Softening of Canine Articular Cartilage After Immobilization of the Knee Joint

Jurvelin, Jukka S.; Kiviranta, Ilkka; Tammi, M.; Jh, Helminen

doi:10.1097/00003086-198606000-00042

Cited by 129 publications

(89 citation statements)

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“…Many studies have shown that mechanical loading of articular cartilage affects the metabolism of chondrocytes and its biochemical composition [1,32,37]. Both animal and human studies have shown that the GAG content is higher in cartilage that is habitually loaded [19,33] or has a higher level of activity [39], whereas immobilization results in a reversible decrease in cartilage PG content [18,30].…”

Section: Introductionmentioning

confidence: 99%

Does Periacetabular Osteotomy Have Depth-related Effects on the Articular Cartilage of the Hip?

Hingsammer

Miller

Millis

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Osteoarthritis may result from abnormal mechanics leading to biochemically mediated degradation of cartilage. In a dysplastic hip, the periacetabular osteotomy (PAO) is designed to normalize the mechanics and our initial analysis suggests that it may also alter the cartilage biochemical composition. Articular cartilage structure and biology vary with the depth from the articular surface including the concentration of glycosaminoglycans (GAG), which are the charge macromolecules that are rapidly turned over and are lost in early osteoarthritis. Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) enables noninvasive measurement of cartilage GAG content. The dGEMRIC index represents an indirect measure of GAG concentration with lower values indicating less GAG content. GAG content can normally vary with mechanical loading; however, progressive loss of GAG is associated with osteoarthritis. By looking at the changes in amounts of GAG in response to a PAO at different depths of cartilage, we may gain further insights into the types of biologic events that are occurring in the joint after a PAO. Questions/purposes We (1) measured the GAG content in the superficial and deep zones for the entire joint before and after PAO; and (2) investigated if the changes in the superficial and deep zone GAG content after PAO varied with different locations within the joint. Methods This prospective study included 37 hips in 37 patients (mean age 26 ± 9 years) who were treated with periacetabular osteotomy for symptomatic acetabular dysplasia and had preoperative and 1-year follow up dGEMRIC scans. Twenty-eight of the 37 also had 2-year scans. Patients were eligible if they had symptomatic acetabular dysplasia with lateral center-edge angle \ 20°a nd no or minimal osteoarthritis. The change in dGEMRIC after surgery was assessed in the superficial and deep cartilage zones at five acetabular radial planes. Results The mean ± SD dGEMRIC index in the superficial zone fell from 480 ± 137 msec preoperatively to 409 ± 119 msec at Year 1 (95% confidence interval [CI], À87 to À54; p \0.001) and recovered to 451 ± 115 msec at Year 2 (95% CI, 34-65; p \ 0.001), suggesting that there is a transient event that causes the biologically sensitive superficial layer to lose GAG. In the deep acetabular cartilage zone, dGEMRIC index fell from 527 ± 148 msec preoperatively to 468 ± 143 msec at Year 1 (95% CI, À66 to À30; p\0.001) and recovered to 494 ± 125 msec at Year 2 (95% CI, 5-32; p = 0.008). When each acetabular radial plane was looked at separately, the change from before surgery to 1 year after was confined to zones around the superior part of the joint.

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Section: Introductionmentioning

confidence: 99%

Does Periacetabular Osteotomy Have Depth-related Effects on the Articular Cartilage of the Hip?

Hingsammer

Miller

Millis

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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“…However, the results of these animal studies have been highly variable and inconsistent. Jurvelin et al (2), for example, observed a 9% decrease in cartilage thickness in the canine knee after 11 weeks of rigid immobilization. Haapala et al (3) reported a large decrease (ϳ20%) in cartilage of the medial femur, but no changes in cartilage of the lateral tibia and lateral femur (4), of canine knee joints.…”

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confidence: 97%

Longitudinal analysis of cartilage atrophy in the knees of patients with spinal cord injury

