New device gives extra dimension to osteoarthritis examination; researchers expect more insight into cartilage repair

Since the end of October 2019, researchers at the LUMC have a new device with which they add an extra dimension to cartilage research. It is much more accurate to determine which factors influence osteoarthritis and which movements are good for cartilage repair. This helps physical therapists in putting together movement therapies and helps elderly or osteoarthritis patients making the right choices with regard to exercise, for example in choosing a sport.

This macroscopic tissue research with the device, which the researchers call 'cartilage indenter', bridges the gap between the molecular research in the lab of prof. Dr. Ingrid Meulenbelt and the biomechanical research in the movement lab of TU Delft (prof. Dr. Ir Jaap Harlaar). The approach from these three scientific perspectives is unique in the world.

Which movements are good for cartilage repair?

In fact, we still know relatively little about what causes strain osteoarthritis and which movement therapies promote cartilage repair. In the scientific program Medical Delta: Improving Mobility with Technology, scientists from the Leiden University Medical Center (LUMC), TU Delft and Erasmus MC are investigating in a movement lab, which movements are harmful or, on the contrary, conducive to cartilage. The focus is on knee osteoarthritis, the most common form. In addition, biomolecular research examines how cartilage cells respond to certain loads or trauma.

The cartilage indenter adds a third dimension to this research. In particular, it measures the thickness and the mechanical quality of the cartilage. The device can also affect decreased cartilage tissue with peak loads. It then scans and measures accurately how the cracking tissue reacts. In addition, it is possible to take a punch and to characterize it molecularly or to culture it. The cartilage indenter was specially made in Canada and could, among other things, be purchased thanks to VICI funds from NWO.

Insight into osteoarthritis

“With the motion lab and with biomolecular research, we look at why certain cartilage cells do not recover or why these cells break down cartilage in microtrauma. We are also investigating which cartilage cells do recover and how this can be promoted, ”says Prof. Ingrid Meulenbelt of the LUMC. “We now know that peak loads are a major cause of osteoarthritis. And also that there are all kinds of elements that increase the risk of osteoarthritis, such as genetic factors, age or overweight. In combination with our existing research methods, research with the cartilage indenter gives us more insight into how the osteoarthritis process proceeds, certainly if we follow it through time. "

1.5 million Dutch people with osteoarthritis

The expectation is that hypotheses that until recently could not be substantiated are now scientifically determined or invalidated. This not only helps science advance, it also creates new applications, for example for movement therapies. Meulenbelt. “Among other things, we hope to gain more insight into which movements are bad or good for the elderly or osteoarthritis patients. We know that too little exercise is not good and that dosed movements help with the recovery of cartilage tissue. But we do not yet know exactly which movements that are. ”

Is cycling, walking or climbing stairs good or bad? Since almost 1.5 million Dutch people are diagnosed with osteoarthritis, you can say that the potential impact of that insight is large. On the daily lives of osteoarthritis patients and the elderly, on physical therapy, but also on health care as a whole. Meulenbelt: "With multidisciplinary researchers from biology and biomechanics, we hope to find those answers in the coming years, and the cartilage indenter will play a crucial role in that."