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 1.4 3区 医学 Q4 ENGINEERING, BIOMEDICAL
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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。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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
Clinical Biomechanics
Clinical Biomechanics 医学-工程:生物医学
CiteScore
3.30
自引率
5.60%
发文量
189
审稿时长
12.3 weeks
期刊介绍: Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.
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