Effect of distraction arthroplasty on osteoarthritic goat models of the articular cartilage
Abstract
Background: Osteoarthritis (OA) is the most common knee degenerative disease, the number of OA patients increases along with the increase of life expectancy. Distraction arthroplasty is a less invasive alternatif for OA management by releaving mechanical stress while maintaining intermitten joint fluid pressure changes, thus halting the OA destructive cycle and inducing repair. This study aims to evaluate the anatomical and histopathological changes after distraction arthroplasty on osteoarthritic animal models.
Methods: The study was performed on 32 goat stiffle joint (16 goats) with mechanically induced OA by lateral meniscectomy. During the study 6 goats were decreased. Distraction arthroplasty was performed using external fixation on 10 knees for 4 weeks, and the contralateral knees left untreated. The knees were anatomically and histopathologically examined using International Cartilage Repair Society (ICRS) staging and Osteoarthritis Research Society International (OARSI) scoring. The differences of the anatomical and histopathological changes are tested for significance using the Wilcoxon test.
Results: There was anatomical and histopathological worsening of the OA on treated knees. The anatomical difference assessed using ICRS stage gave median values of 1.5 and 2.5 respectively (p < 0.002). The histopathological difference assessed using OARSI scoring was significant (6 vs 10; p < 0.002).
Conclusion: Distraction arthroplasty in OA goat models in this study, worsens the OA instead of inducing repair. Further studies are required to find out a convincing biological basis of distraction arthroplasty as an alternative treatment for OA. (Med J Indones. 2013;22:64-9)
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References
Felson DT. Osteoarthritis of the knee. N Engl J Med. 2006;354:841-8.
Gidwani S, Fairbank A. The orthopaedic approach to managing osteoarthritis of the knee. BMJ. 2004;329:1220-4.
Harwin SF. Indications and patient selection. In: Scuderi GR, Tria AJ, editors. Surgical Techniques in total knee arthroplasty. New York: Springer-Verlag; 2002.p. 3-8.
Martyn P, Borroff M, Gregg P, et al. National Joint Registry for England and Wales 9th Annual Report [Internet]. 2012. Available from: http://www.njrcentre.org.uk/NjrCentre/ Portals/0/Documents/England/Reports/9th_annual_report/NJR 9th Annual Report 2012.pdf.
Schemitsch EH, Thornhill TS. Management of bone loss in revision arthroplasty. In: Scuderi GR, Tria AJ, editors. Surgical techniques in total knee arthroplasty. New York: Springer-Verlag; 2002.p.393-9.
Lafeber FP, Intema F, van Roermund PM, Marijnissen AC. Unloading joints to treat osteoarthritis, including joint distraction. Curr Opin Rheumatol. 2006;18(5):519-25.
Marijnissen AC, van Roermund PM, van Melkebeek J, et al. Clinical benefit of joint distraction in the treatment of severe osteoarthritis of the ankle: proof of concept in an open prospective study and in a randomized controlled study. Arthritis Rheum. 2002;46(11):2893-902.
Fioravanti A, Collodel G, Petraglia A, Nerucci F, Moretti E, Galeazzi M. Effect of hydrostatic pressure of various magnitudes on osteoarthritic chondrocytes exposed to IL-1beta. Indian J Med Res. 2010;132:209-17.
Elder BD, Athanasiou KA. Hydrostatic pressure in articular cartilage tissue engineering: from chondrocytes to tissue regeneration. Tissue Eng Part B Rev. 2009;15(1):43-53.
Tellisi N, Fragomen AT, Kleinman D, O’Malley MJ, Rozbruch SR. Joint preservation of the osteoarthritic ankle using distraction arthroplasty. Foot Ankle Int. 2009;30(4):318-25.
Karadam B, Karatosun V, Murat N, Ozkal S, Gunal I. No beneficial effects of joint distraction on early microscopical changes in osteoarthrotic knees. A study in rabbits. Acta Orthop. 2005;76(1):95-8.
Yanai T, Ishii T, Chang F, Ochiai N. Repair of large fullthickness articular cartilage defects in the rabbit: the effects of joint distraction and autologous bone-marrow-derived mesenchymal cell transplantation. J Bone Joint Surg Br. 2005;87(5):721-9.
