Shear properties of articular cartilage of a bovine knee joint subjected to moderate and high loads: an experimental study.

Freshly excised bovine knee joints were subjected to oscillation under constant load on a specially designed knee joint articulating machine with the joints subjected to moderate and high loadings of 1471.5 and 2943 N respectively. Instantaneous and equilibrium shear moduli of the articular cartilage obtained from the experimental knee joints were measured on a mechanical indentor (DuPont 943 TMA) and compared with the corresponding values of the shear moduli of the cartilage obtained from the control knee joints. At moderate load, both the instantaneous and the equilibrium shear moduli exhibit significant increase in their values. However, at high load the constant shear moduli showed a decrease in its value whereas the value of the equilibrium shear modulus was observed to increase slightly.     

The Fractal Structure of Equine Articular Cartilage

The naturally occurring structure of articular cartilage has proven to be an effective means for the facilitation of motion and load support in equine and other animal joints. Cartilage has been found to be a complex and dynamic medium, which has led to an incomplete understanding of the nature and operating mechanisms acting within a joint. Although cartilage has biphasic and triphasic properties, it is believed that the performance of equine articular joints is influenced by the surface roughness of the joint cartilage (Ateshian et al., '98; Chan et al., 2011; Yao and Unsworth, '93). Various joint types with different motions and regimes of lubrication have altered demands on the articular surface that may affect cartilage surface properties. In research performed on freshly harvested samples, equine articular cartilage has been shown to possess a multiscale structure and a fractal dimension. It is thought that by determining the fractal dimension (D) of articular cartilage, a better understanding of the friction, wear, and lubrication mechanisms for biomechanic surfaces can eventually be reached. This study looks at the fractal dimensions of three different articular cartilage surfaces in the equine carpus: the radiocarpal, midcarpal, and carpometacarpal surfaces. The three surfaces provide an ideal comparison of fractal dimensions for a different range of motion, geometry, and loading. In each sample, identical treatment was performed during measurement by a stylus profilometer. SCANNING 34: 418–426, 2012. © 2012 Wiley Periodicals, Inc.     

Improved techniques for measuring the indentation and thickness of articular cartilage

A review of the techniques previously employed in the indentation and measurement of the thickness of articular cartilage has led to new and improved techniques for performing both measurements. By utilizing high-speed, microcomputer-controlled data logging techniques, simultaneous monitoring of signals from a dynamic load cell and a displacement transducer could be made throughout an indentation test. The position of the indenter as it touched the articular surface could thus be determined automatically by identifying the moment at which a positive change in the load signal occurred. Less accurate and more time consuming techniques previously required for determining the position of the cartilage surface were hence avoided. The apparatus also included a critically damped dashpot which prevented any transient loads being applied to the cartilage. Depths of indentation could be measured to an accuracy of 0.005 mm with a measurement repeatability of 2.14 per cent. By replacing the indenter with a sharp needle, the apparatus was also capable of measuring the undeformed thickness of cartilage. An accuracy of +/- 0.012 mm could be achieved with a measurement repeatability of 1.2 per cent. The apparatus is particularly suited to survey work where large numbers of indentation tests are to be performed.     

Investigation of the friction and surface degradation of innovative chondroplasty materials against articular cartilage

Understanding the wear of the biomaterial-cartilage interface is vital for the development of innovative chondroplasty. The aim of this study was to investigate a number of biphasic materials as potential chondroplasty biomaterials. Simple geometry friction and wear studies were conducted using bovine articular cartilage pins loaded against a range of single-phase and biphasic materials. The frictions of each biomaterial was compared within simple and protein-containing lubricants. Longer-term continuous sliding tests within a protein containing lubricant were also conducted at various loading conditions to evaluate the friction and degradation for each surface. All single-phase materials showed a steady rise in friction, which was dependent on the loss of interstitial fluid load support from the opposing cartilage pin. All biphasic materials demonstrated a marked reduction in friction when compared with the single-phase materials. It is postulated that the biphasic nature of each material allowed an element of fluid load support to be maintained by fluid rehydration and expulsion. In the longer-term study, significant differences in the articular cartilage pin (surface damage) between the positive control (stainless steel) and the negative control (articular cartilage) was found. The potential biphasic chondroplasty materials produced a reduction in articular cartilage pin damage when compared with the single-phase materials. The changes in surface topography of the cartilage pin were associated with increased levels of friction achieved during the continuous wear test. The study illustrated the importance of the biphasic properties of potential chondroplasty materials, and future work will focus on the optimization of biphasic properties as well as long-term durability, such that materials will more closely mimic the biotribology of natural articular cartilage.     

