Load Sharing Between Solid and Fluid Phases in Articular Cartilage: I — Experimental Determination of in Situ Mechanical Conditions in a Porcine Knee

1998 ◽  
Vol 120 (5) ◽  
pp. 614-619 ◽  
Author(s):  
N. Mukherjee ◽  
J. S. Wayne
Keyword(s):  
Articular Cartilage ◽  
Articular Surface ◽  
Femoral Condyle ◽  
Compressive Load ◽  
Lateral Femoral Condyle ◽  
Lateral Condyle ◽  
Medial Side ◽  
Contact Pressures ◽  
Fluid Phases

The in situ mechanical conditions of cartilage in the articulated knee were quantified during joint loading. Six porcine knees were subjected to a 445 N compressive load while cartilage deformations and contact pressures were measured. From roentgenograms, cartilage thickness before and during loading allowed the calculation of tissue deformation on the lateral femoral condyle at different times during the loading process. Contact pressures on the articular surface were measured with miniature fiber-optic pressure transducers. Results showed that the medial side of the lateral femoral condyle had higher contact pressures, as well as deformations. To begin to correlate the pressures and resulting deformations, the intrinsic material properties of the cartilage on the lateral condyle were obtained from indentation tests. Data from four normal control specimens indicated that the aggregate modulus of the medial side was significantly higher than in other areas of the condyle. These experimental measures of the in situ mechanical conditions of articular cartilage can be combined with theoretical modeling to obtain valuable information about the relative contributions of the solid and fluid phases to supporting the applied load on the cartilage surface (see Part II).

scholarly journals Particulated Juvenile Articular Cartilage (PJAC) Allograft for Treatment of Lateral Femoral Condyle defect in High-Performance Athletes

2018 ◽  
Vol 6 (6_suppl3) ◽  
pp. 2325967118S0005 ◽  
Author(s):  
Gabriella Bucci ◽  
Michael Begg ◽  
Kevin Pillifant ◽  
Steven B Singleton
Keyword(s):  
Articular Cartilage ◽  
Cartilage Defect ◽  
High Performance ◽  
Femoral Condyle ◽  
Cartilage Lesion ◽  
Lateral Femoral Condyle ◽  
High Grade ◽  
Chondral Defect ◽  
Short Term ◽  
High Level

Background: A relatively new technology for the treatment of high grade articular cartilage lesions is the implantation of particulated articular cartilage obtained from a juvenile allograft donor (PJAC).1-2 Previous studies have reported the ability of juvenile chondrocytes to migrate from cartilage explants after being secured in a cartilage defect.3 There is little in the literature to use as a reference with respect to the use of PJAC for high grade articular cartilage lesion of the lateral femoral condyle after a failure of treatment with a microfracture in the high level athlete. Objective: The aim of this report is to describe the technique of PJAC transplantation for the treatment of chondral lesions of the lateral femoral condyle and to report the short term outcomes in the high performance athlete. Methods: We present a case report of two patients who were treated in our clinic in December 2014. Case 1: 16 year old female Division 1 university soccer player, who one year prior to our index surgery underwent microfractures of a symptomatic lateral femoral condyle articular cartilage lesion without relief. Cae 2: 29 year old male professional tennis player (case 2) with a recurrent, symptomatic chondral defect on the lateral femoral condyle. The player had undergone multiple arthroscopic procedures on the same knee following an injury sustained while playing in the Australian Open, including a surgery 8 months prior to our index operation that had included lateral meniscal tear repair and microfractures. PJAC procedure consists of a minimal debridement and chondroplasty, performed arthroscopically. For these central lateral femoral condyle lesions, a mini-arthrotomy is created along the lateral parapatellar longitudinal axis over a length of about 3 cm. With the chondral defect localized and prepared, a thin fresh layer of fibrin glue is then applied. The PJAC graft is equally distributed in the defect with space in between the fragments so as not over-fill the defect. Then, a new fibrin glue layer is placed to cover the graft. The overall construct remains just below the level of the normal articular surface. The knee is cycled through the range of motion to ensure that the tissue construct is stable. We present images of the cartilage defect after debridement and the allograft implantation procedure. In addition we will submit an instructional video performed on a knee specimen. Results: Outcomes measured were: IKDC, Lysholm, and Tegner knee scores together with arc of motion of the joint. After 28 months follow up, patients had gained complete range of motion and significantly decreased pain. Improvement for each outcome measure used is reported. Conclusions: PJAC transplantation offers pain relief and improved short term outcomes in high level performance athletes. Both of our patients are back to practicing their sport with notable improvement in symptoms. No complications have been noted. Long-term data is not yet available. References: Am J Farr J, Tabet SK, Margerrison E, Cole BJ. Clinical, Radiographic, and Histological Outcomes After Cartilage Repair With Particulated Juvenile Articular Cartilage: A 2-Year Prospective Study. Sports Med. 2014 Jun;42(6):1417-25. Saltzman BM, Lin J, Lee S. Particulated Juvenile Articular Cartilage Allograft Transplantation for Osteochondral Talar Lesions. Cartilage. 2017 Jan;8(1):61-72. Arshi A, Wang D, Jones KJ. Combined Particulated Juvenile Cartilage Allograft Transplantation and Medial Patellofemoral Ligament Reconstruction for Symptomatic Chondral Defects in the Setting of Recurrent Patellar Instability. Arthrosc Tech. 2016 Oct 10;5(5)