Nishino T, Chang F, Ishii T, Yanai T, Mishima H, Ochiai N. Joint distraction and movement for repair of articular cartilage in a rabbit model with subsequent weight-bearing. J Bone Joint Surg Br. 2010;92(7):1033-40.
van Valburg AA, van Roermund PM, Marijnissen AC, et al. Joint distraction in treatment of osteoarthritis (II): effects on cartilage in a canine model. Osteoarthritis Cartilage. 2000;8(1):1-8.
Intema F, van Roermund PM, Marijnissen AC, et al. Tissue structure modification in knee osteoarthritis by use of joint distraction: an open 1-year pilot study. Ann Rheum Dis. 2011;70(8):1441-6.
Hunziker EB. Articular cartilage repair: basic science and clinical progress. A review of the current status and prospects. Osteoarthritis Cartilage 2002;10(6):432-63.
Mastbergen SC, Lafeber FPJG. Animal models of osteoarthritis-why choose a larger model? US Musculoskeletal Review. 2009;4:11-4.
Miot S, Brehm W, Dickinson S, et al. Influence of in vitro maturation of engineered cartilage on the outcome of osteochondral repair in a goat model. Eur Cell Mater. 2012;23:222-36.
Osterhoff G, Löffler S, Steinke H, Feja C, Josten C, Hepp P. Comparative anatomical measurements of osseous structures in the ovine and human knee. Knee 2011;18(2):98-103.
Pearce AI, Richards RG, Milz S, Schneider E, Pearce SG. Animal models for implant biomaterial research in bone: a review. Eur Cell Mater. 2007;13:1-10.
Poole R, Blake S, Buschmann M, et al. Recommendations for the use of preclinical models in the study and treatment of osteoarthritis. Osteoarthritis Cartilage 2010;18 Suppl 3:S10-6.
Mcnicholas MJ, Rowley DI, Mcgurty D, et al. Total meniscectomy in adolescence. A thirty-years follow up. J Bone Joint Surg Br. 2000;82(2):217-21.
Englund M, Lohmander LS. Risk factors for symptomatic knee osteoarthritis fifteen to twenty-two years after meniscectomy. Arthritis Rheum. 2004;50(9):2811-9.
Smith MM, Cake MA, Ghosh P, Schiavinato A, Read, RA, Little CB. Significant synovial pathology in a meniscectomy model of osteoarthritis: modification by intra-articular hyaluronan therapy. Rheumatology 2008;47(8):1172-8.
Burger C, Mueller M, Wlodarczyk P, et al. The sheep as a knee osteoarthritis model: early cartilage changes after meniscus injury and repair. Lab Anim. 2007;41(4):420-31.
Brittberg M, Winalski CS. Evaluation of cartilage injuries and repair . J Bone Joint Surg Am. 2003;85:58-69.
Pritzker KPH, Gay S, Jimenez SA, et al. Osteoarthritis cartilage histopathology: grading and staging. Osteoarthritis Cartilage 2006;14(1):13-29.
Brandt KD. Etiopathogenesis. In: Brandt KD, editor. Diagnosis and nonsurgical management of osteoarthritis. New York: Professional Communications; 2010. p. 53-60.
Grodzinsky AJ, Levenston ME, Jin M, Frank EH. Cartilage tissue remodelling in response to mechanical forces. Annu Rev Biomed Eng. 2000;2:691-713.
Temenoff JS, Mikos AG. Review: tissue engineering for regeneration of articular cartilage. Biomaterials. 2000;21(5):431-40.
Hung S, Nakamura K, Shiro R, Tanaka K, Kawahara H, Kurokawa T. Effects of continuous distraction on cartilage in a moving joint: An investigation on adult rabbits. J Orthop Res. 1997;15(3):381-90.
Manicourt D, Pita J. Progressive depletion of hyaluronic acid in early experimental osteoarthritis in dogs. Arthritis Rheum. 1988;31(4):538-44.
Huang CC, Hagar KL, Frost LE, Sun Y, Cheung HS. Effects of cyclic compressive loading on chondrogenesis of rabbit bone-marrow derived mesenchymal stem cells. Stem cells 2004;22(3):313-23.
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