Due to its avascular nature, articular cartilage exhibits a very limited capacity to regenerate and to repair. Although much of the tissue-engineered cartilage in existence has been successful in mimicking the morphological and biochemical appearance of hyaline cartilage, it is generally mechanically inferior to the natural tissue. In this study, we tested the hypothesis that the application of dynamic deformational loading at physiological strain levels enhances chondrocyte matrix elaboration in cell-seeded agarose scaffolds to produce a more functional engineered tissue construct than in free swelling controls. A custom-designed bioreactor was used to load cell-seeded agarose disks dynamically in unconfined compression with a peak-to-peak compressive strain amplitude of 10 percent, at a frequency of 1 Hz, 3× (1 hour on, 1 hour off)/day, 5 days/week for 4 weeks. Results demonstrated that dynamically loaded disks yielded a sixfold increase in the equilibrium aggregate modulus over free swelling controls after 28 days of loading (100±16kPa versus 15±8kPa,p<0.0001). This represented a 21-fold increase over the equilibrium modulus of day 0 4.8±2.3kPa. Sulfated glycosaminoglycan content and hydroxyproline content was also found to be greater in dynamically loaded disks compared to free swelling controls at day 21 (p<0.0001 and p=0.002, respectively). [S0148-0731(00)00703-2]

1.
Chu
,
C. R.
,
Coutts
,
R. D.
,
Yoshioka
,
M.
,
Harwood
,
F. L.
,
Monosov
,
A. Z.
, and
Amiel
,
D.
,
1995
, “
Articular Cartilage Repair Using Allogenic Perichondrocyte-Seeded Biodegradable Porous Polylactic Acid (PLA): A Tissue Engineering Study
,”
J. Biomed. Mater. Res.
,
29
, No.
9
, pp.
1147
1154
.
2.
Dunkelman
,
N. S.
,
Zimber
,
M. P.
,
Lebaron
,
R. G.
,
Pavelec
,
R.
,
Kwan
,
M.
, and
Purchio
,
A. F.
,
1995
, “
Cartilage Production by Rabbit Articular Chondrocytes on Polyglycolic Acid Scaffolds in a Closed Bioreactor System
,”
Biotechnol. Bioeng.
,
46
, pp.
299
305
.
3.
Freed
,
L. E.
,
Langer
,
R.
,
Martin
,
I.
,
Pellis
,
N. R.
, and
Vunjak-Novakovic
,
G.
,
1997
, “
Tissue Engineering of Cartilage in Space
,”
Proc. Natl. Acad. Sci.
,
94
, pp.
13885
13890
.
4.
Rahfoth
,
B.
,
Weisser
,
J.
,
Sternkopf
,
F.
,
Aigner
,
T.
,
Von Der Mark
,
K.
, and
Brauer
,
R.
,
1998
, “
Transplantation of Allograft Chondrocytes in Agarose Gel Into Cartilage Defects in Rabbits
,”
Osteoarthritis Cartilage
,
6
, No.
1
, pp.
50
65
.
5.
Sittinger
,
M.
,
Bujia
,
J.
,
Minuth
,
W. W.
,
Hammer
,
C.
, and
Burmester
,
G. R.
,
1994
, “
Engineering of Cartilage Tissue Using Bioresorbable Polymer Carriers in Perfusion Culture
,”
Biomaterials
,
15
, No.
6
, pp.
451
456
.
6.
Wakitani
,
S.
,
Goto
,
T.
,
Young
,
R. G.
,
Mansour
,
J. M.
,
Goldberg
,
V. M.
, and
Caplan
,
A. I.
,
1998
, “
Repair of Large Full-Thickness Articular Cartilage Defects With Allograft Articular Chondrocytes Embedded in a Collagen Gel
,”
Tissue Eng.
,
4
, No.
4
, pp.
429
444
.
7.
