低强度脉冲超声在骨关节炎研究中的应用进展

骨关节炎（osteoarthritis，OA）是一种退行性关节疾病，以软骨变性、骨硬化和慢性滑膜炎症为主要病理特征。关节置换术是目前治疗终末期OA的唯一有效方式，但其预后较差，且人工关节寿命有限。因此，OA的研究重点已经转移为疾病预防和早期治疗。低强度脉冲超声（low-intensity pulsed ultrasound，LIPUS）不仅可以促进骨折的愈合和再生，而且在软组织修复、再生和抗炎等方面也发挥重要作用，已有研究证明LIPUS在软组织再生中具有潜在作用。简要介绍了LIPUS的治疗机制及其与OA发病机制的联系，总结了目前LIPUS用于预防OA的发生、发展以及促进关节软骨组织再生的基础和临床研究进展，以期为LIPUS未来做为预防关节软骨退变的潜在治疗方法提供理论依据。     

Muscle-driven finite element simulation of human foot movements

This paper describes a finite element scheme for realistic muscle-driven simulation of human foot movements. The scheme is used to simulate human ankle plantar flexion. A three-dimensional anatomically detailed finite element model of human foot and lower leg is developed and the idea of generating natural foot movement based entirely on the contraction of the plantar flexor muscles is used. The bones, ligaments, articular cartilage, muscles, tendons, as well as the rest soft tissues of human foot and lower leg are included in the model. A realistic three-dimensional continuum constitutive model that describes the biomechanical behaviour of muscles and tendons is used. Both the active and passive properties of muscle tissue are accounted for. The materials for bones and ligaments are considered as homogeneous, isotropic and linearly elastic, whereas the articular cartilage and the rest soft tissues (mainly fat) are defined as hyperelastic materials. The model is used to estimate muscle tissue deformations as well as stresses and strains that develop in the lower leg muscles during plantar flexion of the ankle. Stresses and strains that develop in Achilles tendon during such a movement are also investigated.     

Muscle-driven finite element simulation of human foot movements

This paper describes a finite element scheme for realistic muscle-driven simulation of human foot movements. The scheme is used to simulate human ankle plantar flexion. A three-dimensional anatomically detailed finite element model of human foot and lower leg is developed and the idea of generating natural foot movement based entirely on the contraction of the plantar flexor muscles is used. The bones, ligaments, articular cartilage, muscles, tendons, as well as the rest soft tissues of human foot and lower leg are included in the model. A realistic three-dimensional continuum constitutive model that describes the biomechanical behaviour of muscles and tendons is used. Both the active and passive properties of muscle tissue are accounted for. The materials for bones and ligaments are considered as homogeneous, isotropic and linearly elastic, whereas the articular cartilage and the rest soft tissues (mainly fat) are defined as hyperelastic materials. The model is used to estimate muscle tissue deformations as well as stresses and strains that develop in the lower leg muscles during plantar flexion of the ankle. Stresses and strains that develop in Achilles tendon during such a movement are also investigated.     

A Mathematical Formulation for 3D Quasi-Static Multibody Models of Diarthrodial Joints

This study describes a general set of equations for quasi-static analysis of three-dimensional multibody systems, with a particular emphasis on modeling of diarthrodial joints. The model includes articular contact, muscle forces, tendons and tendon pulleys, ligaments, and the wrapping of soft tissue structures around bone and cartilage surfaces. The general set of equations governing this problem are derived using a consistent notation for all types of links, which can be converted conveniently into efficient computer codes. The computational efficiency of the model is enhanced by the use of analytical Jacobians, particularly in the analysis of articular surface contact and wrapping of soft tissue structures around bone and cartilage surfaces. The usefulness of the multibody model is demonstrated by modeling the patellofemoral joint of six cadaver knees, using cadaver-specific data for the articular surface and bone geometries, as well as tendon and ligament insertions and muscle lines of actions. Good accuracy was observed when comparing the model patellar kinematic predictions to experimental data (mean +/- stand. dev. error in translation: 0.63 +/- 1.19 mm, 0.10 +/- 0.71 mm, -0.29 +/- 0.84 mm along medial, proximal, and anterior directions, respectively; in rotation: -1.41 +/- 1.71 degrees, 0.27 +/- 2.38 degrees, -1.13 +/- 1.83 degrees in flexion, tilt and rotation, respectively). The accuracy which can be achieved with this type of model, and the computational efficiency of the algorithm employed in this study may serve in many applications such as computer-aided surgical planning, and real-time computer-assisted surgery in the operating room.     

