Failure properties and strain distribution analysis of meniscal attachments

The menisci are frequently injured due to both degeneration and traumatic tearing. It has been suggested that the success of a meniscal replacement is dependent on several factors, one of which is the secure fixation and firm attachment of the replacement to the tibial plateau. Therefore, the objectives of the current study were to (1) determine the failure properties of the meniscal horn attachments, and (2) determine the strain distribution over their surfaces. Eight bovine knee joints were used to study the mechanical response of the meniscal attachments. Three meniscal attachments from one knee of each animal were tested in uniaxial tension at 2%/s to determine the load deformation response. During the tests, the samples were marked and local strain distributions were determined with a video extensometer. The linear modulus of the medial anterior attachment (154+/-134 MPa) was significantly less than both the medial posterior (248+/-179 MPa, p=0.0111) and the lateral anterior attachment (281+/-214 MPa, p=0.0007). Likewise, the ultimate strain for the medial anterior attachments (13.5+/-8.8%) was significantly less than the medial posterior (23+/-13%, p<0.0001) and the lateral anterior attachment (20.3+/-11.1%, p=0.0033). There were no significant differences in the structural properties or ultimate stress between the meniscal attachments (p>0.05). No significant differences in ultimate strain or moduli across the surface of the attachments were noted. Based on the data obtained, a meniscal replacement would need different moduli for each of the different attachments. However, the attachments appear to be homogeneous.     

Proteoglycans contribute locally to swelling,but globally to compressive mechanics,in intact cervine medial meniscus

Loss of charged proteoglycans in the knee meniscus, which aid in the support of compressive loads by entraining water, is an effect of degeneration and is often associated with osteoarthritis. In healthy menisci, proteoglycan content is highest in the inner white zone and decreases towards the peripheral red zone. We hypothesized that loss of proteoglycans would reduce both osmotic swelling and compressive stiffness, spatially localized to the avascular white zone of the meniscus. This hypothesis was tested by targeted enzymatic digestion of proteoglycans using hyaluronidase in intact cervine medial menisci. Mechanics were quantified by creep indentation on the femoral surface. Osmotic swelling changes were assessed by measuring collagen fiber crimp period in the radial-axial plane in the lamellar layer along both the tibial and femoral contacting surfaces. All measurements were made in the inner, middle, and outer zones of the anterior, central, and posterior regions. Mechanical measurements showed variation in creep behavior with anatomical location, along with spatially uniform decreases in viscosity (average of 21%) and creep stiffness (average of 15%) with hyaluronidase treatment. Lamellar collagen crimp period was significantly decreased (average of 27%) by hyaluronidase, indicating a decrease in osmotic swelling, with the largest decreases seen in locations with the highest proteoglycan content. Taken together, these results suggest that while proteoglycans have localized effects on meniscus swelling, the resulting effect on compressive properties is distributed throughout the tissue.     

Sensitivities of medial meniscal motion and deformation to material properties of articular cartilage, meniscus and meniscal attachments using design of experiments methods

This study investigated the role of the material properties assumed for articular cartilage, meniscus and meniscal attachments on the fit of a finite element model (FEM) to experimental data for meniscal motion and deformation due to an anterior tibial loading of 45 N in the anterior cruciate ligament-deficient knee. Taguchi style L18 orthogonal arrays were used to identify the most significant factors for further examination. A central composite design was then employed to develop a mathematical model for predicting the fit of the FEM to the experimental data as a function of the material properties and to identify the material property selections that optimize the fit. The cartilage was modeled as isotropic elastic material, the meniscus was modeled as transversely isotropic elastic material, and meniscal horn and the peripheral attachments were modeled as noncompressive and nonlinear in tension spring elements. The ability of the FEM to reproduce the experimentally measured meniscal motion and deformation was most strongly dependent on the initial strain of the meniscal horn attachments (epsilon(1H)), the linear modulus of the meniscal peripheral attachments (E(P)) and the ratio of meniscal moduli in the circumferential and transverse directions (E(theta)E(R)). Our study also successfully identified values for these critical material properties (epsilon(1H) = -5%, E(P) = 5.6 MPa, E(theta)E(R) = 20) to minimize the error in the FEM analysis of experimental results. This study illustrates the most important material properties for future experimental studies, and suggests that modeling work of meniscus, while retaining transverse isotropy, should also focus on the potential influence of nonlinear properties and inhomogeneity.     