Swelling and Curling Behaviors of Articular Cartilage

1998 ◽  
Vol 120 (3) ◽  
pp. 355-361 ◽  
Author(s):  
L. A. Setton ◽  
H. Tohyama ◽  
V. C. Mow
Keyword(s):  
Articular Cartilage ◽  
Residual Strain ◽  
Shape Change ◽  
Articular Surface ◽  
Ion Concentration ◽  
Ex Situ ◽  
Surface Zone ◽  
Sample Orientation ◽  
Residual Strains

A new experimental method was developed to quantify parameters of swelling-induced shape change in articular cartilage. Full-thickness strips of cartilage were studied in free-swelling tests and the swelling-induced stretch, curvature, and areal change were measured. In general, swelling-induced stretch and curvature were found to increase in cartilage with decreasing ion concentration, reflecting an increasing tendency to swell and “curl” at higher swelling pressures. An exception was observed at the articular surface, which was inextensible for all ionic conditions. The swelling-induced residual strain at physiological ionic conditions was estimated from the swelling-induced stretch and found to be tensile and from 3–15 percent. Parameters of swelling were found to vary with sample orientation, reflecting a role for matrix anisotropy in controlling the swelling-induced residual strains. In addition, the surface zone was found to be a structurally important element, which greatly limits swelling of the entire cartilage layer. The findings of this study provide the first quantitative measures of swelling-induced residual strain in cartilage ex situ, and may be readily adapted to studies of cartilage swelling in situ.

scholarly journals Osteochondral Fracture Lateral Femoral Condyle Treated with ORIF Using Z-Plasty: A Modification of Coonse and Adams Approach

2011 ◽  
Vol 2011 ◽  
pp. 1-5
Author(s):  
Sanjay Agarwala ◽  
Ganesh S. Mohrir ◽  
Brijbhushan S. Mahajan
Keyword(s):  
Vitamin D ◽  
Articular Surface ◽  
Femoral Condyle ◽  
Weight Bearing ◽  
Lateral Femoral Condyle ◽  
Full Weight Bearing ◽  
Elevated Alkaline Phosphatase ◽  
Osteochondral Fracture ◽  
History Of ◽  
One Year

Osteochondral fractures of lateral femoral condyle are common in adolescents and young adults. They are usually caused by direct trauma or twisting injuries of the knee. We present a case of large osteochondral fracture of lateral femoral condyle involving the articular surface in a fifteen-year-old male with a positive history of significant weight gain of 5 kilograms in last six months. Blood investigations reported low vitamin D and testosterone levels with elevated alkaline phosphatase. Adequate exposure was achieved by doing Z-plasty of quadriceps apparatus. The fracture was treated with open reduction and internal fixation using Herbert's screws. Medical management in the form of vitamin D and calcium along with testosterone was given. After the surgery, full weight-bearing was allowed at three months. At one year followup, patient has good quadriceps function without any weakness of the muscle.

