examination, specimens showed neocartilage formation. The mechanical testing procedure proved to be sufficiently sensitive to identify differences in properties between cartilage specimens of different origin and at different stages of healing. As an adjunct to histological analysis, mechanical testing may be a valuable tool for judging the utility of engineered cartilage prior to a broad clinical usage.     

Mechanical properties of hyaline and repair cartilage studied by nanoindentation

Articular cartilage is a highly organized tissue that is well adapted to the functional demands in joints but difficult to replicate via tissue engineering or regeneration. Its viscoelastic properties allow cartilage to adapt to both slow and rapid mechanical loading. Several cartilage repair strategies that aim to restore tissue and protect it from further degeneration have been introduced. The key to their success is the quality of the newly formed tissue. In this study, periosteal cells loaded on a scaffold were used to repair large partial-thickness cartilage defects in the knee joint of miniature pigs. The repair cartilage was analyzed 26 weeks after surgery and compared both morphologically and mechanically with healthy hyaline cartilage. Contact stiffness, reduced modulus and hardness as key mechanical properties were examined in vitro by nanoindentation in phosphate-buffered saline at room temperature. In addition, the influence of tissue fixation with paraformaldehyde on the biomechanical properties was investigated. Although the repair process resulted in the formation of a stable fibrocartilaginous tissue, its contact stiffness was lower than that of hyaline cartilage by a factor of 10. Fixation with paraformaldehyde significantly increased the stiffness of cartilaginous tissue by one order of magnitude, and therefore, should not be used when studying biomechanical properties of cartilage. Our study suggests a sensitive method for measuring the contact stiffness of articular cartilage and demonstrates the importance of mechanical analysis for proper evaluation of the success of cartilage repair strategies.