Scanning electron microscopy study of the meniscus of the knee in patients with anterior cruciate ligament lesions]

In the aim of bringing a contribution to role of the knee menisci and the functional connection between meniscal lesions and knee joint instability, four patients have been studied, who underwent arthroscopy for sub-acute tear of anterior cruciate ligament without clinical or morphological evidence of meniscal pathology. In these patients biopsies have been taken from one of the menisci and processed for the examination by the SEM. As control, meniscal fragments from two healthy knees have been studied from patients who underwent amputation at thigh for accidental trauma with irreparable lesion of femoral artery. In patients affected by ligamentous tear, on the meniscal surface a lot of deposited material appears, as well as many microlesions as clefts or cracking and distortion of superficial collagenous fibers. All described alteration are more evident in the central portion of menisci than in the anterior or posterior horns. The above mentioned patterns suggest a strong correlation of the knee instability due to ligamentous lesions and meniscal degenerative process which would onset before its clinical or macroscopical evidence.     

Effect of meniscus replacement fixation technique on restoration of knee contact mechanics and stability

The menisci are important biomechanical components of the knee. We developed and validated a finite element model of meniscal replacement to assess the effect of surgical fixation technique on contact behavior and knee stability. The geometry of femoral and tibial articular cartilage and menisci was segmented from magnetic resonance images of a normal cadaver knee using MIMICS (Materialise, Leuven, Belgium). A finite element mesh was generated using HyperWorks (Altair Inc, Santa Ana, CA). A finite element solver (Abaqus v6.9, Simulia, Providence, RI) was used to compute contact area and stresses under axial loading and to assess stability (reaction force generated during anteroposterior translation of the femur). The natural and surgical attachments of the meniscal horns and peripheral rim were simulated using springs. After total meniscectomy, femoral contact area decreased by 26% with a concomitant increase in average contact stresses (36%) and peak contact stresses (33%). Replacing the meniscus without suturing the horns did little to restore femoral contact area. Suturing the horns increased contact area and reduced peak contact stresses. Increasing suture stiffness correlated with increased meniscal contact stresses as a greater proportion of tibiofemoral load was transferred to the meniscus. A small incremental benefit was seen of simulated bone plug fixation over the suture construct with the highest stiffness (50 N/mm). Suturing the rim did little to change contact conditions. The nominal anteroposterior stiffness reduced by 3.1 N/mm after meniscectomy. In contrast to contact area and stress, stiffness of the horn fixation sutures had a smaller effect on anteroposterior stability. On the other hand suturing the rim of the meniscus affected anteroposterior stability to a much larger degree. This model emphasizes the importance of the meniscus in knee biomechanics. Appropriate meniscal replacement fixation techniques are likely to be critical to the clinical success of meniscal replacement. While contact conditions are mainly sensitive to meniscus horn fixation, the stability of the knee under anteroposterior shear loads appeared to be more sensitive to meniscal rim fixation. This model may also be useful in predicting the effect of biomaterial mechanical properties and meniscal replacement shape on knee contact conditions.     

How the stiffness of meniscal attachments and meniscal material properties affect tibio-femoral contact pressure computed using a validated finite element model of the human knee joint

In an effort to prevent degeneration of articular cartilage associated with meniscectomies, both meniscal allografts and synthetic replacements are subjects of current interest and investigation. The objectives of the current study were to (1) determine whether a transversely isotropic, linearly elastic, homogeneous material model of the meniscal tissue is necessary to achieve a normal contact pressure distribution on the tibial plateau, (2) determine which material and boundary condition (attachments) parameters affect the contact pressure distribution most strongly, and (3) set tolerances on these parameters to restore the contact pressure distribution to within a specified error. To satisfy these objectives, a finite element model of the tibio-femoral joint of a human cadaveric knee (including both menisci) was used to study the contact pressure distribution on the tibial plateau. To validate the model, the contact pressure distribution on the tibial plateau was measured experimentally in the same knee used to create the model. Within physiologically reasonable bounds on five material parameters and four attachment parameters associated with a meniscal replacement, an optimization was performed under 1200 N of compressive load on the set of nine parameters to minimize the difference between the experimental and model results. The error between the experimental and model contact variables was minimized to 5.4%. The contact pressure distribution of the tibial plateau was sensitive to the circumferential modulus, axial/radial modulus, and horn stiffness, but relatively insensitive to the remaining six parameters. Consequently, both the circumferential and axial/radial moduli are important determinants of the contact pressure distribution, and hence should be matched in the design and/or selection of meniscal replacements. In addition, during surgical implantation of a meniscal replacement, the horns should be attached with high stiffness bone plugs, and the attachments of the transverse ligament and deep medial collateral ligament should be restored to minimize changes in the contact pressure distribution, and thereby possibly prevent the degradation of articular cartilage.     

