Formation process of joint contracture after anterior cruciate ligament reconstruction in rats
Formation process of joint contracture after anterior cruciate ligament reconstruction in rats
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DOI：
10.1002/jor.24800
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发表时间：
2020-07-22
影响因子：
2.8
通讯作者：
Yamaoka, Kaoru
中科院分区：
文献类型：
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作者：
Kaneguchi, Akinori;Ozawa, Junya;Yamaoka, Kaoru
膝关节挛缩常由前交叉韧带重建术引起。然而，与ACLR后关节挛缩形成并行发生的炎症事件后的时间和空间关节纤维化变化尚不清楚。本研究旨在揭示：(a)肌源性和关节源性挛缩的时间依赖性变化；(b) ACLR后关节纤维化的发展过程。大鼠单侧膝关节行ACLR。在长达56天的不同时期，在手术前后检查肌切开术前后的被动运动范围（ROMs）以及炎症和纤维化反应。切肌前后ROMs均在第7天最低，之后随时间增加；然而，到第56天仍有重大限制。肌切开术在所有时间点部分增加ROMs，表明肌源性成分对aclr诱导的挛缩的贡献。炎症和纤维化反应在第7天达到高峰。关节纤维化，以关节囊增厚和滑膜长度缩短为特征，在第7天建立，到第56天未完全解决。我们的研究结果表明：(a) ACLR引起的肌源性和关节源性挛缩在术后第7天最大程度发展，此后消退，但至少持续到第56天；(b)关节纤维化在术后第7天形成，在第56天未完全消除。这些结果提示，ACLR术后预防关节挛缩的治疗和干预应在术后7天内进行。
Knee joint contracture is often induced by anterior cruciate ligament reconstruction (ACLR). However, the temporal and spatial arthrofibrotic changes following inflammatory events, which occur in parallel with the formation of joint contractures after ACLR, are unknown. This study aimed to reveal: (a) time-dependent changes in myogenic and arthrogenic contractures; and (b) the process of arthrofibrosis development after ACLR. ACLR was performed on knees of rats unilaterally. Passive ranges of motions (ROMs) before and after myotomy, as well as inflammatory and fibrotic reactions, were examined before and after the surgery at various periods up to 56 days. Both ROMs before and after myotomy exhibited their lowest value on day 7 and increased thereafter in a time-dependent manner; nevertheless, significant restrictions remained by day 56. Myotomy partially increased ROMs at all time points, indicating contribution of the myogenic component to ACLR-induced contracture. Inflammatory and fibrotic reactions peaked on day 7. Arthrofibrosis, characterized by the thickening of the joint capsule and the shortening of the synovial length, was established by day 7 and was not completely resolved by day 56. Our results indicate that: (a) both myogenic and arthrogenic contractures generated through ACLR develop maximally by day 7 after surgery and subside thereafter, but persist at least until day 56; and (b) arthrofibrosis is established by day 7 after surgery and is not completely resolved by day 56. These findings suggest that treatment and intervention for preventing joint contracture after ACLR should be performed within the first 7 days after surgery.