前交叉韧带重建手术的时间会影响大鼠屈曲挛缩的形成吗?

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-09-11 DOI:10.1016/j.clinbiomech.2024.106345
Akinori Kaneguchi , Marina Kanehara , Norikazu Nishida , Kaoru Yamaoka , Junya Ozawa
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引用次数: 0

摘要

背景前交叉韧带损伤通常采用韧带重建手术治疗,但术后关节挛缩是主要并发症之一。前交叉韧带重建的最佳时机仍存在争议,一些临床研究表明,过早手术可能会增加关节挛缩的风险,而另一些研究则发现两者之间并无关联。为了澄清这一问题,我们利用大鼠模型研究了重建手术时机对挛缩形成的影响。方法根据重建时机将前交叉韧带横断的大鼠分为三组:即刻组、早期组和延迟组(分别为横断后 1 天、14 天和 28 天)。一些前交叉韧带横断的大鼠没有接受重建手术。未经处理的大鼠作为对照组。韧带横断后 56 天,我们评估了膝关节伸展活动范围(包括肌源性和关节源性因素)和肌切开术后(仅关节源性因素),以及关节囊的纤维化变化。在所有重建组中,与对照组相比,肌切开术前后的活动范围都明显缩小,这表明重建手术诱发了关节挛缩。在所有重建组中都观察到了关节囊的纤维化变化,这也是关节挛缩形成的原因之一。我们的研究结果可能有助于指导临床决定前交叉韧带重建手术的时机。
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Does the timing of anterior cruciate ligament reconstruction surgery affect flexion contracture formation in rats?

Background

Anterior cruciate ligament injuries are commonly treated with ligament reconstruction surgery, but post-operative joint contracture is a major complication. The optimal timing for anterior cruciate ligament reconstruction remains controversial, with some clinical studies suggesting that early surgery may increase the risk of joint contractures, while others have found no such association. To clarify this, we investigated the effects of the timing of reconstruction surgery on contracture formation using a rat model.

Methods

Anterior cruciate ligament-transected rats were divided into groups based on the timing of reconstruction: immediate, early, and delayed (1, 14, and 28 days after transection, respectively). Some anterior cruciate ligament-transected rats did not receive reconstruction surgery. Untreated rats served as controls. At 56 days after ligament transection, we assessed knee extension range of motion before (including both myogenic and arthrogenic factors) and after myotomy (arthrogenic factor only), as well as fibrotic changes in the joint capsule.

Finding

Anterior cruciate ligament transection alone significantly decreased range of motion before myotomy, but not after myotomy. In all reconstructed groups, both range of motions before and after myotomy were significantly reduced compared to the control, indicating the induction of arthrogenic contracture by reconstruction surgery. Fibrotic changes in the joint capsule were observed in all reconstructed groups, contributing to arthrogenic contracture formation. However, the timing of reconstruction had no effect on range of motions and fibrotic changes in the joint capsule.

Interpretation

Our findings may help guide clinical decision-making regarding the timing of anterior cruciate ligament reconstruction surgery.

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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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