Kuettner, K. E., and Goldberg, V. M., 1995, Osteoarthritic Disorders, American Academy of Orthopaedic Surgeons, Rosemont, IL, Preface p:xix.
8.
Ehrenreich, M., 1999, “Articular Cartilage Repair: Tissue Engineering’s Killer Application?” Techvest, LLC Equity Research.
9.
Malaviya
,
P.
,
Hunter
,
C.
,
Seliktar
,
D.
,
Schreiber
,
R.
,
Symons
,
K.
,
Ratcliffe
,
A.
, and
Nerem
,
R.
,
1998
, “
Fluid-Induced Shear Stresses Promote Chondrocyte Phenotype Alteration
,”
Trans. Annu. Meet.—Orthop. Res. Soc.
,
23
, No.
1
, pp.
228
228
.
10.
Malaviya
,
P.
, and
Nerem
,
R. M.
,
1999
, “
Steady Shear Stress Stimulates Bovine Chondrocyte Proliferation in Monolayer Cultures
,”
Trans. Annu. Meet.— Orthop. Res. Soc.
,
24
, p.
8
8
.
11.
Freed
,
L. E.
,
Vunjak-Novakovic
,
G.
, and
Langer
,
R.
,
1993
, “
Cultivation of Cell-Polymer Cartilage Implants in Bioreactors
,”
J. Cell. Biochem.
,
51
, pp.
257
264
.
12.
Freed
,
L. E.
,
Grande
,
D. A.
,
Lingbin
,
Z.
,
Emmanual
,
J.
,
Marquis
,
J. C.
, and
Langer
,
R.
,
1994
, “
Joint Resurfacing Using Allograft Chondrocytes, and Synthetic Biodegradable Polymer Scaffolds
,”
J. Biomed. Mater. Res.
,
28
, pp.
891
899
.
13.
Freed
,
L. E.
,
Marquis
,
J. C.
,
Vunjak-Novakovic
,
G.
,
Emmanual
,
J.
, and
Langer
,
R.
,
1994
, “
Composition of Cell-Polymer Cartilage Implants
,”
Biotechnol. Bioeng.
,
43
, pp.
605
614
.
14.
Carver
,
S. E.
, and
Heath
,
C. A.
,
1999
, “
Influence of Intermittent Pressure, Fluid Flow, and Mixing on the Regenerative Properties of Articular Chondrocytes
,”
Biotechnol. Bioeng.
,
65
, No.
3
, pp.
274
281
.
15.
Carver
,
S. E.
, and
Heath
,
C. A.
,
1999
, “
Semi-Continuous Perfusion System for Delivering Intermittent Physiological Pressure to Regenerating Cartilage
,”
Tissue Eng.
,
5
, No.
1
, pp.
1
11
.
16.
Davisson
,
T. H.
,
Wu
,
F. J.
,
Jain
,
D.
,
Sah
,
R. L.
, and
Ratcliffe
,
A. R.
,
1999
, “
Effect of Perfusion on the Growth of Tissue Engineered Cartilage
,”
Trans. Annu. Meet.—Orthop. Res. Soc.
,
45
, p.
811
811
.
17.
Goodwin
,
T. J.
,
Jessup
,
J. M.
, and
Wolf
,
D. A.
,
1992
, “
Morphologic Differentiation of Colon Carcinoma Cell Lines HT-29, and HT-29KM in Rotating-Wall Vessels
,”
In Vitro Cell Dev. Biol.
,
28A
, pp.
47
60
.
18.
Goodwin
,
T. J.
,
Schroeder
,
W. F.
,
Wolf
,
D. A.
, and
Moyer
,
M. P.
,
1993
, “
Rotating-Wall Vessel Co-Culture of Small Intestine as a Prelude to Tissue Modeling: Aspects of Simulated Microgravity
,”
Proc. Soc. Exp. Biol. Med.
,
202
, pp.
181
191
.
19.
Duke
,
P. J.
,
Daane
,
E. L.
, and
Montufar-Solis
,
D.
