Long‐term storage and preservation of tissue engineered articular cartilage

With limited availability of osteochondral allografts, tissue engineered cartilage grafts may provide an alternative treatment for large cartilage defects. An effective storage protocol will be critical for translating this technology to clinical use. The purpose of this study was to evaluate the efficacy of the Missouri Osteochondral Allograft Preservation System (MOPS) for room temperature storage of mature tissue engineered grafts, focusing on tissue property maintenance during the current allograft storage window (28 days). Additional research compares MOPS to continued culture, investigates temperature influence, and examines longer‐term storage. Articular cartilage constructs were cultured to maturity using adult canine chondrocytes, then preserved with MOPS at room temperature, in refrigeration, or kept in culture for an additional 56 days. MOPS storage maintained desired chondrocyte viability for 28 days of room temperature storage, retaining 75% of the maturity point Young's modulus without significant decline in biochemical content. Properties dropped past this time point. Refrigeration maintained properties similar to room temperature at 28 days, but proved better at 56 days. For engineered grafts, MOPS maintained the majority of tissue properties for the 28‐day window without clearly extending that period as it had for native grafts. These results are the first evaluating engineered cartilage storage. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:141–148, 2016.     

同种异体软骨移植修复关节软骨缺损实验研究

目的 采用兔膝关节软骨标本经打孔梯度降温冻存后行同种异体移植,研究打孔梯度降温冻存对兔关节软骨的影响及其修复关节软骨缺损的效果.方法 自16只2月龄新西兰白兔膝关节股骨髌面取分别取3块骨软骨移植物,随机分为3组.Ⅰ组为实验组,在软骨上以3 mm×3 mm矩阵打孔,Ⅱ、Ⅲ组为对照组,不打孔.分别将软骨标本置于二甲基亚砜冷冻保护溶液中,并经梯度降温至-80℃(Ⅰ、Ⅱ组)或直接置于-80℃(Ⅲ组)保存1周,复温后移植到成年兔相应膝关节部位.术后分批处死动物,通过对移植物的大体形态学、组织学、免疫组化染色光镜观察,研究各组移植物保存效果的差异.结果 Ⅰ、Ⅱ组光镜观察结果明显优于Ⅲ组;Ⅰ组与Ⅱ组结果差异不明显,但Ⅰ组对中间层软骨组织的保护明显加强.结论 关节软骨的梯度降温冷冻保存效果明显优于快速降温冷冻保存,且关节软骨打孔冷冻保存对深层软骨细胞有一定的保护作用,可提高软骨细胞存活率,延缓移植软骨组织的退变过程.     

在体阻断软骨下营养对关节软骨影响的实验研究

背景：关节软骨无血管分布,其营养来自关节液和软骨下骨,哪条营养通路对关节软骨更为重要是学者们争论的焦点。目的：研究软骨下营养对关节软骨的影响,并探讨软骨下营养与骨关节炎的关系。方法：45只5个月龄雄性新西兰大白兔,建立股骨滑车骨软骨缺损的动物模型,并随机分为3组：自体骨软骨块移植组（Control组,n=15）;假手术组（Sham组,n=15）,用环钻在股骨滑车钻取骨软骨块,将其置入管状PVC内,原位回植;阻断软骨下营养组（DNBM组,n=15）,取出骨软骨后,将其置入帽状PVC内,原位回植。术后4周、8周、12周,每组5只（10膝）,取出膝关节进行大体评分、组织学评分、软骨厚度测量、凋亡染色（TUNEL染色）。结果：与Control组相比,大体评分结果提示,DNBM组软骨无明显退变;组织学评分结果提示,术后12周时DNBM组软骨明显退变（P〈0.005）;软骨厚度测量结果提示,术后8周、12周时DNBM组软骨厚度明显变小（P=0.00）;TUNEL染色结果提示,术后8周、12周时DNBM组关节软骨细胞凋亡明显增加（P〈0.01）。结论：软骨下营养是软骨的重要营养来源,失去软骨下营养,软骨会逐渐发生退变。     