The Effect of Surface-Active Phospholipids on the Lubrication of Osteoarthritic Sheep Knee Joints: Friction

The synovial fluid aspirate from human joints that have experienced serious traumatic injury has been shown to have lower concentrations of phospholipids when compared with healthy joints. Previous studies provide evidence that synovial fluid constituents, specifically dipalmitoyl phosphatidylcholine (L-DPPC), are highly surface active, capable of rapidly depositing a layer of phospholipids onto glass. Such research has demonstrated that the adsorbed surface layers of synovial surfactant are excellent lubricants in vitro, significantly reducing the coefficient of friction under physiological loading in human knee joints. This study aimed to investigate the effect of concentration of L-DPPC lubricant solutions on the coefficient of friction of worn articular cartilage on steel. A pin-on-disc apparatus was used to measure the coefficient of friction of sheep-knee articular cartilage on steel under unidirectional sliding at physiological conditions of load and speed. Concentrations of L-DPPC solution between 100 times less and 100 times more than is normally present in synovial fluid were tested. All specimens were tested following a period of unlubricated induced wear. Trials were carried out at ambient temperature and between 33–37°C (representative of in vivo joint temperature). Friction measurement results demonstrated a reduction in the coefficient of friction of worn articular cartilage against steel with increasing concentrations of L-DPPC in lubricant solution.     

Comparison of human and animal femoral head chondral properties and geometries

Investigations into tissue-preserving orthopaedic treatments should consider the tribology of articular cartilage; where simulations using animal joints are a predominant choice. However, very few studies have investigated the differences between human and animal cartilage. The aim of the present study was to characterise the differences in geometry and mechanical properties of human, porcine, bovine and ovine articular cartilage. Creep indentation was performed on osteochondral plugs taken from the superior region of femoral heads of all these species. Cartilage thickness was measured via the resistive force change of a needle descending through cartilage and bone. A biphasic finite element model was used to derive equilibrium elastic modulus and permeability. Results showed that human cartilage was significantly thicker than all other species tested. A positive correlation was found between femoral head diameter and cartilage thickness when comparing between species of quadrupeds. Human cartilage had the largest equilibrium elastic modulus, which was significant when comparing against porcine and bovine. However, porcine cartilage had significantly lower permeability. Significant differences in geometry and mechanical properties of articular cartilage were found between all species tested. It is necessary to consider these variations when choosing animal tissue to represent human.     

Evaluation of a superior lubrication mechanism with biphasic hydrogels for artificial cartilage

To extend the durability of artificial joints, biomimetic artificial hydrogel cartilage is proposed as a way of improving the lubrication mechanism in artificial joints. The application of hydrogels with properties similar to those of articular cartilage can be expected to duplicate the superior load-carrying capacity and lubricating ability of natural synovial joints. Frictional behaviors with three kinds of poly(vinyl alcohol) (PVA) hydrogels with high water content were examined in reciprocating tests. Interstitial fluid pressure, von Mises stress and fluid flow were compared in biphasic finite element analysis, and frictional behavior was evaluated in terms of biphasic lubrication and surface lubricity. Hybrid gel prepared by a combination of cast-drying and freeze-thawing methods showed superior low friction.     

Techniques for assessment of wear between human cartilage surfaces

Osteoarthritis (OA) is a disease of joints, affecting a large number of people worldwide. One of the symptoms of OA is wear of articular cartilage; it is thought that among other factors this may be due to failure of lubrication. Injection of bio-lubricants into a joint may remedy this problem. Wear of cartilage and its prevention is a focus of much interest. The present paper describes wear tests performed using human cartilage on cartilage under various working conditions. Several techniques assessing wear are described, such as changes in surface morphology using optical profilometry and variation in the content of collagen and proteoglycans (PG) in the lubricating solution. Of all these techniques the PG content analysis was found to be the most efficient one.     

Spatial and temporal changes of subchondral bone proceed to articular cartilage degeneration in rats subjected to knee immobilization

This study was aimed to investigate the spatial and temporal changes of subchondral bone and its overlying articular cartilage in rats following knee immobilization. A total of 36 male Wistar rats (11–13 months old) were assigned randomly and evenly into 3 groups. For each group, knee joints in 6 rats were immobilized unilaterally for 1, 4, or 8 weeks, respectively, while the remaining rats were allowed free activity and served as external control groups. For each animal, femurs at both sides were dissected after sacrificed. The distal part of femur was examined by micro‐CT. Subsequently, femoral condyles were collected for further histological observation and analysis. For articular cartilage, significant changes were observed only at 4 and 8 weeks of immobilization. The thickness of articular cartilage and chondrocytes numbers decreased with time. However, significant changes in subchondral bone were defined by micro‐CT following immobilization in a time‐dependent manner. Immobilization led to a thinner and more porous subchondral bone plate, as well as a reduction in trabecular thickness and separation with a more rod‐like architecture. Changes in subchondral bone occurred earlier than in articular cartilage. More importantly, immobilization‐induced changes in subchondral bone may contribute, at least partially, to changes in its overlying articular cartilage. Microsc. Res. Tech. 79:209–218, 2016. © 2016 Wiley Periodicals, Inc.     