scholarly journals ARTICULAR CARTILAGE THICKNESS IN PEDIATRIC AND ADOLESCENT KNEES DECREASES WITH AGE AND SKELETAL MATURITY: IMPLICATIONS FOR OSTEOCHONDRAL GRAFTING PROCEDURES

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0019
Author(s):  
Sreetha Sidharthan ◽  
Annie Yau ◽  
Bryan Aristega Almeida ◽  
Kevin G. Shea ◽  
Kristofer J. Jones ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Linear Regression ◽  
Skeletal Maturity ◽  
Femoral Condyle ◽  
Cartilage Thickness ◽  
Medial Femoral Condyle ◽  
Lateral Femoral Condyle ◽  
Cartilage Restoration ◽  
Text Figure ◽  
Mri Scans

Background: Quantifying native cartilage thickness in pediatric and adolescent knees can help match donor and recipient sites for articular cartilage restoration procedures such as osteochondral autograft transplantation (OATS) and osteochondral allograft transplantation (OCA). Hypothesis/Purpose: The purpose of the current study was to quantify articular cartilage thickness in pediatric and adolescent knees using magnetic resonance imaging (MRI). We hypothesized that cartilage thickness is inversely correlated with skeletal maturity and age. Methods: One hundred and twenty MRI scans were evaluated in a cohort of patients 9 to 18 years old without osteochondral lesions, chondral wear or pathology, intraarticular fractures, history of knee surgery, or inflammatory arthropathy. Measurements of articular cartilage thickness at the medial femoral condyle, lateral femoral condyle, lateral trochlea, and patella were made on axial, coronal, and sagittal MRI scans (Figure 1). Skeletal maturity was categorized as ‘open’, ‘closing’, or ‘closed’ based on the status of the proximal tibial and distal femoral growth plates. Descriptive statistics was used to evaluate cartilage thickness by age and sex. Independent samples t-test, analysis of variance (ANOVA), and linear regression were performed to investigate for associations with sex, skeletal maturity, and age. Results: On the femur, cartilage was thickest at the lateral trochlea with mean articular thickness of 4.2 ± 1.4 mm in males and 3.6 ± 1.3 mm in females ( p=0.015) (Table 1). Skeletally immature patients with open physes had significantly thicker cartilage at the medial femoral condyle, lateral femoral condyle, and lateral trochlea compared to patients with closing and closed physes (Figure 2). Linear regression analysis also revealed a significant association between femoral cartilage thickness and age (Figure 3). Age explained 63% of the variance at the medial femoral condyle (B=6.1, p<0.001), 64% of the variance at the lateral femoral condyle (B=4.9, p<0.001), and 68% of the variance at the lateral trochlea (B=8.2, p<0.001) (Table 2). In contrast, cartilage thickness at the patella did not significantly vary by age, sex, or skeletal maturity (Figures 2 and 4). Conclusion: There is a strong inverse association between increasing age and cartilage thickness of the femoral condyles and lateral trochlea. In particular, pediatric knees demonstrate relatively thick cartilage at the lateral trochlea that decreases with age. This information will help surgeons understand recipient site anatomy and identify appropriate donor site tissue for articular cartilage restoration procedures such as OATS and OCA in children and adolescents. Tables: [Table: see text][Table: see text] Figures: [Figure: see text][Figure: see text][Figure: see text][Figure: see text]

scholarly journals MICROENVIRONMENTAL INFLUENCES ON ARTICULAR CHONDROCYTE DIFFERENTIATION

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0023
Author(s):  
Michael Chau ◽  
Ferenc Toth ◽  
Ameya Bendre ◽  
Alexandra Armstrong ◽  
Jeffrey Macalena ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Growth Plate ◽  
Endochondral Ossification ◽  
Articular Surface ◽  
Surface Growth ◽  
Articular Chondrocyte ◽  
Medial Condyle ◽  
Text Figure ◽  
Biomechanical Stimuli