Electrostatic interactions enable rapid penetration,enhanced uptake and retention of intra‐articular injected avidin in rat knee joints

Intra‐articular (i.a.) drug delivery for local treatment of osteoarthritis remains inadequate due to rapid clearance by the vasculature or lymphatics. Local therapy targeting articular cartilage is further complicated by its dense meshwork of collagen and negatively charged proteoglycans, which can prevent even nano‐sized solutes from entering. In a previous in vitro study, we showed that Avidin, due to its size (7 nm diameter) and high positive charge (pI 10.5), penetrated the full thickness of bovine cartilage and was retained for 15 days. With the goal of using Avidin as a nano‐carrier for cartilage drug delivery, we investigated its transport properties within rat knee joints. Avidin penetrated the full thickness of articular cartilage within 6 h, with a half‐life of 29 h, and stayed inside the joint for 7 days after i.a. injection. The highest concentration of Avidin was found in cartilage, the least in patellar tendon and none in the femoral bone; in contrast, negligible Neutravidin (neutral counterpart of Avidin) was present in cartilage after 24 h. A positive correlation between tissue sGAG content and Avidin uptake (R² = 0.83) confirmed the effects of electrostatic interactions. Avidin doses up to at least 1 µM did not affect bovine cartilage explant cell viability, matrix catabolism or biosynthesis. © 2014 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 32:1044–1051, 2014.     

Articular cartilage repair using an intra‐articular magnet and synovium‐derived cells

The purpose of this study was to investigate the chondrogenic potential of magnetically labeled synovium‐derived cells (M‐SDCs) and examine whether M‐SDCs could repair the articular cartilage using an intra‐articular magnet after delivery to the lesion. Synovium‐derived cells (SDCs) were cultured from the synovium of a rat knee, and were magnetically labeled with ferumoxides. M‐SDCs were examined with a transmission electron microscope. A pellet culture system was used to evaluate the chondrogenic potential of M‐SDCs in a magnetic field. In a rat model, allogeneic M‐SDCs were injected into the knee after we made an osteochondral defect on the patellar groove and implanted an intra‐articular magnet at the bottom of the defect. We histologically examined the defects at 48 h, 4 weeks, 8 weeks, and 12 weeks after treatment. Electron microscopy showed the transfection of ferumoxides into SDCs. The pellet cultures revealed the chondrogenic potential of M‐SDCs in a magnetic field. M‐SDCs accumulated in the osteochondral defect at 48 h after treatment, and we confirmed the regeneration of the articular cartilage at 4 weeks, 8 weeks, and 12 weeks after treatment using an intra‐articular magnet. We demonstrated that articular cartilage defects could be repaired using an intra‐articular magnet and M‐SDCs. We believe that this system will be useful to repair human articular cartilage defects. © 2010 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 29:531–538, 2011     

Development of partial thickness articular cartilage injury in an ovine model.

The purpose of this study was to create a controlled partial thickness cartilage lesion in a sheep model, and to provide a foundation to study the natural history of the progression of this lesion. Twenty-eight sheep divided into four groups (1, 12, 24, and 52 weeks, n=7/group) were used in this study. In one stifle, a mechanical tool was used to create a 200 microm partial thickness lesion (1.5x1.5 cm2) on the medial femoral condyle via arthroscopy. Joint fluid was drawn presurgery and after euthanasia for analysis of collage II 3/4 C (long) (C2C). After euthanasia, the condyle was analyzed by gross appearance, confocal laser microscopy (CLM) for cell viability, scanning electronic microscopy (SEM) for surface roughness, Artscan for cartilage stiffness, and histology for cartilage morphology. The gross appearance of the treated area appeared rough, soft, and swollen compared to untreated control over time. CLM demonstrated that the depth of cell death increased to 590 microm at 52 weeks after surgery. SEM demonstrated that the treated area became more irregular over time. Stiffness of the treated area was significantly less than control by 12 weeks after surgery. Histologic analysis demonstrated that the 12, 24, and 52 week groups had significantly poorer histologic scores than the 1 week group. Joint fluid analysis demonstrated that the treatment group at 1 week had significant higher levels of C2C than the pretreatment baseline data. The results of this study demonstrated that partial thickness injury of cartilage continued to propagate and degenerate over time in this sheep model. Options for the prevention or treatment of this lesion may be tested using this model in the future.     

