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Orthopaedic Proceedings
Vol. 91-B, Issue SUPP_I | Pages 171 - 172
1 Mar 2009
Stolz M Raiteri R Gottardi R Daniels D Friederich N Imer R Staufer U Fässler R Aebi U
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We have explored indentation-type scanning force microscopy (IT SFM) that allows for a direct, quantitative inspection of cartilage morphology and biomechanical properties from the millimeter to the nanometer scale ex vivo, and ultimately, in situ (Stolz et al., 2004). Here we present three examples of using IT SFM where morphological and biomechanical changes could only be spotted at the sub-micrometer scale:

We employed IT SFM for quality control of engineered cartilage cultured under various conditions. These measurements harbor the prospect to optimize and yield engineered cartilage that exhibits long-term mechanical stability, functionality and biocompatibility for joint arthroplasty.

For a more rational understanding of cartilage biology and pathology, we have recently investigated the articular cartilage of mice lacking the β1-integrin in chondrocytes. The β1-integrin gene knock-out mice differed only in stiffness when measured at the nanometer scale, i.e., exhibiting a softer extracellular matrix compared to their wild-type controls.

We inspected the changes of aging articular cartilage by employing a mouse model.

Accordingly, the stiffness of the aging cartilage increased concomitant with a decrease of its glycosaminoclycan (GAG) moiety. Frequently, aging articular cartilage takes a pathological turn called osteoarthritis (OA), which usually ends with a complete disappearance of the articular cartilage layer. Towards an early detection of OA in the human body, we inspected the morphological and biomechanical status of articular cartilage biopsies representing different grades of OA according to the ‘Outerbridge scale’. Most significantly, the early changes (grades 0 to 2) were only detectable at the nanometer scale, but not at the micrometer or millimeter scale. Based on such ex vivo indentation testing, we started to move from the bench to the patient, aiming to directly inspect the quality of human articular knee cartilage by an arthroscopic SFM (Imer et al., 2006). The arthroscopic SFM might just be the beginning of a new generation of nano tools designed for endoscopic or catheter-based interventions of other parts of the body. For such prophylactic interventions to eventually being tolerated by the patient, not only have these to be ambulant and minimally invasive, but they will require a change of paradigm vis-à-vis the patient, namely to undergo an invasive procedure without feeling sick – indeed a big challenge for nanomedicine and managed health care!