Vanwanseele¹,

Eckstein²,

Knecht³

et al. 2003

Arthritis & Rheumatism

138

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Objective. A previous cross-sectional study indicated that the morphology of patellar and tibial cartilage is subject to change after spinal cord injury (SCI). The aim of this study was to perform a longitudinal analysis of cartilage atrophy in all knee compartments, including the femoral condyles, in SCI patients over 12 months.Methods. The right knees of 9 patients with complete, traumatic SCI were examined shortly after the injury (mean ؎ SD 9 ؎ 4 weeks) and at 6 and 12 months postinjury. Three-dimensional morphology of the patellar, tibial, and femoral cartilage (mean and maximum thickness, volume, and surface area) was determined from coronal and transversal magnetic resonance images (fat-suppressed gradient-echo sequences) using validated postprocessing techniques.Results. The mean thickness of knee joint cartilage decreased significantly during the first 6 months after injury (range 5-7%; P < 0.05). The mean change at 12 months was 9% in the patella, 11% in the medial tibia, 11% in the medial femoral condyle, 13% in the lateral tibia, and 10% in the lateral femoral condyle (P < 0.05 for all compartments).Conclusion. This is the first report of a longitudinal analysis of cartilage atrophy in patients with SCI. These data show that human cartilage atrophies in the absence of normal joint loading and movement after SCI, with a rate of change that is higher than that observed in osteoarthritis (OA). A potential clinical implication is that cartilage thinning after SCI may affect the stress distribution in the joint and render it vulnerable to OA. Future studies should focus on whether specific exercise protocols and rehabilitation programs can prevent cartilage thinning.Integrity of the morphologic and mechanical properties of articular cartilage is a prerequisite for appropriate function of diarthrodial joints. As suggested by various animal studies, a certain amount of mechanical loading and movement of the joint is required in order to maintain normal cartilage morphology, biochemical composition, and biomechanical properties (1). However, the results of these animal studies have been highly variable and inconsistent. Jurvelin et al (2), for example, observed a 9% decrease in cartilage thickness in the canine knee after 11 weeks of rigid immobilization. Haapala et al (3) reported a large decrease (ϳ20%) in cartilage of the medial femur, but no changes in cartilage of the lateral tibia and lateral femur (4), of canine knee joints. In contrast, Leroux et al (5) found that a shorter period of nonrigid immobilization (4 weeks) did not change the knee cartilage thickness of the dogs in their study.Spinal cord injury (SCI) causes unloading and restricted movement of the lower limb joints for substantial periods of time. As a consequence, patients with SCI encounter secondary complications, such as decreases in muscle mass, cardiovascular fitness, and bone density (6,7). Radiographic evidence of narrowing of the hip joint space by more than 50% in 25 of 200 patients with flaccid paralysis was identified in one st...

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“…There have been many reports of articular cartilage degeneration after immobilization (Evans et al 1960;Thaxter et al 1965;Jurvelin et al 1986;Behrens et al 1989;Setton et al 1997). Because the method of immobilization and evaluated areas were quite different from study to study, the events that occurred in the joint after immobilization have not been clarified (Haapala et al 1999;Trudel et al 2005).…”

Section: Discussionmentioning

confidence: 99%

“…These severe changes of the articular cartilage may depend on a method of immobilization. Immobilization methods are divided into "non-rigid fixation" using sling, plaster (Roy 1970;Jurvelin et al 1986;Haapala et al 1999) and wire (Akeson et al 1967) or "rigid fixation" using an internal or external fixator (Evans et al 1960;Thaxter et al 1965;Behrens et al 1989). Behrens et al compared degenerative changes of the articular cartilage by cast and external fixator in the canine immobilized knee model, and revealed the changes were more severe in the external fixator group than in the cast group (Behrens et al 1989).…”

Section: Discussionmentioning

confidence: 99%

Intra-articular Injection of Hyaluronan Diminishes Loss of Chondrocytes in a Rat Immobilized-Knee Model

Andõ

Hagiwara

Chimoto

et al. 2008

Tohoku J. Exp. Med.

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Joint immobilization is a useful and common treatment modality in orthopedics. However, it also causes unfavorable outcome such as articular cartilage degeneration. Intra-articular injection of hyaluronan has been accepted as a treatment of osteoarthritis, but its effects on immobilized joint remain to be clarified. Hyaluronan is a polysaccharide, distributed ubiquitously in various tissues. In this study, we examined the effect of hyaluronan on the articular cartilage in immobilized joints. The unilateral knee joints of adult male rats were immobilized at 150° in flexion with an internal plate and screws for 1, 2, 4, 6, 8, 12, or 16 weeks (n = 84). Hyaluronan or saline (50 μ l/each injection) was administered intra-articularly on the day of surgery and once a week. The articular cartilage from the medial midcondylar region of the knee was obtained, and divided into non-contact, contact and transitional areas (between the non-contact and the contact areas). In each area, a degree of degeneration was evaluated by histomorphometric grading, and measurements of thickness and number of chondrocytes. Histological grading scores in the hyaluronan group were smaller at 12 and 16 weeks compared with those in the saline group. The thickness of the articular cartilage increased in the transitional area in both groups. The number of chondrocytes in the contact and transitional areas gradually decreased, but their number in the hyaluronan group was greater at 12 and 16 weeks compared with that in the saline group. Hyaluronan showed chondroprotective effects on the articular cartilage in a rat immobilized-knee model.

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Softening of Canine Articular Cartilage After Immobilization of the Knee Joint

Cited by 129 publications

References 0 publications

Does Periacetabular Osteotomy Have Depth-related Effects on the Articular Cartilage of the Hip?

Does Periacetabular Osteotomy Have Depth-related Effects on the Articular Cartilage of the Hip?

Longitudinal analysis of cartilage atrophy in the knees of patients with spinal cord injury

Intra-articular Injection of Hyaluronan Diminishes Loss of Chondrocytes in a Rat Immobilized-Knee Model

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