Mechanical asymmetry during articulation of tibial and femoral cartilages: Local and overall compressive and shear deformation and properties

During knee movement, femoral cartilage articulates against cartilage from the tibial plateau, and the resulting mechanical behavior is yet to be fully characterized. The objectives of this study were to determine (1) the overall and depth-varying axial and shear strains and (2) the associated moduli, of femoral and tibial cartilages during the compression and shearing of apposing tibial and femoral samples. Osteochondral blocks from human femoral condyles (FCs) characterized as normal and donor-matched lateral tibial plateau (TP) were apposed, compressed 13%, and subjected to relative lateral motion. When surfaces began to slide, axial (?E_zz) and shear (E_xz) strains and compressive (E) and shear (G) moduli, overall and as a function of depth, were determined for femoral and tibial cartilages. Tibial ?E_zz was ～2-fold greater than FC ?E_zz near the surface (0.38 versus 0.22) and overall (0.16 versus 0.07). Near the surface, E_xz of TP was 8-fold higher than that of FC (0.41 versus 0.05), while overall E_xz was 4-fold higher (0.09 versus 0.02). For TP and FC, ?E_zz and E_xz were greatest near the surface and decreased monotonically with depth. E for FC was 1.7-fold greater than TP, both near the surface (0.40 versus 0.24 MPa) and overall (0.76 versus 0.47 MPa). Similarly, G was 7-fold greater for FC (0.22 MPa) than TP near the surface (0.03 MPa) and 3-fold higher for FC (0.38 MPa) than TP (0.13 MPa) overall. These results indicate that tibial cartilage deforms and strains more axially and in shear than the apposing femoral cartilage during tibial–femoral articulation, reflecting their respective moduli.     

Glenoid cancellous bone strength and modulus.

The objectives of this study were to determine the strength and modulus of glenoid cancellous bone, including regional variations. The motivations were: to select a suitable bone substitute for standardized testing of glenoid prosthesis loosening, to assist in shoulder prosthesis design and to provide input data for finite element analyses. Ten glenoids from eight cadavers (mean age, 81) were tested by in situ indentation. Mean strength ranged from 6.7 to 17 MPa for the ten glenoids, the overall mean being 10.3 MPa. Mean E moduli ranged from 67 to 171 MPa for the individual glenoids, the overall mean being 99 MPa. These values are likely at the lower end of what would be expected for normal bone since strength and modulus decrease with age and the available specimens were older. These values may be appropriate for prosthesis design, however, since mechanical properties are reduced in rheumatoid arthritic bone. Regional trends were very similar for modulus and strength. The strongest region was postero-superior. The central column, correlating with the keel position in many glenoid components, was weaker than both the anterior and posterior regions but deeper. A large drop in strength and modulus below the subchondral layer emphasizes the importance of maintaining this layer during prosthetic replacement.     

Postnatal deletion of Alk5 gene in meniscal cartilage accelerates age-dependent meniscal degeneration in mice