Changes of articular cartilage after immobilization in a rat knee contracture model

The objective was to determine the changes of articular cartilage of the knee joint during immobilization in a rat model. The knee joints of adult male rats were immobilized at 150° of flexion using an internal fixator for 3 days, and 1, 2, 4, 8, and 16 weeks. The articular cartilage from the medial midcondylar region of the knee was obtained, divided into three areas (non‐contact area, transitional area, contact area), and in each area, a degree of degeneration was evaluated by gross observation, histomorphometric grading, and measurements of thickness and number of chondrocytes. Elasticity of the articular cartilage was estimated by measuring the sound speed with use of scanning acoustic microscopy. Degeneration of the articular cartilage was mainly observed in the contact and transitional areas. Matrix staining intensity by safranin‐O and number of chondrocytes were decreased in these two areas. The thickness of the articular cartilage in the non‐contact and contact areas was unchanged, but it was increased in the transitional area. Decrease in sound speed was observed in the transitional area of both the femoral and tibial cartilage, indicating the softening of the articular cartilage. The changes of articular cartilage became obvious as early as 1 week after immobilization. These changes may be due to a lack of mechanical stress or a lack of joint fluid circulation during immobilization. Although we do not know the reversibility of these changes of articular cartilage, early mobilization is preferable to avoid these cartilage changes. © 2008 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 27:236–242, 2009     

A rabbit model demonstrates the influence of cartilage thickness on intra‐articular drug delivery and retention within cartilage

For evaluation of new approaches to drug delivery into cartilage, the choice of an animal model is critically important. Since cartilage thickness varies with animal size, different levels of drug uptake, transport and retention should be expected. Simple intra‐articular injection can require very high drug doses to achieve a concentration gradient high enough for drug diffusion into cartilage. New approaches involve nanoparticle delivery of functionalized drugs directly into cartilage; however, diffusion‐binding kinetics proceeds as the square of cartilage thickness. In this study, we demonstrate the necessity of using larger animals for sustained intra‐cartilage delivery and retention, exemplified by intra‐articular injection of Avidin (drug‐carrier) into rabbits and compared to rats in vivo. Penetration and retention of Avidin within cartilage is greatly enhanced by electrostatic interactions. Medial tibial cartilage was the thickest of rabbit cartilages, which generated the longest intra‐cartilage half‐life of Avidin (τ_1/2 = 154 h). In contrast, Avidin half‐life in thinner rat cartilage was 5–6 times shorter (τ_1/2 ～ 29 h). While a weak correlation (R² = 0.43) was found between Avidin half‐lives and rabbit tissue GAG concentrations, this correlation improved dramatically (R² = 0.96) when normalized to the square of cartilage thickness, consistent with the importance of cartilage thickness to evaluation of drug delivery and retention. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 33:660–667, 2015.     

组织培养法在关节软骨保存中的应用

[目的]探讨3种保存方法对关节软骨细胞活性的不同影响,寻求效果优良的软骨组织保存方法.[方法]切取成年猪骨软骨,制成约4.5 mm×5 mm大小的圆柱形骨软骨块.采用组织培养法、慢速梯度降温冷冻法、传统慢速连续降温冷冻法对软骨块进行保存处理,观察并比较保存后软骨细胞活性的变化.[结果]保存8周时,采用传统冷冻法的关节软骨细胞存活率不足50%,软骨基质成分大量丢失;采用慢速梯度降温冷冻法的细胞存活率66%,而使用组织培养法保存的关节软骨细胞存活率高达76%以上,软骨基质成分仅少量丢失.[结论]3种方法相比较,组织培养法可以长期保存关节软骨组织活性,是更为理想的软骨组织保存方法.     