Analysis of biphasic lubrication of articular cartilage loaded by cylindrical indenter

Combination of theoretical biphasic analyses and corresponding experimental measurements for articular cartilage has successfully revealed the fundamental material properties and time-depending mechanical behaviors of articular cartilage containing plenty of water. The insight of load partitioning between solid and fluid phases advanced the prediction of the frictional behavior of articular cartilage. One of the recent concerns about biphasic finite element (FE) analysis seems to be a dynamic and physiological condition in terms of mechanical functionality as a load-bearing for articular joint system beyond material testing, which has mainly focused on time-dependent reaction force and deformation in relatively small and low speed compression. Recently, the biphasic FE model for reciprocating sliding motion was applied to confirm the frictional effect on the migrating contact area. The results indicated that the model of a cylindrical indenter sliding over the cartilage surface remarkably sustained the higher proportion of fluid load support than a condition without migrating contact area, but the effectiveness of constitutive material properties has not been sufficiently evaluated for sliding motion. In our present study, at the first stage, the compressive response of the articular cartilage was examined by high precision testing machine. Material properties for the biphasic FE model, which included inhomogeneous apparent Young's modulus of solid phase along depth, strain-dependent permeability and collagen reinforcement in tensile strain, were estimated in cylindrical indentation tests by the curve fitting between the experimental time-dependent behavior and FE model simulation. Then, the biphasic lubrication mechanism of the articular cartilage including migrating contact area was simulated to elucidate functionality as a load-bearing material. The results showed that the compaction effect on permeability of solid phase was functional particularly in the condition without the migrating contact area, whereas in sliding condition the compaction effect did not clearly show its role in terms of the proportion of fluid load support. The reinforcement of solid phase, which represented the collagen network in the tissue, improved the proportion of fluid load support especially in the sliding condition. Thus, a functional integration of constitutive mechanical properties as a load-bearing was evaluated by FE model simulation in this study.     

A spatial model of the knee for the preoperative planning of knee surgery

A model on the spatial mechanical behaviour of the passive knee is presented. The femoral articular surfaces were represented by generalized, sagittally elliptical, toroidal surfaces. The medial and lateral tibial articular surfaces were represented by a dished spherical surface and the lower hemihyperbolic region of a torus respectively. Anatomical articular cartilage, knee ligaments and the posterior capsule were represented by spring-like deformable elements with non-linear load versus deflection characteristics. All the forces that act on the femur relative to the tibia were represented by three orthogonal forces and three associated moments. Spatial, articulation-dependent femorotibial kinematic constraint equations of the passive knee were formulated in an analytically explicit manner, based on the natural coordinates of the articular surfaces. The constraint equations were solved algebraically in closed form. Equations were derived that describe spatial femoro-tibial motion, ligament length, ligament strain, ligament-based elastic potential energy and the quasi-static equilibrium of the passive knee. Software was written, simulations on the motion characteristics and load versus deflection characteristics of the knee were carried out and graphical results were presented. The simulation of planar flexion/extension was almost spontaneous. The time taken to simulate spatial six-degree-of-freedom femoro-tibial motion was less than 2.5 min. The models were found to be capable of representing real-life passive knees to a high degree of satisfaction. It has been demonstrated that the models can provide knee surgeons with additional information on major aspects of the preoperative planning of knee surgery. The models can be used to enhance the preoperative planning of ligament reconstruction, articular surfaces related surgery, osteotomy and patellar tendon transfer surgery.     