Background: Immature articular cartilage (a.k.a. articular epiphyseal cartilage complex, AECC), serves dual functions as an articulating layer and surface growth plate. The AECC originates from an uninterrupted cartilaginous template during embryogenesis, presumably stemming from the same pool of progenitors, but it is unclear how the articulating layer is maintained throughout life, while the surface growth plate undergoes endochondral ossification. Hypothesis: The function and fate of chondrocytes in the AECC are not predetermined in the embryo, but instead can be influenced during development by biochemical and/or biomechanical stimuli in the cellular microenvironment. Methods: Microenvironments of the articulating layer and surface growth plate were switched in an in vivo goat model. Twelve 3-week-old goats were used. Osteochondral autografts were harvested from medial and lateral condyles and trochlea of the distal femur. Subchondral bone was removed (Figures 1A and 1B). Grafts were inverted and press-fit into select sites, which were full (condyles) or low (trochlea) weightbearing (Figures 1C through 1E). Animals were allowed ambulation and range of motion as tolerated. Two goats each were euthanized at 1, 2, 3, 6, 12, and 24 weeks postoperatively. Distal femurs were harvested and grafts were analyzed with trichrome staining and in situ hybridization for Col10, Col2, and Prg4. Results: All animals survived surgery, ambulated within 24 hours, and none exhibited signs of surgical site infection. Macroscopically, grafts at the trochlea and lateral condyle maintained a more cartilaginous appearance than those at the medial condyle, but all eventually developed an osseous appearance. Histologically, there was healing over time, with early grafts often containing areas of hemorrhage and occasionally necrosis, followed by formation of granulation tissue and subjacent myelofibrosis, with eventual invasion and ossification. At later timepoints, there was better graft incorporation at the articular surface without replacement by fibrosis at the medial condyle (Figure 2). In situ hybridization demonstrated some Prg4 positive cells and a decrease in Col10 expression at the articular surface (Figure 3). Conclusions: The synovial microenvironment may play a protective role against endochondral ossification. Some incorporation of epiphyseal cartilage into articular cartilage occurred at sites subjected to both compressive and shear forces. Data suggest the existence of local cytokines and/or matrix effects on chondrocytes that stimulate different cell functions and fates. A limitation of this study is its observational nature. Further understanding of articular chondrocyte differentiation and identification of key biochemical and/or biomechanical stimuli hold therapeutic promise for articular cartilage regeneration, repair, and replacement. [Figure: see text][Figure: see text][Figure: see text]

The Effects of Aggressive Notchplasty on the Normal Knee in Dogs

1998 ◽  
Vol 26 (2) ◽  
pp. 193-200 ◽  
Author(s):  
Robert F. LaPrade ◽  
Glenn C. Terry ◽  
Ronald D. Montgomery ◽  
David Curd ◽  
David J. Simmons
Keyword(s):  
Articular Surface ◽  
Femoral Condyle ◽  
Significant Loss ◽  
Lateral Femoral Condyle ◽  
Sham Operation ◽  
Trochlear Groove ◽  
Long Term Effects ◽  
Sham Operation Group ◽  
Group I ◽  
Group Ii

We assessed the possible association between an aggressive intercondylar notchplasty and histopathologic, radiographic, and gait changes to the knee. Three groups of six adult greyhounds were observed for 6 months. Group I dogs had a sham operation. Group II dogs had a 4-mm notchplasty of the lateral femoral condyle where it articulates with the lateral tibial spine. Group III dogs had a 7- to 8-mm notchplasty of the lateral femoral condyle to simulate the long-term effects of an overly aggressive notchplasty. Force plate gait analyses were not significantly different for any dogs at 3 and 6 months. Histopathologic studies (hematoxylin and eosin and safranin O stains) revealed notchplasty area remodeling with a thin layer of lamellar bone covered by fibrous connective tissue. Both Group II and III dogs had significant loss of lateral femoral condyle and trochlear groove articular surface proteoglycans. The radiographic notch width index remained unchanged throughout the study for Group I; the indexes increased immediately after surgery in Groups II and III because of the notchplasty, but after 6 months these values returned to near-preoperative measurements. An aggressive intercondylar notchplasty caused articular cartilage histopathologic changes at 6 months consistent with those found in knees with early degenerative arthritis. Significant refilling of a non-impinged notchplasty occurred by 6 months after surgery. Our results raise concern about the effects of aggressive intercondylar notch widening in humans.