A Mathematical Formulation for 3D Quasi-Static Multibody Models of Diarthrodial Joints

This study describes a genera] set of equations for quasi-static analysis of three-dimensional multibody systems, with a particular emphasis on modeling of diarthrodial joints. The model includes articular contact, muscle forces, tendons and tendon pulleys, ligaments, and the wrapping of soft tissue structures around bone and cartilage surfaces. The general set of equations governing this problem are derived using a consistent notation for all types of links, which can be converted conveniently into efficient computer codes. The computational efficiency of the model is enhanced by the use of analytical Jacobians, particularly in the analysis of articular surface contact and wrapping of soft tissue structures around bone and cartilage surfaces. The usefulness of the multibody model is demonstrated by modeling the patellofemoral joint of six cadaver knees, using cadaver-specific data for the articular surface and bone geometries, as well as tendon and ligament insertions and muscle lines of actions. Good accuracy was observed when comparing the model patellar kinematic predictions to experimental data (mean ± stand, dev. error in translation: 0.63 ± 1.19 mm, 0.10 ± 0.71 mm, -0.29 ± 0.84 mm along medial, proximal, and anterior directions, respectively; in rotation: -1.41 ± 1.71°, 0.27 ±2.38°, -1.13 ± 1.83° in flexion, tilt and rotation, respectively). The accuracy which can be achieved with this type of model, and the computational efficiency of the algorithm employed in this study may serve in many applications such as computer-aided surgical planning, and real-time computer-assisted surgery in the operating room.     

The effect of storage on the biomechanical behavior of articular cartilage--a large strain study.

The transplantation of stored shell osteochondral allografts is a potentially useful alternative to total joint replacements for the treatment of joint ailments. The maintenance of normal cartilage properties of the osteochondral allografts during storage is important for the allograft to function properly and survive in the host joint. Since articular cartilage is normally under large physiological stresses, this study was conducted to investigate the biomechanical behavior under large strain conditions of cartilage tissue stored for various time periods (i.e., 3, 7, 28, and 60 days) in tissue culture media. A biphasic large strain theory developed for soft hydrated connective tissues was used to describe and determine the biomechanical properties of the stored cartilage. It was found that articular cartilage stored for up to 60 days maintained the ability to sustain large compressive strains of up to 40 percent or more, like normal articular cartilage. Moreover, the equilibrium stress-strain behavior and compressive modulus of the stored articular cartilage were unchanged after up to 60 days of storage.     

Standardizing a protocol of magnetic resonance imaging of temporomandibular joints. Part 2. Unification of analysis of obtained data

The paper presents a unified protocol for analyzing the data obtained by magnetic resonance tomography, which has been used to examine 350 patients. It characterizes the MR semiotics of different pathological conditions of articular structures, which are illustrated by MR images. An optimal terminology is proposed for the evaluation of bone and soft tissue changes.     

Effects of friction on the unconfined compressive response of articular cartilage: a finite element analysis

A finite element analysis is used to study a previously unresolved issue of the effects of platen-specimen friction on the response of the unconfined compression test; effects of platen permeability are also determined. The finite element formulation is based on the linear KLM biphasic model for articular cartilage and other hydrated soft tissues. A Galerkin weighted residual method is applied to both the solid phase and the fluid phase, and the continuity equation for the intrinsically incompressible binary mixture is introduced via a penalty method. The solid phase displacements and fluid phase velocities are interpolated for each element in terms of unknown nodal values, producing a system of first order differential equations which are solved using a standard numerical finite difference technique. An axisymmetric element of quadrilateral cross-section is developed and applied to the mechanical test problem of a cylindrical specimen of soft tissue in unconfined compression. These studies show that interfacial friction plays a major role in the unconfined compression response of articular cartilage specimens with small thickness to diameter ratios.     

The functional environment of chondrocytes within cartilage subjected to compressive loading: a theoretical and experimental approach

A non-invasive methodology (based on video microscopy, optimized digital image correlation and thin plate spline smoothing technique) has been developed to determine the intrinsic tissue stiffness (H(a)) and the intrinsic fixed charge density (c(0)(F)) distribution for hydrated soft tissues such as articular cartilage. Using this technique, the depth-dependent inhomogeneous parameters H(a)(z) and c(0)(F)(z) were determined for young bovine cartilage and incorporated into a triphasic mixture model. This model was then used to predict the mechanical and electrochemical events (stress, strain, fluid/osmotic pressure, and electrical potentials) inside the tissue specimen under a confined compression stress relaxation test. The integration of experimental measurements with theoretical analyses can help to understand the unique material behaviors of articular cartilage. Coupled with biological assays of cell-scale biosynthesis, there is also a great potential in the future to study chondrocyte mechanotransduction in situ with a new level of specificity.     

