不同活动方式对ACL横断后关节软骨的影响
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摘要
目的：探索持续被动活动对膝关节软骨退变影响的分子机制。方法：新西兰白兔24只,随机选取一侧行膝关节ACL横断术,术后随机分为4组：Ⅰ组：笼内自由活动组(6只),术后不加任何处理因素,使其在笼内进行自由活动；Ⅱ组：制动组(6只),在术后第二天对其膝关节进行石膏固定；Ⅲ组：持续被动运动组(6只),在术后第二天使其在兔膝关节持续被动活动仪上每天进行8h持续被动运动。运动后任其自由活动； Ⅳ组：持续被动运动后制动组(6只),在术后第二天开始每天8h被动活动。每次活动结束后对其膝关节进行石膏固定。训练4周后取术侧膝关节股骨外髁软骨进行大体观察和免疫组化染色分析。结果：持续被动运动组和持续被动运动后制动组的关节软骨细胞中IL-1β、MMP-1表达均显著性低于制动组和自由活动组(P<0.01),制动组IL－1β、MMP)-1表达高于自由活动组,但差异没有显著性。持续被动运动组和持续被动运动后制动组之间IL-1β、MMP-1表达不存在显著性差异。结论：前交叉韧带横断后,不论进行哪种运动方式,都会导致关节软骨退变。持续被动运动可以降低软骨细胞IL-1β、MMP-1的表达,减缓软骨退变过程,为前交叉韧带重建提供理论依据。
Object:this study aims to research the effects of different activities on articular cartilage after anterior cruciate ligament injury in rabbits, Methods:Twenty four male New Zealand white rabbits (about three-months-old) were randomly selected one side of the knee joints to the anterior cruciate ligament transaction and divided into four groups averagely after operation:free feeding group, immobilization group, continuous passive movement group, and immobilization group after continuous passive movement. After Four weeks. The lateral femoral condylewere researched to observe the general morphology,IL-1β、MMP-1expression in the articular cartilage. Rusult:the cartilage surface of each group are different degrees of cartilage degeneration. IL-1β and MMP-1expression in the articular cartilage of continuous passive motion group and immobilization group after continuous passive movement was significantly lower than free feeding group (p<0.01) and the immobilization group (p<0.01), IL-1βand MMP-1expression in the articular cartilage of immobilization group was higher than free feeding group, but the differences is not significant The difference of the IL-1β and MMP-1expression in the articular cartilage between the continuous passive motion group and immobilization group after continuous passive movement. Conclusion: After anterior cruciate ligament injury, the cartilage degeneration is inevitable, continuous passive motion can reduce the expression of IL-1β and MMP-1in the articular cartilage, Slow Down the Cartilage Degeneration, and lay the foundation for anterior cruciate ligament reconstruction.
Object:this study aims to research the effects of different activities on articular cartilage after anterior cruciate ligament injury in rabbits, Methods:Twenty four male New Zealand white rabbits (about three-months-old) were randomly selected one side of the knee joints to the anterior cruciate ligament transaction and divided into four groups averagely after operation:free feeding group, immobilization group, continuous passive movement group, and immobilization group after continuous passive movement. After Four weeks. The lateral femoral condylewere researched to observe the general morphology,IL-1β、MMP-1expression in the articular cartilage. Rusult:the cartilage surface of each group are different degrees of cartilage degeneration. IL-1β and MMP-1expression in the articular cartilage of continuous passive motion group and immobilization group after continuous passive movement was significantly lower than free feeding group (p<0.01) and the immobilization group (p<0.01), IL-1βand MMP-1expression in the articular cartilage of immobilization group was higher than free feeding group, but the differences is not significant The difference of the IL-1β and MMP-1expression in the articular cartilage between the continuous passive motion group and immobilization group after continuous passive movement. Conclusion: After anterior cruciate ligament injury, the cartilage degeneration is inevitable, continuous passive motion can reduce the expression of IL-1β and MMP-1in the articular cartilage, Slow Down the Cartilage Degeneration, and lay the foundation for anterior cruciate ligament reconstruction.
