Abstract
Conventional arthroscopic evaluation of articular cartilage is subjective and insufficient for assessing early compositional and structural changes during the progression of post-traumatic osteoarthritis. Therefore, in this study, arthroscopic near-infrared (NIR) spectroscopy is introduced, for the first time, for in vivo evaluation of articular cartilage thickness, proteoglycan (PG) content, and collagen orientation angle. NIR spectra were acquired in vivo and in vitro from equine cartilage adjacent to experimental cartilage repair sites. As reference, digital densitometry and polarized light microscopy were used to evaluate superficial and full-thickness PG content and collagen orientation angle. To relate NIR spectra and cartilage properties, ensemble neural networks, each with two different architectures, were trained and evaluated by using Spearman’s correlation analysis (ρ). The ensemble networks enabled accurate predictions for full-thickness reference properties (PG content: ρin vitro, Val= 0.691, ρin vivo= 0.676; collagen orientation angle: ρin vitro, Val= 0.626, ρin vivo= 0.574) from NIR spectral data. In addition, the networks enabled reliable prediction of PG content in superficial (25%) cartilage (ρin vitro, Val= 0.650, ρin vivo= 0.613) and cartilage thickness (ρin vitro, Val= 0.797, ρin vivo= 0.596). To conclude, NIR spectroscopy could enhance the detection of initial cartilage degeneration and thus enable demarcation of the boundary between healthy and compromised cartilage tissue during arthroscopic surgery.
Highlights
Osteoarthritis (OA) is a prevalent disease characterised by joint pain, restricted mobility, and instability of joint.[9]
No previous study has utilized 1D-convolutional NN (CNN) to investigate the relationship between cartilage NIR spectra and reference properties; these relations have been previously demonstrated in several in vitro studies.[3,25,26]
The findings presented here demonstrate the clinical potential of NIRS for the evaluation of cartilage thickness, composition, and structure
Summary
Osteoarthritis (OA) is a prevalent disease characterised by joint pain, restricted mobility, and instability of joint.[9]. As articular cartilage is aneural and avascular tissue,[29] initial symptoms (e.g., joint pain) may occur in the later stages of the disease, making cartilage repair challenging. Current methods to treat small chondral defects include arthroscopic debridement and lavage, osteochondral grafting, and autologous chondrocyte implantation.[37] tissue engineering has advanced rapidly in the last decade, no engineered cartilage currently exists that matches the properties of native cartilage.[37] In the event of insufficient repair, cartilage surrounding injury sites slowly degrades and will often exhibit signs of early to mid-stage degeneration (similar to those associated with early OA).[15]
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