Activation of transforming growth factor-β (TGF-β) signaling has been used to enhance healing of meniscal degeneration in several models. However, the exact role and molecular mechanism of TGF-β signaling in meniscus maintenance and degeneration are still not understood due to the absence of in vivo evidence. In this study, we found that the expression of activin receptor-like kinases 5 (ALK5) in the meniscus was decreased with the progression of age and/or osteoarthritis induced meniscal degeneration. Col2α1 positive cells were found to be specifically distributed in the superficial and inner zones of the anterior horn, as well as the inner zone of the posterior horn in mice, indicating that Col2α1-CreER^T2 mice can be a used for studying gene function in menisci. Furthermore, we deleted Alk5 in Col2α1 positive cells in meniscus by administering tamoxifen. Alterations in the menisci structure were evaluated histologically. The expression levels of genes and proteins associated with meniscus homeostasis and TGF-β signaling were analyzed by quantitative real-time PCR analysis (qRT-PCR) and immunohistochemistry (IHC). Our results revealed severe and progressive meniscal degeneration phenotype in 3- and 6-month-old Alk5 cKO mice compared with Cre-negative control, including aberrantly increased hypertrophic meniscal cells, severe fibrillation, and structure disruption of meniscus. qRT-PCR and IHC results showed that disruption of anabolic and catabolic homeostasis of chondrocytes may contribute to the meniscal degeneration phenotype observed in Alk5 cKO mice. Thus, TGF-β/ALK5 signaling plays a chondro-protective role in menisci homeostasis, in part, by inhibiting matrix degradation and maintaining extracellular matrix proteins levels in meniscal tissues.     

Mechanical properties of metaphyseal bone in the proximal femur

We used a three-point bending test to investigate the structural behavior of 123 rectangular flat plate specimens harvested from the metaphyseal shell of the cervical and intertrochanteric regions of five fresh/frozen human proximal femora. For comparison purposes, 36 specimens of similar geometry were also fabricated from bone of the femoral diaphysis. All specimens were oriented in either the local longitudinal or transverse directions. The mean longitudinal elastic modulus was 9650 +/- 2410 (SD) MPa and demonstrated a 24% decrease from that measured for the diaphysis (12500 +/- 2140 MPa) using the same testing technique. However, the transverse elastic moduli did not differ significantly between the proximal (5470 +/- 1720 MPa) and diaphyseal (5990 +/- 1520 MPa) specimens. The globally averaged values for the ultimate tensile strengths of the metaphyseal shell were 101 +/- 26 MPa in the longitudinal and 50 +/- 12 MPa in the transverse directions. These compared with diaphyseal values of 128 +/- 16 MPa and 47 +/- 12 MPa, respectively. While these differences were largely due to the reduced density of the proximal specimens, a slight decrease in transverse anisotropy for the proximal specimens was also noted by comparing the ratio of longitudinal to transverse moduli (1.76) and tensile strength (2.02) to the diaphyseal values (2.09 and 2.71, respectively). Use of these data should lead to improved performance of analytical models for the proximal femur, and thus help focus increased attention on the structural contribution of trabecular bone to the strength and rigidity of the proximal femur.     

A new in vivo technique for 3-dimensional analysis of the translation of femoral condyles and the menisci responding to antagonistic muscle forces]

The aim of our study was to develop a 3-D MR-based technique for the analysis of meniscal and femoral translations during flexion of the knee, and under the influence of antagonistic muscle forces in healthy subjects. In an open MR system, 5 knees were examined at 30 degrees and 90 degrees flexion using a T1-weighted 3-D gradient echo sequence. A force of 30 Newtons, first in the extending and then in the flexing direction, was applied to the distal lower leg. After three-dimensional reconstruction, the minimal distances between the centre of the tibial plateau and the posterior edge of the menisci and femoral condyles were determined. At 30 degrees flexion, the minimum distance for the meniscus was larger medially than laterally (23.2 +/- 1.8 mm vs. 16.2 +/- 3.3 mm), and this also applied to the condyles (25.1 +/- 1.5 vs. 19.0 +/- 3.0 mm). During flexion to 90 degrees, a posterior translation of 0.5 +/- 0.2 mm was observed for the lateral, and of 3.4 +/- 1.2 mm for the medial, meniscus. The condyles demonstrated a different posterior translation (lateral 2.2 +/- 0.56 mm; medial 1.8 +/- 1.9 mm). No obvious differences were found between extension and flexion muscle activity for the different positions of the knee. In the present study, a new 3-D technique is presented for the analysis of the femoral and meniscal translation at various positions of the knee, and under muscle activity. The results suggest different translation for the menisci and condyles.     

