Motivated by the conceptual framework of multi-scale biomechanics, this narrative review highlights recent major advances with a focus on gait and joint kinematics, then tissue-level mechanics, cell mechanics and mechanotransduction, matrix mechanics, and finally the nanoscale mechanics of matrix macromolecules. A literature review was conducted from January 2014 to April 2015 using PubMed to identify major developments in mechanics related to osteoarthritis (OA). Studies of knee adduction, flexion, rotation, and contact mechanics have extended our understanding of medial compartment loading. In turn, advances in measurement methodologies have shown how injuries to both the meniscus and ligaments, together, can alter joint kinematics. At the tissue scale, novel findings have emerged regarding the mechanics of the meniscus as well as cartilage superficial zone. Moving to the cell level, poroelastic and poro-viscoelastic mechanisms underlying chondrocyte deformation have been reported, along with the response to osmotic stress. Further developments have emerged on the role of calcium signaling in chondrocyte mechanobiology, including exciting findings on the function of mechanically activated cation channels newly found to be expressed in chondrocytes. Finally, AFM-based nano-rheology systems have enabled studies of thin murine tissues and brush layers of matrix molecules over a wide range of loading rates including high rates corresponding to impact injury. With OA acknowledged to be a disease of the joint as an organ, understanding mechanical behavior at each length scale helps to elucidate the connections between cell biology, matrix biochemistry and tissue structure/function that may play a role in the pathomechanics of OA.

Nanobiomechanics of living cells is very important to understand cell-materials interactions. This would potentially help to optimize the surface design of the implanted materials and scaffold materials for tissue engineering. The nanoindentation techniques enable quantifying nanobiomechanics of living cells, with flexibility of using indenters of different geometries. However, the data interpretation for nanoindentation of living cells is often difficult. Despite abundant experimental data reported on nanobiomechanics of living cells, there is a lack of comprehensive discussion on testing with different tip geometries, and the associated mechanical models that enable extracting the mechanical properties of living cells. Therefore, this paper discusses the strategy of selecting the right type of indenter tips and the corresponding mechanical models at given test conditions.