,
1993
, “
Studies of Chondrogenesis in Rotating Systems
,”
J. Cell. Biochem.
,
51
, pp.
274
282
.
20.
Spaulding
,
G. F.
,
Jessup
,
J. M.
, and
Goodwin
,
T. J.
,
1993
, “
Advances in Cellular Construction
,”
J. Cell. Biochem.
,
51
, pp.
249
251
.
21.
Grumbles
,
R. M.
,
Howell
,
D. S.
,
Howard
,
G. A.
,
1995
, “
Cartilage Metalloproteases in Disuse Atrophy
,”
J. Rheumatol.
,
43
(Supplement), pp.
146
148
.
22.
Setton
,
L. A.
,
Mow
,
V. C.
, and
Howell
,
D. S.
,
1995
, “
Mechanical Behavior of Articular Cartilage in Shear Is Altered by Transection of the Anterior Cruciate Ligament
,”
J. Orthop. Res.
,
13
, No.
4
, pp.
473
482
.
23.
Lee
,
D. A.
, and
Bader
,
D. L.
,
1995
, “
The Development, and Characterization of an in Vitro System to Study Strain-Induced Cell Deformation in Isolated Chondrocytes
,”
In Vitro Cell Dev. Biol.
,
31
, pp.
828
835
.
24.
Lee
,
D. A.
, and
Bader
,
D. L.
,
1997
, “
Compressive Strains at Physiological Frequencies Influence the Metabolism of Chondrocytes Seeded in Agarose
,”
J. Orthop. Res.
,
15
, pp.
181
188
.
25.
Lee
,
D. A.
,
Frean
,
S. P.
,
Lees
,
P.
, and
Bader
,
D. L.
,
1998
, “
Dynamic Mechanical Compression Influences Nitric Oxide Production by Articular Chondrocytes Seeded in Agarose
,”
Biochem. Biophys. Res. Commun.
,
251
, pp.
580
585
.
26.
Knight
,
M. M.
,
Lee
,
D. A.
, and
Bader
,
D. L.
,
1998
, “
The Influence of Elaborated Pericellular Matrix on the Deformation of Isolated Articular Chondrocytes Cultured in Agarose
,”
Biochim. Biophys. Acta
,
1405
, pp.
67
77
.
27.
Buschmann
,
M. D.
,
Gluzband
,
Y. A.
,
Grodzinsky
,
A. J.
, and
Hunziker
,
E. B.
,
1995
, “
Mechanical Compression Modulates Matrix Biosynthesis in Chondrocyte/Agarose Cultures
,”
J. Cell. Sci.
,
108
, pp.
1497
1508
.
28.
Benya
,
P. D.
, and
Shaffer
,
J. D.
,
1982
, “
Dedifferentiated Chondrocytes Reexpress the Differentiated Collagen Phenotype When Cultured in Agarose Gels
,”
Cell
,
30
, pp.
215
224
.
29.
Atala
,
A.
,
Cima
,
L. G.
,
Kim
,
W.
,
Paige
,
K. T.
,
Vacanti
,
J. P.
,
Retik
,
A. B.
, and
Vacanti
,
C. A.
,
1993
, “
Injectable Alginate Seeded With Chondrocytes as a Potential Treatment for Vesicoureteral Reflux
,”
J. Urol.
,
150
, pp.
745
747
.
30.
Hauselmann
,
H. J.
,
Fernandes
,
R. J.
, and
Mok
,
S. S.
,
1994
, “
Phenotypic Stability of Bovine Articular Chondrocytes After Long-Term Culture in Alginate Beads
,”
J. Cell. Sci.
,
107
, pp.
17
27
.
31.
Hauselmann
,
H. J.
,
Masuda
,
K.
,
Hunziker
,
E. B.
,
Neidhart
,
M.
