In-Situ Cartilage Functionality Assessment Based on Advanced MRI Techniques and Precise Compartmental Knee Joint Loading through Varus and Valgus Stress

Said, Oliver; Schock, Justus; Abrar, D; Schad, Philipp; Kühl, Christiane; Nolte, Teresa; Knobe, Matthias; Prescher, Andreas; Truhn, Daniel; Nebelung, Sven

doi:10.3390/diagnostics11081476

Cited by 1 publication

(2 citation statements)

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“…According to the above reported findings, the elastic behaviour of AC at the millimetre scale has been primarily evaluated by indentation [89][90][91][92][93][94][95][96][97][98] and compression [92,[98][99][100][101][102][103][104][105][106], followed by tensile [93,107] and shear [103] tests (Table 2).…”

Section: Articular Cartilagementioning

confidence: 99%

“…Delayed gadolinium-enhanced MRI (dGEMRIC), T2, and T1rho are the main sequences allowing to quantitatively evaluate AC, relating the extent of the signal to the tissue composition. dGEMRIC sequences permit an indirect measure of AC GAG content, while T2 and T1rho signals are directly related to free water, indirectly to collagen content and orientation, and inversely to PG/GAG content, respectively [101,[172][173][174]. Such sequences represent a powerful tool not only to investigate AC composition, but also to detect the onset of degenerative pathologies, like OA.…”

Section: Complementary Approaches To Investigate the Oc Unit's Biomec...mentioning

confidence: 99%

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Biomechanics of the Human Osteochondral Unit: A Systematic Review

Berni,

Marchiori,

Baleani

et al. 2024

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The damping system ensured by the osteochondral (OC) unit is essential to deploy the forces generated within load-bearing joints during locomotion, allowing furthermore low-friction sliding motion between bone segments. The OC unit is a multi-layer structure including articular cartilage, as well as subchondral and trabecular bone. The interplay between the OC tissues is essential in maintaining the joint functionality; altered loading patterns can trigger biological processes that could lead to degenerative joint diseases like osteoarthritis. Currently, no effective treatments are available to avoid degeneration beyond tissues’ recovery capabilities. A thorough comprehension on the mechanical behaviour of the OC unit is essential to (i) soundly elucidate its overall response to intra-articular loads for developing diagnostic tools capable of detecting non-physiological strain levels, (ii) properly evaluate the efficacy of innovative treatments in restoring physiological strain levels, and (iii) optimize regenerative medicine approaches as potential and less-invasive alternatives to arthroplasty when irreversible damage has occurred. Therefore, the leading aim of this review was to provide an overview of the state-of-the-art—up to 2022—about the mechanical behaviour of the OC unit. A systematic search is performed, according to PRISMA standards, by focusing on studies that experimentally assess the human lower-limb joints’ OC tissues. A multi-criteria decision-making method is proposed to quantitatively evaluate eligible studies, in order to highlight only the insights retrieved through sound and robust approaches. This review revealed that studies on human lower limbs are focusing on the knee and articular cartilage, while hip and trabecular bone studies are declining, and the ankle and subchondral bone are poorly investigated. Compression and indentation are the most common experimental techniques studying the mechanical behaviour of the OC tissues, with indentation also being able to provide information at the micro- and nanoscales. While a certain comparability among studies was highlighted, none of the identified testing protocols are currently recognised as standard for any of the OC tissues. The fibril-network-reinforced poro-viscoelastic constitutive model has become common for describing the response of the articular cartilage, while the models describing the mechanical behaviour of mineralised tissues are usually simpler (i.e., linear elastic, elasto-plastic). Most advanced studies have tested and modelled multiple tissues of the same OC unit but have done so individually rather than through integrated approaches. Therefore, efforts should be made in simultaneously evaluating the comprehensive response of the OC unit to intra-articular loads and the interplay between the OC tissues. In this regard, a multidisciplinary approach combining complementary techniques, e.g., full-field imaging, mechanical testing, and computational approaches, should be implemented and validated. Furthermore, the next challenge entails transferring this assessment to a non-invasive approach, allowing its application in vivo, in order to increase its diagnostic and prognostic potential.

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