Towards an analytical model of soft biological tissues

In the past years, soft-tissue modelling research has seen substantial developments, a significant part of which can be ascribed to the refinement of numerical techniques, such as Finite Element analysis. A large class of physico-mechanical properties can be effectively simulated and predictions can be made for a variety of phenomena. However, there is still much that can be conceptually explored by means of fundamental theoretical analysis. In the past few years, driven by our interest in articular cartilage mechanics, we have developed theoretical microstructural models for linear elasticity and permeability that accounted for the presence and arrangement of collagen fibres in cartilage. In this paper, we investigate analytically the non-linear elasticity of soft tissues with collagen fibres arranged according to a given distribution of orientation, a problem that, aside from the case of fibres aligned in a finite number of distinct directions, has been treated exclusively numerically in the literature. We show that, for the case of a tissue with complex fibre arrangement, such as articular cartilage, the theoretical framework commonly used leads to an integral expression of the elastic strain energy potential. The present model is a first attempt in the development of a unified analytical microstructural model for non-linear elasticity and permeability of hydrated, fibre-reinforced soft tissues.     

Ultrasonic measurement of depth-dependent transient behaviors of articular cartilage under compression

We previously reported an ultrasound method for measuring the depth-dependent equilibrium mechanical properties of articular cartilage using quasi-static compression. The objective of this paper was to introduce our recent development for nondestructively measuring the transient depth-dependent strains of full-thickness articular cartilage specimens prepared from bovine patellae. A 50 MHz focused ultrasound transducer was used to collect ultrasound echoes from articular cartilage specimens (n=8) and sponge phantoms with open pores (n=10) during tests of compression and subsequent stress-relaxation. The transient displacements of the tissues at different depths along the compression direction were calculated from the ultrasound echoes using a cross-correlation tracking technique. An LVDT sensor and a load cell were used to measure the overall deformation of the tissue and the applied force, respectively. Results showed that the tissues inside the cartilage layer continued to move during the stress-relaxation phase after the compression was completed. In the equilibrium state, the displacements of the cartilage tissues at the depths of 1/4, 1/2, and 3/4 of the full-thickness reduced by 51%+/-22%, 54%+/-17%, and 50+/-17%, respectively, in comparison with its peak value. However, no similar phenomenon was observed in the sponge phantoms. Our preliminary results demonstrated that this ultrasound method may provide a potential tool for the nondestructive measurement of the transient depth-dependent processes involved in biological and bioengineered soft tissues as well as soft biomaterials under dynamic loading.     

Depth-dependent biomechanical and biochemical properties of fetal, newborn, and tissue-engineered articular cartilage

Adult articular cartilage has depth-dependent mechanical and biochemical properties which contribute to zone-specific functions. The compressive moduli of immature cartilage and tissue-engineered cartilage are known to be lower than those of adult cartilage. The objective of this study was to determine if such tissues exhibit depth-dependent compressive properties, and how these depth-varying properties were correlated with cell and matrix composition of the tissue. The compressive moduli of fetal and newborn bovine articular cartilage increased with depth (p<0.05) by a factor of 4-5 from the top 0.1 mm (28+/-13 kPa, 141+/-10 kPa, respectively) to 1 mm deep into the tissue. Likewise, the glycosaminoglycan and collagen content increased with depth (both p<0.001), and correlated with the modulus (both p<0.01). In contrast, tissue-engineered cartilage formed by either layering or mixing cells from the superficial and middle zone of articular cartilage exhibited similarly soft regions at both construct surfaces, as exemplified by large equilibrium strains. The properties of immature cartilage may provide a template for developing tissue-engineered cartilage which aims to repair cartilage defects by recapitulating the natural development and growth processes. These results suggest that while depth-dependent properties may be important to engineer into cartilage constructs, issues other than cell heterogeneity must be addressed to generate such tissues.     

Magnetic resonance imaging in psoriatic arthritis: a review of the literature

Psoriatic arthritis is a diverse condition that may be characterized by peripheral inflammatory arthritis, axial involvement, dactylitis and enthesitis. Magnetic resonance imaging (MRI) allows visualization of soft tissue, articular and entheseal lesions, and provides a unique picture of the disease process that cannot be gained using other imaging modalities. This review focuses on the literature on MRI in psoriatic arthritis published from 1996 to July 2005. The MRI features discussed include synovitis, tendonitis, dactylitis, bone oedema, bone erosions, soft tissue oedema, spondylitis/sacroiliitis and subclinical arthropathy. Comparisons have been drawn with the more extensive literature describing the MRI features of rheumatoid arthritis and ankylosing spondylitis.     