,
Mok
,
S. S.
,
Michel
,
B. A.
, and
Thonar
,
E. J.
,
1996
, “
Adult Human Chondrocytes Cultured in Alginate Form a Matrix Similar to Native Human Articular Cartilage
,”
Am. J. Physiol.
,
271
(No.
3
, Pt 1), pp.
742
752
.
32.
Paige
,
K. T.
, and
Vacanti
,
C. A.
,
1995
, “
Engineering New Tissue, Formation of Neo-Cartilage
,”
Tissue Eng.
,
1
, p.
97
97
.
33.
Van Susante
,
J. L.
,
Buma
,
P.
,
Van Osch
,
G. J.
,
Versleyen
,
D.
,
Van Der Kraan
,
P. M.
,
Van Der Berg
,
W. B.
, and
Homminga
,
G. N.
,
1995
, “
Culture of Chondrocytes in Alginate, and Collagen Carrier Gels
,”
Acta Orthop. Scand.
,
66
, No.
6
, pp.
549
556
.
34.
Ragan
,
P. M.
,
Staples
,
A. K.
,
Hung
,
H. K.
,
Chin
,
V.
,
Binette
,
F.
, and
Grodzinsky
,
A. J.
,
1998
, “
Mechanical Compression Influences Chondrocyte Metabolism in a New Alginate Disk Culture System
,”
Trans. Annu. Meet.— Orthop. Res. Soc.
,
23
, No.
2
, p.
918
918
.
35.
Rowley
,
J. A.
,
Madlambayan
,
G.
, and
Mooney
,
D. J.
,
1999
, “
Alginate Hydrogels as Synthetic Extracellular Matrix Materials
,”
Biomaterials
,
20
, pp.
45
53
.
36.
Mow
,
V. C.
,
Kuei
,
S. C.
,
Lai
,
W. M.
, and
Armstrong
,
C. G.
,
1980
, “
Biphasic Creep, and Stress Relaxation of Articular Cartilage in Compression: Theory, and Experiments
,”
ASME J. Biomech. Eng.
,
102
, pp.
73
84
.
37.
Soltz
,
M. A.
, and
Ateshian
,
G. A.
,
1998
, “
Experimental Verification, and Theoretical Prediction of Cartilage Interstitial Fluid Pressurization at an Impermeable Contact Interface in Confined Compression
,”
J. Biomech.
,
31
, pp.
927
934
.
38.
Farndale
,
R. W.
,
Sayers
,
C. A.
, and
Barrett
,
A. J.
,
1982
, “
A Direct Spectrophotometric Microassay for Sulfated Glycosaminoglycans in Cartilage Cultures
,”
Connect. Tissue Res.
,
9
, pp.
247
248
.
39.
Seibel
,
M. J.
,
Macauley
,
W.
,
Jelsma
,
R.
,
Saed-Nejad
,
F.
, and
Ratcliffe
,
A.
,
1992
, “
Antigenic Properties of Keratin Sulfate: Influence of Antigen Structure, Monoclonal Antibodies, and Antibody Valency
,”
Arch. Biochem. Biophys.
,
296
, pp.
410
418
.
40.
Onobakhare
,
B. O.
,
Bader
,
D. L.
, and
Lee
,
D. A.
,
1996
, “
Quantification of Sulfated Glycosaminoglycans in Chondrocyte/Alginate Cultures, by Use of 1,9-Dimethylmethylene Blue
,”
Anal. Biochem.
,
243
, pp.
189
191
.
41.
Stegeman
,
H.
, and
Stalder
,
K.
,
1967
, “
Determination of Hydroxyproline
,”
Clin. Chim. Acta
,
19
, pp.
267
273
.
42.
Frank
,
E. H.
, and
Grodzinsky
,
A. J.
,
1987
, “
Cartilage Electromechanics —II. A Continuum Model of Cartilage Electrokinetics and Correlation With Experiments
,”
J. Biomech.
,
20
, No.
6
, pp.
629
639
.
43.