不同手术方式对关节软骨影响的实验研究

[目的]了解3种不同手术方式对活体关节软骨的影响。[方法]用光镜、扫描电镜及生物化学方法观察3种手术后不同时点兔膝关节软骨的结构及基质蛋白多糖的变化。[结果]3种手术对关节软骨都会造成损伤，使蛋白多糖的含量降低，暴露组造成不可逆性损伤，保护组和灌注组造成可逆性损伤，灌注组软骨损伤最轻、恢复最快。[结论]3种关节手术均会造成关节软骨损伤，关节灌注组的影响最小。     

Anatomic variation of depth‐dependent mechanical properties in neonatal bovine articular cartilage

Articular cartilage has well known depth‐dependent structure and has recently been shown to have similarly non‐uniform depth‐dependent mechanical properties. Here, we study anatomic variation of the depth‐dependent shear modulus and energy dissipation rate in neonatal bovine knees. The regions we specifically focus on are the patellofemoral groove, trochlea, femoral condyle, and tibial plateau. In every sample, we find a highly compliant region within the first 500 µm of tissue measured from the articular surface, where the local shear modulus is reduced by up to two orders of magnitude. Comparing measurements taken from different anatomic sites, we find statistically significant differences localized within the first 50 µm. Histological images reveal these anatomic variations are associated with differences in collagen density and fiber organization. © 2012 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 31: 686–691, 2013     

Effects of varying intensities of laser energy on articular cartilage: a preliminary study

The effects of laser energy on articular cartilage were studied utilizing the neodymium YAG laser. Partial-thickness cartilage defects were surgically attempted in the femoral condyles of knee joints in guinea pigs. The defects were exposed to laser energy of varying intensities [group I, 25 J (5 W X 5 sec); group II, 75 J (15 W X 5 sec); group III, 125 J (25 W X 5 sec)]. A fourth group was studied, in which the defect was not lased. Animals were killed at weekly intervals from 1 to 6 weeks and the knee joints were subjected to histological analysis. At 5 weeks, the knees exposed to 25 and 75 J demonstrated a reparative process with chondral proliferation. The knees exposed to 125 J demonstrated fibrotic tissue and tissue necrosis that resulted in fibrosis. In the knees not exposed to laser energy, numerous foci of granulation tissue were present at all stages with the end point of healing being one of fibrosis with disorganized patchy cartilage islands.     

Effects of confinement on the mechanical properties of self‐assembled articular cartilage constructs in the direction orthogonal to the confinement surface

This study examined the effects of radial confinement and passive axial compression‐induced vertical confinement, on the biomechanical, biochemical, and histological properties of self‐assembled chondrocyte constructs. The self‐assembled constructs, engineered without the use of an exogenous scaffold, exhibited significant increases in stiffness in the direction orthogonal to that of the confinement surface. With radial confinement, the significantly increased aggregate modulus was accompanied by increased collagen organization in the direction perpendicular to the articular surface, with no change in collagen or glycosaminoglycan (GAG) content. Additionally, radial confinement was most beneficial when applied before 2 weeks. With passive axial compression, the significantly increased Young's modulus and ultimate tensile strength were accompanied by a significant increase in collagen production. This study is the first to demonstrate the beneficial effects of confinement on tissue engineered constructs in the direction orthogonal to that of the confinement surface. © 2007 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 26:238–246, 2008     

Murine articular cartilage morphology and compositional quantification with high resolution cationic contrast‐enhanced μCT