Development of artificial articular cartilage

Attempts have been made to develop an artificial articular cartilage on the basis of a new viewpoint of joint biomechanics in which the lubrication and load-bearing mechanisms of natural and artificial joints are compared. Polyvinyl alcohol hydrogel (PVA-H), 'a rubber-like gel', was investigated as an artificial articular cartilage and the mechanical properties of this gel were improved through a new synthetic process. In this article the biocompatibility and various mechanical properties of the new improved PVA-H is reported from the perspective of its usefulness as an artificial articular cartilage. As regards lubrication, the changes in thickness and fluid pressure of the gap formed between a glass plate and the specimen under loading were measured and it was found that PVA-H had a thicker fluid film under higher pressures than polyethylene (PE) did. The momentary stress transmitted through the specimen revealed that PVA-H had a lower peak stress and a longer duration of sustained stress than PE, suggesting a better damping effect. The wear factor of PVA-H was approximately five times that of PE. Histological studies of the articular cartilage and synovial membranes around PVA-H implanted for 8-52 weeks showed neither inflammation nor degenerative changes. The artificial articular cartilage made from PVA-H could be attached to the underlying bone using a composite osteochondral device made from titanium fibre mesh. In the second phase of this work, the damage to the tibial articular surface after replacement of the femoral surface in dogs was studied. Pairs of implants made of alumina, titanium or PVA-H on titanium fibre mesh were inserted into the femoral condyles. The two hard materials caused marked pathological changes in the articular cartilage and menisci, but the hydrogel composite replacement caused minimal damage. The composite osteochondral device became rapidly attached to host bone by ingrowth into the supporting mesh. The clinical implications of the possible use of this material in articular resurfacing and joint replacement are discussed.     

The effect of cartilage deformation on the laxity of the knee joint

In this paper, deformation of the articular cartilage layers is incorporated into an existing two-dimensional quasi-static model of the knee joint. The new model relates the applied force and the joint displacement, as measured in the Lachmann drawer test, and allows the effect of cartilage deformation on the knee joint laxity to be determined. The new model augments the previous knee model by calculating the tibio-femoral contact force subject to an approximate 'thin-layer' constitutive equation, and a method is described for finding the configuration of the knee under a specified load, in terms of a displacement from a zero-load reference configuration. The results show that inclusion of deformable cartilage layers can cause a reduction of between 10 and 35 per cent in the force required to produce a given tibial displacement, over the range of flexion angles considered. The presence of cartilage deformation was found to be an important modifier of the loading response but is secondary to the effect of ligamentous extension. The flexion angle dependence of passive joint laxity is much more strongly influenced by fibre recruitment in the ligaments than by cartilage deformation.     

Immunohistochemical analysis of structural changes in collagen for the assessment of osteoarthritis

Collagen fibrillation within articular cartilage (AC) plays a key role in joint osteoarthritis (OA) progression and, therefore, studying collagen synthesis changes could be an indicator for use in the assessment of OA. Various staining techniques have been developed and used to determine the collagen network transformation under microscopy. However, because collagen and proteoglycan coexist and have the same index of refraction, conventional methods for specific visualization of collagen tissue is difficult. This study aimed to develop an advanced staining technique to distinguish collagen from proteoglycan and to determine its evolution in relation to OA progression using optical and laser scanning confocal microscopy (LSCM). A number of AC samples were obtained from sheep joints, including both healthy and abnormal joints with OA grades 1 to 3. The samples were stained using two different trichrome methods and immunohistochemistry (IHC) to stain both colourimetrically and with fluorescence. Using optical microscopy and LSCM, the present authors demonstrated that the IHC technique stains collagens only, allowing the collagen network to be separated and directly investigated. Fluorescently-stained IHC samples were also subjected to LSCM to obtain three-dimensional images of the collagen fibres. Changes in the collagen fibres were then correlated with the grade of OA in tissue. This study is the first to successfully utilize the IHC staining technique in conjunction with laser scanning confocal microscopy. This is a valuable tool for assessing changes to articular cartilage in OA.     

Effects of ageing on the biomechanical properties of rat articular cartilage

Previous studies have demonstrated that male Sprague Dawley (SD) rats experience age-related bone loss with the same characteristics as that in ageing men. As articular cartilage, like bone, is a critical component of the health and function of the musculoskeletal system, the authors hypothesized that articular cartilage in the untreated male SD rats could be a suitable model for studying the age-related deterioration of articular cartilage in men. To test this hypothesis, male SD rats were killed at between 6 and 27 months. The right femur of each rat was removed. The effects of ageing on the structural integrity of the distal femoral articular cartilage were studied by biomechanical testing with a creep indentation apparatus. The aggregate modulus, Poisson's ratio, permeability, thickness, and percentage recovery of articular cartilage were determined using finite element/non-linear optimization modelling. No significant differences were observed in these biomechanical properties of the distal femoral articular cartilage as a function of age. Therefore, untreated male SD rats appear to be unsuitable for studying the age-related changes of articular cartilage as they occur in men. However, and more intriguingly, it is also possible that ageing does not affect the biomechanical properties of articular cartilage in the absence of cartilage pathology.     