Buschmann
,
M. D.
,
Gluzband
,
Y. A.
,
Grodzinsky
,
A. J.
,
Kimura
,
J. H.
, and
Hunziker
,
E. B.
,
1992
, “
Chondrocytes in Agarose Culture Synthesize a Mechanically Functional Extracellular Matrix
,”
J. Orthop. Res.
,
10
, pp.
745
758
.
44.
Baer
,
A. E.
,
Setton
,
L. A.
,
Wang
,
J. Y.
,
Nickisch
,
F.
, and
Guilak
,
F.
,
1999
, “
Static Compression of Chondrocytes in Alginate Culture Does Not Alter Aggrecan Gene Expression as Measured by Competitive PCR
,”
Trans. Annu. Meet.—Orthop. Res. Soc.
,
45
, p.
726
726
.
45.
Leroux
,
M. A.
,
Hernandez
,
C. H.
,
Guilak
,
F.
, and
Setton
,
L. A.
,
1999
, “
Characterization of the Mechanical Behavior of Alginate Gel for in Vitro Chondrocyte Culture Applications
,”
Trans. Annu. Meet.—Orthop. Res. Soc.
,
45
, p.
657
657
.
46.
Palmoski
,
M.
,
Perricone
,
E.
, and
Brandt
,
K. D.
,
1979
, “
Development and Reversal of a Proteoglycan Aggregation Defect in Normal Canine Knee Cartilage After Remobilization
,”
Arthritis Rheum.
22
, pp.
508
517
.
47.
Jones
,
I. L.
,
Klamfeldt
,
A.
, and
Sanstrom
,
T.
,
1982
, “
The Effect of Continuous Mechanical Pressure Upon the Turnover of Articular Cartilage Proteoglycans in Vitro
,”
Clin. Orthop.
,
165
, pp.
283
289
.
48.
Gray
,
M. L.
,
Pizzanelli
,
A. M.
,
Grodzinsky
,
A. J.
, and
Lee
,
R. C.
,
1988
, “
Mechanical, and Physicochemical Determinants of the Chondrocyte Biosynthetic Response
,”
J. Orthop. Res.
,
6
, pp.
777
792
.
49.
Sah
,
R. L. Y.
,
Doong
,
J.-Y. H.
,
Grodzinsky
,
A. J.
,
Plaas
,
A. H. K.
, and
Sandy
,
J. D.
,
1991
, “
Effects of Compression on the Loss of Newly Synthesized Proteoglycans, and Proteins From Cartilage Explants
,”
Arch. Biochem. Biophys.
,
286
, pp.
20
29
.
50.
Sah
,
R. L. Y.
,
Kim
,
Y. J.
,
Doong
,
J.-Y. H.
,
Grodzinsky
,
A. J.
,
Plaas
,
A. H. K.
, and
Sandy
,
J. D.
,
1989
, “
Biosynthetic Response of Cartilage Explants to Dynamic Compression
,”
J. Orthop. Res.
,
7
, pp.
619
636
.
51.
Guilak
,
F.
,
Meyer
,
B. C.
,
Ratcliffe
,
A.
, and
Mow
,
V. C.
,
1994
, “
The Effects of Matrix Compression on Proteoglycan Metabolism in Articular Cartilage Explants
,”
Osteoarthritis Cartilage
,
2
, pp.
91
101
.
52.
Paul
,
J. P.
,
1967
, “
Forces Transmitted by Joints in the Human Body
,”
Proc. Inst. Mech. Eng.
,
181
(No.
3J
), p.
8
8
.
53.
Dillman, C. J., 1975, “Kinematic Analyses of Running,” in: Exercise and Sport Sciences Review, Academic Press, New York, pp. 193–218.
54.
Armstrong
,
C. G.
,
Bahrani
,
A. S.
, and
Gardner
,
D. L.
,
1979
, “
In Vitro Measurement of Articular Cartilage Deformations in the Intact Human Hip Joint Under Load
,”
J. Bone Jt. Surg.
,
61A
, No.