Age-related changes in the tensile properties of human articular cartilage: a comparative study between the femoral head of the hip joint and the talus of the ankle joint

Specimens of articular cartilage from the superficial and mid-depth zones of the human femoral head and the talus of the ankle joint were tested in tension in planes parallel to the articular surface and parallel to the predominant orientation of the superficial collagen fibrils. The tensile fracture stress of cartilage from both the superficial and mid-depth zones of the femoral head decreased considerably with age. The superficial zone decreased from 33 MPa at 7 years to 10 MPa by the age of 90 years, while the mid-depth zone decreased from 32 MPa at 7 years to 2 MPa by the age of 85 years. In contrast the fracture stress of both levels of cartilage from the talus of the ankle did not decrease significantly with increasing age. The tensile stiffness at 10 MPa of both the superficial and mid-depth zones of the femoral head decreased with age. That of the superficial zone decreased from 150 MPa at 7 years to 80 MPa at 90 years, while the mid-depth zone decreased from 60 MPa at 7 years to 10 MPa at 60 years. The stiffness of talar cartilage from the superficial zone decreased by 20%, while that of the mid-depth zone showed a slight increase in stiffness at 10 MPa with increasing age. There was no significant decrease in the tensile stiffness at 1 MPa with age for either the femoral head or talar cartilage. Based on the results of previous studies it is possible to conclude that the decrease in tensile properties seen in the femoral head results from a deterioration in the tensile properties of the network of collagen fibrils. It is suggested that progressive fatigue failure, perhaps with associated changes in the structure of cartilage due to altered chondrocyte metabolism, causes the reduction in tensile properties with age. The results offer a potential explanation for the observation that osteoarthritis commonly occurs in the hip and knee joints at an increasing incidence as age increases, while the condition only rarely occurs in the ankle joint except as a secondary event to trauma.     

Osmotic loading to determine the intrinsic material properties of guinea pig knee cartilage

Few methods exist to study cartilage mechanics in small animal joints due to the difficulties associated with handling small tissue samples. In this study, we apply an osmotic loading method to quantify the intrinsic material properties of articular cartilage in small animal joints. Cartilage samples were studied from the femoral condyle and tibial plateau of two-month old guinea pigs. Swelling strains were measured using confocal fluorescence scanning microscopy in samples subjected to osmotic loading. A histochemical staining method was developed and calibrated for quantification of negative fixed charge density in guinea pig cartilage. Site-matched swelling strain data and fixed charge density values were then used with a triphasic theoretical model for cartilage swelling to determine the uniaxial modulus of the cartilage solid matrix. Moduli obtained in this study (7.2 MPa femoral condyle; 10.8 MPa, tibial plateau) compare well with previously reported values for the tensile moduli of human and other animal cartilages determined from uniaxial tension experiments. This study provides the first available data for material properties and fixed charge density in cartilage from the guinea pig knee and suggests a promising method for tracking changes in cartilage mechanics in small animal models of degeneration.     

Geometry,time-dependent and failure properties of human meniscal attachments

Meniscectomies have been shown to lead to osteoarthritis and the success of meniscal replacements remains questionable. It has been suggested that the success of a meniscal replacement is dependent on several factors, one of which is the secure fixation and firm attachment of the replacement to the tibial plateau at the horn locations. To aid in the development of meniscal replacements, the objectives of the current study were to determine the time-dependent and failure properties of human meniscal attachments. In contrast to the time-dependent tests, during uniaxial failure testing a charge-coupled video camera was used to document the local strain and linear modulus distribution across the surface of the attachments. The lateral attachments were statistically smaller in cross-sectional area and longer than the medial attachments. The anterior attachments were statistically longer and had a smaller cross-sectional area than the posterior attachments. From the stress relaxation tests, the load and stress relaxation rates of the medial anterior attachment were statistically greater than the medial posterior attachment. There were no significant differences in the creep, structural properties or the ultimate stress between the different attachments. Ultimate strain varied between attachments, as well as along the length of the attachment. Ultimate strain in the meniscus region (10.4±6.9%) and mid-substance region (12.7±16.4%) was smaller than the bony insertion region (32.2±21.5%). The lateral and anterior attachments were also found to have statistically greater strain than the medial and posterior attachments, respectively. The linear modulus was statistically weaker in the bony insertion region (69.7±33.7 MPa) compared to the meniscus region (153±123 MPa) and mid-substance region (195±121 MPa). Overall the anterior attachments (169±130 MPa) were also found to be statistically stronger than the posterior attachments (90.8±64.9 MPa). These results can be used to help design tissue-engineered replacement menisci and their insertions and show the differences in material properties between attachments, as well as within an attachment.     

