Meniscal Tissue Degradation as

the first sign of Osteoarthritis.

THE PROCESS OF MECHANOTRANSDUCTION IN
THE MENISCAL TISSUE.

Barbara Zielinska
Michigan University of Technology
 Structure of the Meniscus

Photos from: Knee Meniscus- Basic and Clinical Foundations, 1992, Raven Press NY
 C-shape (wedge-shape  Strong attachments to
in cross-section profile) bone
disks of fibro cartilage  Inner 2/3 poor
 Interposed between the vacularization
condyles of the femur
and tibia

HUMAN KNEE – cross-section profile

HUMAN KNEE – top view
 Motivation
 Studies show that the meniscus is involved
in the early stages of OA development.

 A better understanding of the loading

environment and biochemical response of
meniscal tissue may help us understand the
etiology of OA.
 Project definition
 FE model of medial partial meniscectomy
MEASUREMENT OF THE CHANGES IN THE CONTACT PARAMETERS ON
THE MENISCUS AFTER DIFFERENT PARTIAL MENISCECTOMIES

 Biochemical tests on the post incubated media

MEASURMENTS OF THE AMOUNT OF VARIOUS MOLECULES RELEASED
INTO THE MEDIA AFTER DIFFERENT LOAD CONDITIONS

 Real time RT-PCR

MEASURMENT OF THE GENE EXPRESSION IN THE MENISCAL TISSUE
AFTER DIFFERENT LOAD CONDITIONS
 Clinical Treatment of Meniscal
Tears

Photos from: Knee Meniscus- Basic and Clinical Foundations, 1992, Raven Press NY
 Meniscal repair
– Does not heal in avascular DIFFERENT TYPE OF TEARS
zone (Arnoczky, S.P. 1992; King, D. 1936)
 Allograft
– Poor fixation technique
Horizontal
– Difficulties with finding a
donor of correct size
(Paletta, G.A.,et al., 1997; Peters, G.A. et al.,2003; Felixs,
N.A. & Paulos, L.E., 2003)

 Partial meniscectomy Radial

– Changes in contact area and

stress distribution contribute
to osteoarthritis (OA)
(Baratz, M.E. et. al., 1986; Fukubayashi, T. & Kurosawa, H.,
1980; Cole, B.J., 2004; Rangger, C., et al., 1995; Cox,
J.S., et a;., 1975; Wyland, D.J., et a;., 2002; Fahmy, N.R.J
et al., 1983) Bucket-handle
 Aims of the study

 Examine changes in contact parameters on

superior surface of meniscus after medial
meniscectomy.

 Examine changes on lateral meniscus after

medial meniscectomy.
 Finite Element Model
FEMUR CARTILAGE

FEMUR

MEDIAL MENISCUS

TIBIA CARTILAGE

FRONT VIEW
TIBIA
LATERAL MENISCUS

Donahue, T.L., et al., A finite element model of the human knee joint
for the study of tibio-femoral contact. J Biomech Eng, 2002. 124(3): TOP VIEW
p. 273-80.
 Simulations of Medial Partial
Meniscectomies
ANT-CENT CENT POST-CENT POST

5%

10 %

ANT-CENT POST-CENT ANT-CENT-POST

30 % 60 %
 Intact Case
MEDIAL MENISCUS, SUPERIOR SIDE
POSTERIOR

ANTERIOR

CONTACT PRESSURE (CP) AXIAL STRAIN (LE3)

MAX CP = 4.669 [MPa] MAX L3= 9 %

MEAN CP = 1.570 [MPa]

 Measurement of GAGs
GAG Concentration GAG's Concentratiom vs. Compression

80
80
70
70
60
5% 60

Concentration
Concentration

50 20% Load
10% 50
.05 Mpa
40 15% 40
20% .1MPa
30 30
Controls Controls
20 20
10 10
0 0
% Com pression (Load) Load applied

 Release of GAGs into the media after load from

tissue explants is a sign of tissue matrix destruction.
 Measurement of PGE2
PGE2 TOP PGE2 BOTTOM

600 400
350
500
300

400 250
C C
200
300 5% 5%
150
10% 10%
200 100
15% 15%
50
20% 20%
100 0
-50
0
-100
-100 -150

 PGE2, an intracellular signaling molecule, is high in

patients with OA and is necessary in the cell death
process.
 Real time RT-PCR
 Measurement of Collagen, COX-2 and
MMPs gene expression.
– COX-2 is responsible for elevation of the PGE2
level
– MMPs- enzymes which are capable of
collectively degrading all kinds of extracellular
matrix proteins