5
, pp.
744
755
.
55.
Macirowski
,
T.
,
Tepic
,
S.
, and
Mann
,
R. W.
,
1994
, “
Cartilage Stresses in the Human Hip Joint
,”
ASME J. Biomech. Eng.
,
116
, pp.
10
18
.
56.
Eckstein
,
F.
,
Tieschky
,
M.
, and
Faber
,
S.
,
1998
, “
In Vivo Quantification of Patellar Cartilage Volume, and Thickness Changes After Strenuous Dynamic Physical Activity—A Magnetic Resonance Imaging Study
,”
Trans. Annu. Meet.—Orthop. Res. Soc.
,
23
, p.
486
486
.
57.
Ateshian
,
G. A.
, and
Wang
,
H.
,
1995
, “
A Theoretical Solution for the Frictionless Rolling Contact of Cylindrical Biphasic Articular Cartilage Layers
,”
J. Biomech.
,
28
, pp.
1341
1355
.
58.
Vunjak-Novakovic
,
G.
,
Martin
,
I.
,
Obradovic
,
B.
,
Treppo
,
S.
,
Grodzinsky
,
A. J.
,
Langer
,
R.
, and
Freed
,
L. E.
,
1999
, “
Bioreactor Cultivation Conditions Modulate the Composition, and Mechanical Properties of Tissue-Engineered Cartilage
,”
J. Orthop. Res.
,
17
, pp.
130
138
.
59.
Ma
,
P. X.
, and
Langer
,
R.
,
1999
, “
Morphology, and Mechanical Function of Long-Term in Vitro Engineered Cartilage
,”
J. Biomed. Mater. Res.
,
44
, No.
2
, pp.
217
221
.
60.
Armstrong
,
C.
,
Lai
,
W.
, and
Mow
,
V.
,
1984
, “
An Analysis of the Unconfined Compression of Articular Cartilage
,”
ASME J. Biomech. Eng.
,
106
, pp.
165
173
.
61.
Kim
,
Y. J.
,
Sah
,
R. L.
,
Grodzinsky
,
A. J.
,
Plaas
,
A. H.
, and
Sandy
,
J. D.
,
1994
, “
Mechanical Regulation of Cartilage Biosynthetic Behavior: Physical Stimuli
,”
Arch. Biochem. Biophys.
,
311
, No.
1
, pp.
1
12
.
62.
Mow, V. C., Bachrach, N. M., Setton, L. A., and Guilak, F., 1994, “Stress, Strain, Pressure, and Flow Fields in Articular Cartilage and Chondrocytes,” in: Cell Mechanics and Cellular Engineering, Springer-Verlag, New York, pp. 345–379.
63.
Garcia
,
A. M.
,
Frank
,
E. H.
,
Grimshaw
,
P. E.
, and
Grodzinsky
,
A. J.
,
1996
, “
Contributions of Fluid Convection, and Electrical Migration to Transport in Cartilage: Relevance to Loading
,”
Arch. Biochem. Biophys.
,
333
, No.
2
, pp.
317
325
.
64.
Buschmann
,
M. D.
,
Kim
,
Y.-J.
,
Wong
,
M.
,
Frank
,
E.
,
Hunziker
,
E. B.
, and
Grodzinsky
,
A. J.
,
1999
, “
Stimulation of Aggrecan Synthesis in Cartilage Explants by Cyclic Loading Is Localized to Regions of High Interstitial Fluid Flow
,”
Arch. Biochem. Biophys.
,
366
, No.
1
, pp.
1
7
.
65.
Soltz, M. A., Stankiewicz, A., Mauck, R. L., Hung, C. T., and Ateshian, G. A., 1999, “Direct Hydraulic Permeability Measurements of Agarose Hydrogels Used As Cell Scaffolds,” Advances in Bioengineering, ASME BED-Vol. 43, pp. 229–230.
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