Articular cartilage lines the load‐bearing surfaces of long bones and undergoes compositional and structural degeneration during osteoarthritis progression. Contrast enhanced microcomputed tomography (μCT) is being applied to a variety of preclinical models, including the mouse, to map structural and compositional properties in 3‐D. The thinness (∼30–50 μm) and high cellularity of mouse articular cartilage presents a significant imaging challenge. Our group previously showed that mouse articular cartilage and proteoglycan (PG) content can be assessed by μCT with the ioxagalate‐based contrast agent Hexabrix, but the voxel size used (6 μm) was deemed to be barely adequate. The objective of the present study is to assess the utility of a novel contrast agent, CA4+, to quantify mouse articular cartilage morphology and composition with high resolution μCT imaging (3 μm voxels) and to compare the sensitivity of CA4+ and Hexabrix to detect between‐group differences. While both contrast agents are iodine‐based, Hexabrix is anionic and CA4+ is cationic so they interact differently with negatively charged PGs. With CA4+, a strong correlation was found between non‐calcified articular cartilage thickness measurements made with histology and μCT (R ² = 0.72, p < 0.001). Cartilage degeneration—as assessed by loss in volume, thickness, and PG content—was observed in 34‐week‐old mice when compared to both 7‐ and 12‐week‐old mice. High measurement precision was observed with CA4+, with the coefficient of variation after repositioning and re‐imaging samples equaling 2.8%, 4.5%, 7.4% and 5.9% for attenuation, thickness, volume, and PG content, respectively. Use of CA4+ allowed increased sensitivity for assessing PG content compared to Hexabrix, but had no advantage for measurement of cartilage thickness or volume. This improvement in imaging should prove useful in preclinical studies of cartilage degeneration and regeneration. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2740–2748, 2017.

     

Changes in chondrocyte gene expression following in vitro impaction of porcine articular cartilage in an impact injury model

Our objective was to monitor chondrocyte gene expression at 0, 3, 7, and 14 days following in vitro impaction to the articular surface of porcine patellae. Patellar facets were either axially impacted with a cylindrical impactor (25 mm/s loading rate) to a load level of 2,000 N or not impacted to serve as controls. After being placed in organ culture for 0, 3, 7, or 14 days, total RNA was isolated from full thickness cartilage slices and gene expression measured for 17 genes by quantitative real‐time RT‐PCR. Targeted genes included those encoding proteins involved with biological stress, inflammation, or anabolism and catabolism of cartilage extracellular matrix. Some gene expression changes were detected on the day of impaction, but most significant changes occurred at 14 days in culture. At 14 days in culture, 10 of the 17 genes were differentially expressed with col1a1 most significantly up‐regulated in the impacted samples, suggesting impacted chondrocytes may have reverted to a fibroblast‐like phenotype. © 2012 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 31: 385–391, 2013     

降钙素在体内体外实验中对兔关节炎关节软骨退变及软骨下骨骨代谢的影响

[目的]研究降钙素(calcitonin, CT)对骨性关节炎关节软骨退变和软骨下骨骨代谢的影响.[方法]30只3个月龄雌性日本大耳白兔随机分为三组,其中两组行右膝关节前交叉韧带切断术(anterior cruciate ligament transaction,ACLT),分为ACLT+CT组和ACLT+NS组,第3组为Sham组.ACLT+CT给予每日1次皮下注射降钙素5 IU/(kg·d),持续8周,ACLT+NS组给予同样剂量生理盐水.术后8周后处死所有动物.取股骨髁制成切片行MMP-13和Ⅱ型胶原免疫组化染色.取胫骨近端制成硬组织切片行骨形态计量学检测.体外实验中,取兔膝关节软骨,经消化、培养,将第3代软骨细胞分三组:向IL-1β组加入人重组IL-1β(10 ng/ml). IL-1β+CT组加入人重组IL-1β (10 ng/ml)2 d后,再向培养液中加入CT(50 ng/ml).正常组不加任何诱导剂和干扰剂培养.然后行MMP-13、Ⅱ型胶原免疫组化检测和Realtime RT-PCR法检测.[结果]Sham组和ACLT+CT组软骨下骨骨小梁相对体积和厚度等均显著高于ACLT+NS组.Sham组和ACLT+CT组的Ⅱ型胶原的光密度值均显著高于ACLT+NS组,而MMP-13的光密度值显著低于ACLT+NS组(P<0.05).正常组和IL-1β+CT组的Ⅱ型胶原光密度值均显著高于IL-1β组而MMP-13的光密度值都显著低于IL-1β组(P<0.05).在正常组和IL-1β+CT组中Ⅱ型胶原的mRNA含量均显著高于IL-1β组而MMP-13的mRNA含量均显著低于IL-1β组(P<0.05).[结论]降钙素5 IU/(kg·d)皮下注射能够增加ACLT兔膝关节软骨Ⅱ型胶原的分泌和抑制MMP-13的表达,并可能通过调节软骨下骨的骨代谢和微结构来保护关节软骨; CT(50 ng/ml)能增加体外培养的含有IL-1β(10 ng/ml)的软骨细胞中Ⅱ型胶原的含量和抑制MMP-13分泌.     