Stiffness of the ligaments of the human wrist joint.

In the present study the stiffness of the superficial ligaments of 14 human cadaver wrist joints have been determined. In these experiments the tested, fresh-frozen carpal joints are divided into a number of bone-ligament-bone complexes, which are loaded in a tensile testing machine at a rate of 66% of the ligaments' initial length per second to a maximal strain of 15%. From the force-elongation curves and ligament dimensions the tangent moduli for the ligament-bone strips are derived. The results show that, with regard to the tangent modulus, there is not a clear differentiation among ligament strips. Only the dorsal radiotriquetrum ligament (RTD) and the palmar radiocapitate ligament (RCP) appear to consist of a material of a relatively high tangent modulus, about 93 and 83 MPa, respectively. The other seven ligaments tested have similar tangent moduli, ranging from 25 to about 50 MPa.     

T2 Values of Posterior Horns of Knee Menisci in Asymptomatic Subjects

Purpose

The magnetic resonance (MR) T2 value of cartilage is a reliable indicator of tissue properties and therefore may be used as an objective diagnostic tool in early meniscal degeneration. The purpose of this study was to investigate age, gender, location, and zonal differences in MR T2 value of the posterior horns of knee menisci in asymptomatic subjects.

Methods

Sixty asymptomatic volunteers (30 men and 30 women) were enrolled and divided into three different age groups: 20–34, 35–49 and 50–70 years. The inclusion criteria were BMI<30 kg/cm² _, normalized Western Ontario and McMaster Universities (WOMAC) pain score of zero, and no evidence of meniscal and ligamentous abnormalities on routine knee MR imaging. The T2 values were measured on images acquired with a T2-weighted fat-suppressed turbo spin-echo sequence at 3T.

Results

The mean T2 values in both medial and lateral menisci for the 20–34, 35–49, and 50–70 age groups were 9.94 msec±0.94, 10.73 msec±1.55, and 12.36 msec±2.27, respectively, for women and 9.17 msec±0.74, 9.64 msec±0.67, and 10.95 msec±1.33, respectively, for men. The T2 values were significantly higher in the 50–70 age group than the 20–34 age group (P<0.001) and in women than in men (P = 0.001, 0.004, and 0.049 for each respective age group). T2 values were significantly higher in medial menisci than in lateral menisci only in women age 50–70 (3.33 msec, P = 0.006) and in the white zone and red/white zone of the 50–70 and 35–49 age groups than that of the 20–34 age group (2.47, 1.02; 2.77, 1.16 msec, respectively, all P<0.01).

Conclusion

The MR T2 values of the posterior meniscal horns increase with increasing age in women and are higher in women than in men. The age-related rise of T2 values appears to be more severe in medial menisci than in lateral menisci. Differences exist in the white zone and red/white zone.     

In-vitro measurement of static pressure distribution in synovial joints--Part I: Tibial surface of the knee

In this first part of a two-part paper, the results of measurement of static pressure distribution on the tibial surface of the knee are presented. Results with intact menisci have been obtained from 18 specimens. Eight of these specimens were the subject of further measurements following medial meniscectomy. The study has been carried out at various flexion angles of the knee with the joint subjected to a compressive force, with or without an initial passive relative displacement between the joint members. The results indicate that a significant fraction of the joint compressive load is transmitted through the menisci and that total meniscectomy causes a drastic alteration in the pressure distribution on the tibial surface. Clinical implications of these results, in terms of post-meniscectomy degenerative changes and mechanism of meniscal lesions, have been discussed.     