Dehydration rates of meniscus and articular cartilage in vitro using a fast and accurate laser-based coordinate digitizing system

When used in in vitro studies, soft tissues such as the meniscus and articular cartilage are susceptible to dehydration and its effects, such as changes in size and shape as well as changes in structural and material properties. To quantify the effect of dehydration on the meniscus and articular cartilage, the first two objectives of this study were to (1) determine the percent change in meniscal dimensions over time due to dehydration, and (2) determine the percent change in articular cartilage thickness due to dehydration. To satisfy these two objectives, the third objective was to develop a new laser-based three-dimensional coordinate digitizing system (3-DCDS II) that can scan either the meniscus or articular cartilage surface within a time such that there is less than a 5% change in measurements due to dehydration. The new instrument was used to measure changes in meniscal and articular cartilage dimensions of six cadaveric specimens, which were exposed to air for 120 and 130 min, respectively. While there was no change in meniscal width, meniscal height decreased linearly by 4.5% per hour. Articular cartilage thickness decreased nonlinearly at a rate of 6% per hour after 10 min, and at a rate of 16% per hour after 130 min. The system bias and precision of the new instrument at 0 degrees slope of the surface being scanned were 0.0 and 2.6 microm, respectively, while at 45 degrees slope the bias and precision were 31.1 and 22.6 microm, respectively. The resolution ranged between 200 and 500 microm. Scanning an area of 60 x 80 mm (approximately the depth and width of a human tibial plateau) took 8 min and a complete scan of all five sides of a meniscus took 24 min. Thus, the 3-DCDS II can scan an entire meniscus with less than 2% change in dimensions due to dehydration and articular cartilage with less than 0.4% change. This study provides new information on the amount of time that meniscal tissue and articular cartilage can be exposed to air before marked changes in size and shape, and possibly biomechanical, structural and material properties, occur. The new 3-DCDS II designed for this study provides fast and accurate dimensional measurements of both soft and hard tissues.     

Articular soft tissue anatomy of the archosaur hip joint: Structural homology and functional implications

Archosaurs evolved a wide diversity of locomotor postures, body sizes, and hip joint morphologies. The two extant archosaurs clades (birds and crocodylians) possess highly divergent hip joint morphologies, and the homologies and functions of their articular soft tissues, such as ligaments, cartilage, and tendons, are poorly understood. Reconstructing joint anatomy and function of extinct vertebrates is critical to understanding their posture, locomotor behavior, ecology, and evolution. However, the lack of soft tissues in fossil taxa makes accurate inferences of joint function difficult. Here, we describe the soft tissue anatomies and their osteological correlates in the hip joint of archosaurs and their sauropsid outgroups, and infer structural homology across the extant taxa. A comparative sample of 35 species of birds, crocodylians, lepidosaurs, and turtles ranging from hatchling to skeletally mature adult were studied using dissection, imaging, and histology. Birds and crocodylians possess topologically and histologically consistent articular soft tissues in their hip joints. Epiphyseal cartilages, fibrocartilages, and ligaments leave consistent osteological correlates. The archosaur acetabulum possesses distinct labrum and antitrochanter structures on the supraacetabulum. The ligamentum capitis femoris consists of distinct pubic‐ and ischial attachments, and is homologous with the ventral capsular ligament of lepidosaurs. The proximal femur has a hyaline cartilage core attached to the metaphysis via a fibrocartilaginous sleeve. This study provides new insight into soft tissue structures and their osteological correlates (e.g., the antitrochanter, the fovea capitis, and the metaphyseal collar) in the archosaur hip joint. The topological arrangement of fibro‐ and hyaline cartilage may provide mechanical support for the chondroepiphysis. The osteological correlates identified here will inform systematic and functional analyses of archosaur hindlimb evolution and provide the anatomical foundation for biomechanical investigations of joint tissues. J. Morphol. 276:601–630, 2015. © 2014 Wiley Periodicals, Inc.     