Effects of heme oxygenase‐1 on bacterial antigen‐induced articular chondrocyte catabolism in vitro

This study tested the hypothesis that heme oxygenase‐1 (HO‐1) expression counteracts bacterial antigen‐induced catabolic metabolism in human articular chondrocytes. HO‐1 expression was induced in chondrocytes by the iron‐containing porphoryin, hemin. Anti‐catabolic and anti‐apoptotic effects of HO‐1 expression were evaluated following bacterial antigen (lipopolysaccharides, LPS) activation of chondrocytes by quantification of cytokine and cartilage matrix protein expression. Effects of HO‐1 over‐expression on chondrocyte matrix metabolism were evaluated using plasmid‐driven protein synthesis. Hemin increased HO‐1 expression and LPS increased interleukin‐1beta and interleukin‐6 gene and protein expression in chondrocytes. Hemin‐induced HO‐1 decreased LPS‐induced interleukin‐1beta and interleukin‐6 gene and protein expression. Increased HO‐1 expression partially reversed LPS‐suppression of aggrecan and type II collagen gene expression and suppressed LPS‐induced gene expression of IL‐6, inducible nitric oxide synthase (iNOS), matrix metalloproteinases (MMPs), and IL‐1beta. HO‐1 induction was inversely correlated with LPS‐induced chondrocyte apoptosis. HO‐1 over‐expression in chondrocytes decreased matrix protein gene expression. With LPS activation, increased HO‐1 expression decreased chondrocyte catabolism, partially reversed LPS‐dependent inhibition of cartilage matrix protein expression and protected against apoptosis. Without LPS, hemin‐induced HO‐1 and plasmid‐based over‐expression of HO‐1 inhibited cartilage matrix gene expression. The results suggest that elevated HO‐1 expression in chondrocytes is protective of cartilage in inflamed joints but may otherwise suppress matrix turn over. © 2013 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 31:1943–1949, 2013     

Effect of low‐dose X‐ray irradiation and Ti particles on the osseointegration of prosthetic

Low‐dose irradiation (LDI) exhibits a positive effect on osteoblasts and inhibitory effect of inflammation. Here, we test the hypothesis that LDI can promote osseointegration and inhibit the inflammatory membrane formation in the presence of titanium (Ti) particles. Endotoxin‐free titanium particles were injected into rabbit, prior to the insertion of a Ti6‐Al‐4‐V sticks pre‐coated with hydroxyapatite. Two days after operation, both distal femurs of the animal were exposed to 0.5 Gy X‐ray irradiation. All ani­mals were euthanized 8 weeks after the operation. The PINP concentration was determined at day 0, 2, 4, and 8 weeks after operation. Trabecular morphology around the implants 8 weeks after operation was assessed using micro‐CT, then the maximum push out force of simples was assessed using biomechanics test. Five samples in each group were chosen for bone histomorphology study without decalcification 8 weeks after operation. The results confirmed that the LDI can significantly improve ingrowth of bone into the prosthetic interface and stability of the prosthesis when there was no wear particles. Although promotion effects for bone formation induced by LDI can be counteracted by wear particles, LDI can significantly inhibit the interface membrane formation around the implant induced by wear particles. Based on these results, we conclude that LDI may be useful for enhancing the stability of prosthesis when there are no wear particles and for inhibiting the interface membrane formation during the early stage of aseptic loosening in the presence of wear particles. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1688–1696, 2016.