Regional differences of tibial and femoral cartilage in the chondrocyte gene expression,immunhistochemistry and composite in different stages of osteoarthritis

The function of articular cartilage as an avascular tissue is mainly served by collagen type II and proteoglycan molecules. Within this matrix homeostasis between production and breakdown of the matrix is exceptionally sensitive.The current study was conducted to identify regional differences in specific alterations in cartilage composition during the osteoarthritic process of the human knee joint. Therefor the changes in the expression of the key molecules of the extracellular matrix were measured in dependence of the anatomical side (femoral vs tibial) and associated with immunohistochemistry and quantitative measurement.60 serial osteochondral femoral condyle and the tibial plateau samples of patients undergoing implantation of total knee endoprosthesis of areas showing mild (Group A, macroscopically ICRS grade 1b) respectively advanced (Group B, macroscopically ICRS grade 3a/3b) (30 each) osteoarthritis according to the histological-histochemical grading system (HHGS) were compared with 20 healthy biopsies with immunohistochemistry and histology. We quantified our results on the gene expression of collagen type I and II and aggrecan with the help of real-time (RT)-PCR. Proteoglycan content was measured colorometrically.In group A slightly increased colour intensity was found for collagen II in deeper layers, suggesting a persisting but initially still intact repair process. But especially on the medial tibia plateau the initial Col II increase in gene expression is followed by a decrease leading to the lowest over all Col II expression on the medial plateau, here especially in the central part. There in late stage diseases the collagen type I expression was also more pronounced. Markedly decreased safranin O staining intensity was observed in the radial zone and less reduced intensity in the transitional zone with loss of zonal anatomy in 40% of the specimens in group A and all specimens in group B. Correlation between colorometrically analysed proteoglycan GAG content and aggrecan Real Time PCR is mainly weak.Tibial and femoral cartilage in contrast to patellar cartilage both are preferential exposed to compressive stresses, but presence of menisci affects the load distribution at the tibial side, which creates varying conditions for the different cartilage surfaces in the knee.As directly measured Poissońs ratio in tibial cartilage is higher but Youn?s modulus is lower than in femoral cartilage, different resulting feedback amplification loops interact with proceeding cartilage damage. The initial loss of aggrecan may support Matrix metalloproteinases (Mmps) in the access to the collagen network and the considerably differing mechanical properties at both joint surfaces result in varying increased synthesis and release of matrix degrading enzymes.The present study has identified a selection of events which reflect the response of cartilage structure and composite, chondrocytes itself and their productivity to changes in mechanical stress depending on the anatomical site.     

Hyperelastic properties of human meniscal attachments

Meniscal attachments are ligamentous tissues anchoring the menisci to the underlying subchondral bone. Currently little is known about the behavior of meniscal attachments, with only a few studies quantitatively documenting their properties. The objective of this study was to quantify and compare the tensile mechanical properties of human meniscal attachments in the transverse direction, curve fit experimental Cauchy stress-stretch data to evaluate the hyperelastic behavior, and couple these results with previously obtained longitudinal data to generate a more complete constitutive model. Meniscal attachment specimens were tested using a uniaxial tension test with the collagen fibers oriented perpendicular to the loading axis. Tests were run until failure and load-optical displacement data was recorded for each test. The medial posterior attachment was shown to have a significantly greater elastic modulus (6.42±0.78 MPa) and ultimate stress (1.73±0.32 MPa) when compared to the other three attachments. The Mooney-Rivlin material model was selected as the best fit for the transverse data and used in conjunction with the longitudinal data. A novel computational approach to determining the transition point between the toe and linear regions is presented for the hyperelastic stress-stretch curves. Results from piece-wise non-linear longitudinal curve fitting correlate well with previous linear elastic and SEM findings. These data can be used to advance the design of meniscal replacements and improve knee joint finite element models.     

Radial fibre proportions in human knee joint menisci. Measurement by scanning optical microscopy

The proportions of medial and lateral knee joint menisci represented by radially orientated collagen (COL) were measured in 42 specimens from 24 hospital patients examined post-mortem. Images of the fibre bundles were obtained by the 488-nm laser confocal scanning of hydrated, fixed radial blocks taken from the anterior, middle and posterior regions of the menisci after staining with picro-Sirius red. Measurements of the percentage of each image occupied by fluorescent, doubly refractile COL were made by means of a Kontron IBAS image analyser, after interactive segmentation. In areas adjoining the outer, lateral parts of both the medial and lateral menisci, the proportion of all samples identified as radial COL was 7.56 +/- 0.28%. The corresponding figure for areas near the inner, medial edges of the menisci was 17.80 +/- 0.80%. However, no relationship was demonstrable between age and sex and meniscal radial fibre optical density, and there was no difference between the proportion of radial fibres in the anterior, middle or posterior regions.