Experimental and numerical investigation of the behaviour of articular cartilage under shear loading—Interstitial fluid pressurisation and lubrication mechanisms

In this paper, the mechanical and frictional responses of articular cartilage when subjected to alternating shearing forces under a constant load were investigated. Shear testing was performed at physiological contact pressures to ascertain the influence of interstitial fluid support on the evolution of frictional forces during cyclic loading.Numerical studies were also performed using the finite element software Abaqus. The tissue was modelled as a biphasic material with strain dependent permeability. The influence of the material characteristics on the lubrication mechanisms occurring when cartilage is subject to compression and shear was studied to corroborate the experimental findings.     

The effect of glycosaminoglycan depletion on the friction and deformation of articular cartilage

Glycosaminoglycans (GAGs) have been shown to be responsible for the interstitial fluid pressurization of articular cartilage and hence its compressive stiffness and load-bearing properties. Contradictory evidence has been presented in the literature on the effect of depleting GAGs on the friction properties of articular cartilage. The aim of this study was to investigate the effect of depleting GAGs on the friction and deformation characteristics of articular cartilage under different tribological conditions. A pin-on-plate machine was utilized to measure the coefficient of friction of native and chondroitinase ABC (CaseABC)-treated articular cartilage under two different models: static (4 mm/s start-up velocity) and dynamic (4 mm/s sliding velocity; 4 mm stroke length) under a load of 25 N (0.4 MPa contact stress) and with phosphate-buffered saline as the lubricant. Indentation tests were carried out at 1 N and 2 N loads (0.14 MPa and 0.28 MPa contact stress levels) to study the deformation characteristics of both native and GAG-depleted cartilage samples. CaseABC treatment rendered the cartilage tissue soft owing to the loss of compressive stiffness and a sulphated-sugar assay confirmed the loss of GAGs from the cartilage samples. CaseABC treatment significantly increased (by more than 50 per cent) the friction levels in the dynamic model (p < 0.05) at higher loading times owing to the loss of biphasic lubrication. CaseABC treatment had no effect on friction in the static model in which the cartilage surfaces did not have an opportunity to recover fluid because of static loading unlike the cartilage tissue in the dynamic model, in which translation of the cartilage surfaces was involved, ensuring effective biphasic lubrication. Therefore the depletion of GAGs had a smaller effect on the coefficient of friction for the static model. Indentation tests showed that GAG-depleted cartilage samples had a lower elastic modulus and higher permeability than native tissue. These results corroborate the role of GAGs in the compressive and friction properties of articular cartilage and emphasize the need for developing strategies to control GAG loss from diseased articular cartilage tissue.     

Morphometric characterization of murine articular cartilage—Novel application of confocal laser scanning microscopy

A new technique for characterization of the three-dimensional morphology of murine articular cartilage is proposed. The technique consists of a novel application of confocal laser scanning microscopy (CLSM), where the objective was to develop and validate it for cartilage measurements in murine joints. Murine models are used in arthritis research, because they are well-described for manipulating the disease pathophysiology, facilitating our understanding of the disease, and identifying new targets for therapy. A calibration and reproducibility study was carried out to provide a consistent testing methodology for quantification of murine joints. The proximal tibial condyles from male C57BL/6 mice were scanned using a CLS microscope with an isotropic voxel size of 5.8 μm. Measurements and analyses were repeated three times on different days, and in a second step the analysis was repeated three times for a single measurement. Calculation of precision errors (coefficient of variation) for cartilage thickness and volume was made. The bias of the system was estimated through comparison with histology. This technique showed good precision, with errors in the repeated analysis ranging from 0.63% (lateral thickness) to 3.48% (medial volume). The repeated analysis alone was robust, with intraclass correlations for the different compartments between 0.918 and 0.991. Measurement bias was corrected by scaling the confocal images to 32% of their width to match histology. CLSM provided a fast and reproducible technique for gathering 3D image data of murine cartilage and will be a valuable tool in understanding the efficacy of arthritis treatments in murine models. Microsc. Res. Tech. 2009. © 2009 Wiley-Liss, Inc.     

Recent developments in the tribology of artificial joints

A history of the tribological development of artificial joints compares how these are lubricated with the mechanisms involved in human joints. It is concluded that while healthy human joints are lubricated by fluid film action, all current artificial joints at best are lubricated by mixed lubrication and hence wear is taking place throughout the life of the prosthesis. A new concept in artificial joints is described. Soft elastic layers simulate articular cartilage and if selected carefully can develop full fluid film lubrication with consequential low friction and minimal wear.