Histological tissue response and synovial fluid analysis after arthroscopic surgery with electrocautery in TMJ

目的：目的：从组织学、放射学和生化学角度，对关节镜下电凝松解绵羊颞下颌关节（TMJ）后的组织反应和滑液进行分析。方法：选用成年美利奴羊13只，体重约60 kg。本研究中使用的器械是新开发的用于TMJ手术的具有通道（直径1.1mm）的Artroscope（Int.J.Oral Maxillofac.手术26S：159，1997），将电烙器插入内通道，将尖端直接抵靠后囊的滑膜放置，并通过功率为125瓦的电烙器从内侧壁到外侧壁损伤表面。然后将头端贴着从内侧到外侧部分用电烙术损坏的结节关节面放置，直到暴露下层骨。分别于术后第2、4、8、12周麻醉处死。将标本脱钙并从外侧到内侧矢状切片用于组织学研究。同时收集关节液。结果：术后4周，所有椎间盘均穿孔，术后4周，关节液中MMP-3的含量均明显增加。术后第12周髁突关节面部分裸露，部分表面纤维化修复，关节盘向前方移位。影像学和组织学上与晚期骨关节炎相似。结论：关节镜下电凝松解颞下颌关节后囊滑膜可诱导绵羊颞下颌关节骨关节炎性改变

Aims : To evaluate the tissue response and synovial fluid analysis after arthroscopic lysis with electrocautery in the temporomandibular joint (TMJ) of sheep histologically, radiologically and biochemicallyMethod : Thirteen adult merino sheep, weighting about 60 kg, were used. The instruments used in this study were a newly developed artroscope with a channel (1.1mm in diameter) for TMJ surgery (Int. J. Oral Maxillofac. Surg.26S : 159, 1997), Electrocautery was inserted into the inner channel and the tip placed directly against the synovial membrane of the posterior pouch and the surface was injured from medial to lateral walls by electrocautery with a power of 125 watts. The tip is then placed against the articular surface of the tuber which was damaged from medial to lateral part with electrocautery until the underlining bone was exposed. At the 2nd, 4th, 8th, 12th week after the initial operation, the sheep were sacrificed by an anesthetic overdose. The specimens were decalified and sagitally sectioned from lateral to medial for histological study. Synovial fluid was collected at same time. Casein zymography was performed to detect the presence of MMP-3 in synovial fluidResults : At the 4th week after the initial operation, all discs were perforated. At the 12th week after the initial operation, the condylar articular surface was partly denuded in some areas, and part of the surface showed fibrous repair, and the disc was displaced ot the anterior portion. These canges were radiographically and histologically similar to adovanced osteoarthritis. Pro MMP-3 was detected in all experimental groupsConclusion : It was suggested that an arthroscopic lysis with electrocautery agaist the synovial membrance of the posterior pouch was induced the osteoarthritic change of sheep TMJ