The influence of early degenerative changes on the vulnerability of articular cartilage to impact-induced injury.

ABSTRACT

BACKGROUND: Recently, the structural changes in a bovine model of early degeneration were validated by our research group to be analogous to that in early human osteoarthritis. The hypothesis of this study was that the structural changes associated with increasing levels of degeneration would lead to higher levels of tissue damage in response to impact induced injury. METHODS: A total of forty bovine patellae were obtained for this study. Cartilage-on-bone samples were extracted from the distal lateral quarter, a region known to be affected by varying levels of degeneration. A single impact drop test was applied to these samples delivering 2.3J of energy. A dynamic load cell and image capture at 2000fps allowed for the calculation of the reaction stress and coefficient of restitution. The extent of tissue damage was examined from the micro to ultrastructural levels using differential interference contrast optical microscopy and scanning electron microscopy respectively. FINDINGS: The impact mechanical properties of mildly degenerate articular cartilage were not significantly different but showed a significantly larger amount of structural damage. From comparing the mechanical and structural response of intact and mildly degenerate cartilage, to tissue showing increased macro-scale tissue degeneration, the significance of the surface layer and fibrillar scale transverse interconnectivity in effectively attenuating impact loads is demonstrated in this study. INTERPRETATION: This study shows that even though articular cartilage can appear visibly normal under macroscopic observation, the micro-scale structural changes associated with very early stage osteoarthritis can have a significant effect on its vulnerability to impact damage.