A linearized formulation of triphasic mixture theory for articular cartilage,and its application to indentation analysis

The negative charges on proteoglycans significantly affect the mechanical behaviors of articular cartilage. Mixture theories, such as the triphasic theory, can describe quantitatively how this charged nature contributes to the mechano-electrochemical behaviors of such tissue. However, the mathematical complexity of the theory has hindered its application to complicated loading profiles, e.g., indentation or other multi-dimensional configurations. In this study, the governing equations of triphasic mixture theory for soft tissue were linearized and dramatically simplified by using a regular perturbation method and the use of two potential functions. We showed that this new formulation can be used for any axisymmetric problem, such as confined or unconfined compressions, hydraulic perfusion, and indentation. A finite difference numerical program was further developed to calculate the deformational, electrical, and flow behaviors inside the articular cartilage under indentation. The calculated tissue response was highly consistent with the data from indentation experiments (our own and those reported in the literature). It was found that the charged nature of proteoglycans can increase the apparent stiffness of the solid matrix and lessen the viscous effect introduced by fluid flow. The effects of geometric and physical properties of indenter tip, cartilage thickness, and that of the electro-chemical properties of cartilage on the resulting deformation and fluid pressure fields across the tissue were also investigated and presented. These results have implications for studying chondrocyte mechanotransduction in different cartilage zones and for tissue engineering designs or in vivo cartilage repair.     

Tooth Eruption Results from Bone Remodelling Driven by Bite Forces Sensed by Soft Tissue Dental Follicles: A Finite Element Analysis

Intermittent tongue, lip and cheek forces influence precise tooth position, so we here examine the possibility that tissue remodelling driven by functional bite-force-induced jaw-strain accounts for tooth eruption. Notably, although a separate true ‘eruptive force’ is widely assumed, there is little direct evidence for such a force. We constructed a three dimensional finite element model from axial computerized tomography of an 8 year old child mandible containing 12 erupted and 8 unerupted teeth. Tissues modelled included: cortical bone, cancellous bone, soft tissue dental follicle, periodontal ligament, enamel, dentine, pulp and articular cartilage. Strain and hydrostatic stress during incisive and unilateral molar bite force were modelled, with force applied via medial and lateral pterygoid, temporalis, masseter and digastric muscles. Strain was maximal in the soft tissue follicle as opposed to surrounding bone, consistent with follicle as an effective mechanosensor. Initial numerical analysis of dental follicle soft tissue overlying crowns and beneath the roots of unerupted teeth was of volume and hydrostatic stress. To numerically evaluate biological significance of differing hydrostatic stress levels normalized for variable finite element volume, ‘biological response units’ in Nmm were defined and calculated by multiplication of hydrostatic stress and volume for each finite element. Graphical representations revealed similar overall responses for individual teeth regardless if incisive or right molar bite force was studied. There was general compression in the soft tissues over crowns of most unerupted teeth, and general tension in the soft tissues beneath roots. Not conforming to this pattern were the unerupted second molars, which do not erupt at this developmental stage. Data support a new hypothesis for tooth eruption, in which the follicular soft tissues detect bite-force-induced bone-strain, and direct bone remodelling at the inner surface of the surrounding bony crypt, with the effect of enabling tooth eruption into the mouth.     

Genotype–environment interaction and the ontogeny of diet-induced phenotypic plasticity in size and shape of Melanoplus femurrubrum (Orthoptera: Acrididae)

The developmental origin of phenotypic plasticity in morphological shape can be attributed to environment-specific changes in growth of overall body size, localized growth of a morphological structure or a combination of both. I monitored morphological development in the first four nymphal instars of grasshoppers (Melanoplus femurrubrum) raised on two different plant diets to determine the ontogenetic origins of diet-induced phenotypic plasticity and to quantify genetic variation for phenotypic plasticity. I measured diet-induced phenotypic plasticity in body size (tibia length), head size (articular width and mandible depth) and head shape (residual articular width and residual mandible depth) for grasshoppers from 37 full-sib families raised on either a hard plant diet (Lolium perenne) or a soft plant diet (Trifolium repens). By the second to third nymphal instar, grasshoppers raised on a hard plant diet had significantly smaller mean tibia length and greater mean residual articular width (distance between mandibles adjusted for body size) compared with full-sibs raised on a soft plant diet. However, there was no significant phenotypic plasticity in mean unadjusted articular width and mandible depth, and in mean residual mandible depth. At the population level, development of diet-induced phenotypic plasticity in grasshopper head shape is mediated by plastic changes in allocation to tissue growth that maintain growth of head size on hard, low-nutrient diets while reducing growth of body size. Within the population, there was substantial variation in the plasticity of growth trajectories since different full-sib families developed phenotypic plasticity of residual articular width through different combinations of head and body size growth. Genetic variation for diet-induced phenotypic plasticity of residual articular width, residual mandible depth and tibia length, as estimated by genotype–environment interaction, exhibited significant fluctuation through ontogeny (repeated measures MANOVA , family × plant × instar, P < 0.01). For example, there was significant genetic variation for phenotypic plasticity of residual articular width in the third nymphal instar, but not earlier or later in ontogeny. The observed patterns of genetic variation are discussed with reference to short-term constraints and the evolution of phenotypic plasticity.