scholarly journals Contralateral Lateral Femoral Condyle Allografts Provide an Acceptable Surface Match for Simulated Classic Osteochondritis Dissecans Lesions of the Medial Femoral Condyle

2018 ◽  
Vol 6 (7_suppl4) ◽  
pp. 2325967118S0013 ◽  
Author(s):  
Nabeel Salka ◽  
John A. Grant
Keyword(s):  
Surface Topography ◽  
Clinical Outcomes ◽  
Articular Surface ◽  
Femoral Condyle ◽  
Standard Procedure ◽  
Medial Femoral Condyle ◽  
Lateral Femoral Condyle ◽  
Intercondylar Notch ◽  
Surface Deviation ◽  
Fresh Frozen

Objectives: The purpose of this study was to determine whether contralateral lateral femoral condyle (LFC) allografts can provide an acceptable surface topography match for classic osteochondritis dessicans (OCD) lesions of the medial femoral condyle (MFC). Achievement of an acceptable donor-recipient articular surface match (1 mm deviation) has been associated with physiological joint stresses and predictably positive clinical outcomes. It was hypothesized that LFC and MFC allografts would show no differences in step-off height or surface deviation in all four quadrants of the graft. Methods: ample size calculation suggested ten groups of fresh frozen size-matched human condyles, each group consisting of a donor MFC, donor LFC, and recipient MFC. A 20 mm circular osteochondral “defect” simulating a “classic” OCD lesion was created in the recipient MFC. Its most anterior position was 1 cm posterior and 1 cm medial to the roof of the intercondylar notch. A randomly selected donor MFC or LFC plug was then harvested and transplanted using standard procedure (Fig 1A). The transplanted condyle was scanned with nano-CT, reconstructed (Fig 1B), registered to an initial scan of the recipient MFC, and processed with a custom MATLAB program to determine the surface root mean squared deviation (dRMS) between the native and donor surfaces (Fig 1C), percent area unacceptably proud (>1 mm; %Aproud) and sunken (<-1 mm; %Asunk). Scans were uploaded into DragonFly software where step-off height (hRMS), percent circumference unacceptably proud (>1 mm; %Cproud) and sunken (< -1 mm; %Csunk) were measured (Fig 1D). The process was then repeated for the other allograft plug. Two-way mixed ANOVAs with Sidak corrections for multiple comparisons (α=0.05) were used. Exempt status was obtained from the University’s IRB. Results: Both MFC and LFC plugs showed acceptable step-off heights in all four quadrants. Neither allograft type nor location within the defect had a main effect on step-off height (hRMS). In general, plugs were more unacceptably sunken than proud, though no differences in %Csunk were seen between allograft types or locations within the defect. In LFC plugs, %Cproud was significantly greater laterally (by the intercondylar notch) compared to all other locations around the plug (p<0.0001), while no differences were seen based on location in MFC plugs. The cartilage surface deviationn (dRMS), %Aproud, and %Asunk were not significantly affected by allograft type or location (Table 1). Conclusion: Previous studies demonstrated that contralateral LFCs provide acceptable surface topography matches for centrally located defects of the MFC. In evaluating the utility of LFC allografts for more laterally located lesions characteristic of OCD, it was found that, similarly, allograft type does not have an effect on surface deviation or step-off height. With comparable surface deviations, both MFC and LFC allografts can be expected to present similar stresses on the knee joint and achieve predictably positive clinical outcomes, thus improving donor availability and reducing surgical wait times for matches. LFC plugs did not differ from MFC plugs in overall %Aproud, %Asunk, %Cproud, or %Csunk suggesting that well placed LFC plugs, like MFC plugs, may result in few post-surgical complications. Higher step-off heights of LFC plugs near the intercondylar notch may contribute to higher joint stresses and may serve as an area of focus in future studies. [Figure: see text][Table: see text]

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