Grading cartilage damage with diffuse reflectance spectroscopy: Optical markers and mechanical properties

Osteoarthritis (OA) is one of the most common joint diseases worldwide. Unfortunately, clinical methods lack the ability to detect OA in the early stages. Timely detection of the knee joint degradation at the level of tissue changes can prevent its progressive damage. Here, diffuse reflectance spectroscopy (DRS) in the NIR range was used to obtain optical markers of the cartilage damage grades and to assess its mechanical properties. It was observed that the water content obtained by DRS strongly correlates with the cartilage thickness (R = .82) and viscoelastic relaxation time (R = .7). Moreover, the spectral parameters, including water content (OH-band), protein content (CH-band), and scattering parameters allowed for discrimination between the cartilage damage grades (10⁻⁴ < P ≤ 10⁻³). The developed approach may become a valuable addition to arthroscopy, helping to identify lesions at the microscopic level in the early stages of OA and complement the surgical analysis.     

Effects of femoral component placement on the balancing of a total knee at surgery

Misalignment and soft-tissue imbalance in total knee arthroplasty (TKA) can cause discomfort, pain, inadequate motion and instability that may require revision surgery. Balancing can be defined as equal collateral ligament tensions or equal medial and lateral compartmental forces during the flexion range. Our goal was to study the effects on balancing of linear femoral component misplacements (proximal, distal, anterior, posterior); and different component rotations in mechanical alignment compared to kinematic alignment throughout the flexion path. A test rig was constructed such that the position of a standard femoral component could be adjusted to simulate the linear and rotational positions. With the knee in neutral reference values of the collateral tensions were adjusted to give anatomic contact force patterns, measured with an instrumented tibial trial. The deviations in the forces for each femoral component position were then determined. Compartmental forces were significantly influenced by 2 mm linear errors in the femoral component placement. However, the errors were least for a distal error, equivalent to undercutting the distal femur. The largest errors mainly increase the lateral condyle force, occurred for proximal and posterior component errors. There were only small contact force differences between kinematic and mechanical alignment. Based on these results, surgeons should avoid overcutting the distal femur and undercutting the posterior femur. However, the 2–3 degrees varus slope of the joint line as in kinematic alignment did not have much effect on balancing, so mechanical or kinematic alignment were equivalent.     

Quantification of soft tissue balance in total knee arthroplasty using finite element analysis

Unbalanced contact force on the tibial component has been considered a factor leading to loosening of the implant and increased wear of the bearing surface in total knee arthroplasty. Because it has been reported that good alignment cannot guarantee successful clinical outcomes, the soft tissue balance should be checked together with the alignment. Finite element models of patients' lower extremities were developed to analyse the medial and lateral contact force distribution on the tibial insert. The distributions for four out of five patients were not balanced equally, even though the alignment angles were within a clinically acceptable range. Moreover, the distribution was improved by changing soft tissue release and ligament tightening for the specific case. Integration of the biomechanical modelling, image matching and finite element analysis techniques with the patient-specific properties and various dynamic loading would suggest a clinically relevant pre-operative planning for soft tissue balancing.     

Repeatability and precision of a weighted centroid method for estimating dynamic in vivo tibiofemoral surface interactions in sheep

Persistent changes in joint biomechanics resulting from knee injury are thought to contribute to progressive cartilage damage and post-traumatic osteoarthritis (PTOA). The identification and quantification of in vivo tibiofemoral surface interactions are critical to understanding them, particularly abnormal interactions that are damaging to articular cartilage and other structures of the knee. In this study, we describe an approach for understanding such potential interactions by using a weighted centroid derived from in vivo stifle kinematics in sheep. Collectively, repeatability and sensitivity analyses indicate that the magnitude of the changes in tibiofemoral centroid location resulting from combined ligament transection is greater than the repeatability and precision of the current weighted centroid approach, making this method useful for describing the changes in dynamic surface interactions that may be relevant in the pathogenesis of PTOA in this stifle injury model.     

CircSLC7A2 protects against osteoarthritis through inhibition of the miR‐4498/TIMP3 axis

ObjectivesCircular RNAs (circRNAs) are noncoding RNAs that compete against other endogenous RNA species, such as microRNAs, and have been implicated in many diseases. In this study, we investigated the role of a new circRNA (circSLC7A2) in osteoarthritis (OA).Materials and MethodsThe relative expression of circSLC7A2 was significantly lower in OA tissues than it was in matched controls, as shown by real‐time quantitative polymerase chain reaction (RT‐qPCR). Western blotting, RT‐qPCR and immunofluorescence experiments were employed to evaluate the roles of circSLC7A2, miR‐4498 and TIMP3. The in vivo role and mechanism of circSLC7A2 were also conformed in a mouse model.ResultscircSLC7A2 was decreased in OA model and the circularization of circSLC7A2 was regulated by FUS. Loss of circSLC7A2 reduced the sponge of miR‐4498 and further inhibited the expression of TIMP3, subsequently leading to an inflammatory response. We further determined that miR‐4498 inhibitor reversed circSLC7A2‐knockdown‐induced OA phenotypes. Intra‐articular injection of circSLC7A2 alleviated in vivo OA progression in a mouse model of anterior cruciate ligament transection (ACLT).ConclusionsThe circSLC7A2/miR‐4498/TIMP3 axis of chondrocytes catabolism and anabolism plays a critical role in OA development. Our results suggest that circSLC7A2 may serve as a new therapeutic target for osteoarthritis.