引文
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[2]Hardingham TE. Proteoglyeans:Their structure, interactions, and molecular organization in cartilage. Biochem Soc Trans,1981,9:489-497
[3]郭建刚.骨性关节炎软骨的生化及代谢变化.中华骨伤杂志,1998,Vol.11(5)：73～74
[4]Han SK,Federico S,Epstein M, et al. An articular cartilage contact model based on real surface geometry..J Biomech,2005,38 (1):179-184
[5]Nagase H,Woessner JF Jr. Matrix metalloproteinases.J Biol Chem,1999,274 (31):21491-21494
[6]徐雁,敖英芳.前十字韧带断裂继发半月板损害的临床研究.中华骨科杂志,2002,Vol.22(4)：216-219
[7]Buckwalter JA. Articular cartilage injuries. Clin Orthop.2002,402:21-37
[8]Miehael GE.Biochemical confirmation of an experimental osteoarthritis model. J Bone and Joint Surg,1975, Vol.57 (a):392
[9]Blumenfeld I,Livne E.The role of tranforming growth factor (TGF)-beta,insulin-like growth factor (IGF)-1, interleukin-1 in osteoarthritis and aging of joints [J].Exp Gerontol,1999;34 (2):821~829
[10]Aida Y,Maeno M,Suzuki N.et al. The effect of IL-1 beta on the expression of matrix metalloproteinases and tissue in-hibitors of matrix metalloproteinases in human chondrocytes .Life Sci,2005, Vol.77 (25):3210-3221
[11]李思鸿.前交义韧带断裂对内侧胫骨平台影响的实验研究：[博士学位论文].湖南：中南大学,2009
[12]Shinmei M,Masuda K, Kikuchi T, et al. Interleukin-1, tumor necrosis factor, and interleukin-6 as mediators of cartilage desturction.Semin Arthritis Rheum,1989,18 (3 suppl 1):27~32
[13]赵琛.基质金属蛋白酶家族及其抑制剂在OA软骨组织中的表达及意义[硕士学位论文]青岛：青岛大学,2007
[14]Fernandes JC,Martel-Pelletier J,Lascau-Coman V,et al.Collage-nase-1 and collagenase-3 synthesis in normal and early experimental osteoarthritic canine cartilage:an immunohistochemical study. J Rheumatol,1998,25:1585~1594
[15]Salter RB,Field P.Effect of continuous compression on the living articular cartilage An experimental investigation,J Bone Joint Surg. (Am),1960,42:31
[16]黄涛,黄吕林.运动对免膝退变关节软骨形态学的影响.中国康复医学杂志,1999 Vol.14(5)：198～201
[17]纪斌平,卫小春,包尚恕等.制动影响关节软骨愈合的实验研究.中国矫形外科杂志1998,Vol.10,5,5,438～439
[18]钟汉馨,黄涛.不同运动方式对关节软骨改变的病理研究.现代康复2001,1,(5)：36～37
[19]Driscoll SW,Giori NJ.Continuous passive motion theory and principles of clinical application.J Rehabilation ResRev,2000. Vol.37 (2):179-188
[20]Carver SE,Heath CA. Increasing extracellular matrix production in regeneration
[21]李嘉.不同运动方式对膝关节内骨折及关节软骨损伤愈合的影响.[硕十学位论文].广州：第一军医大学,2005
[22]Mario Ferretti,Abiraman Srinivasan,Jmes Deschner,et al. Journal Of Orthopaedic Research. 2005,23:1165-1171
[23]Zhongfa Xu, Michael J,Buckley, et al. Cyclic Tensile Strain Acts as an Antagonist of IL-1B Actions in Chondrocytes J. Immunol.2000;165;453-460
[24]Lazovic DWirth CJKnoscl T et alMeniscus replancement using incongruent transplantsan experimental study.Z Orthop Ihre Grenzgeb,1997,135 (2):131-137
[25]Salminen HJ, Saamanen AM,Vankemmelbeke MN,et al. Differential expression patterns of matrix metalloproteinases and their inhibitors during development of osteoarthritis in a transgenic mouse model..Ann Rheum Dis,2002, Vol.61 (7):591-597
[26]张英.关继奎白细胞介素-1、基质金属蛋白酶-1在膝关节骨性关节炎发病中的作用探讨.福建医药杂志,2005,Vol.27(6)：12~13
[27]Pelletier JP.Coordinate syhthesis of stromelysin,interleukin-1 and oncogene proteins in experimental osteoarthritis:Animinunological study.Am J Pathol,1993, Vol.142:95-105
[28]Radin EL, Rose RM.Role of subchondral bone in the initiation and progression of cartilage damage Vol.Clin Orthop,1986,213:34-40
[29]LibicherM, Ivancic M,Hoffmann M,et al.Early changes in experi-mental osteoarthritis using the Pond-Nuki dogmode:1 technical procedure and initial results of in vivo MR imaging Vol.Eur Radio,1 2005,15:390-394
[30]董启榕,陈向阳.骨性关节炎软骨下骨力学性能变化的实验研究.中华创伤杂志,2007,Vol.23(5)：386～389
[31]Day JS, DingM, van der Linden JC,et al.A decreased subchondral trabecular bone tissue elastic modulus is associated with pre-arthritic cartilage damage. Journal of Orthopaedic Research,2001,19:914-918
[32]Shimizu T,Videman T,Shimazaki K,et al.Experimental study on the repair of full thickness articular cartilage defects:effects of varying periods of continuous passive motion,cageactivity,and immobilization.J Orthop Res.1987,5:187-197
[33]黄红拾,敖英芳,陈里宁,张阔.兔膝关节持续被动运动器的研制与初步应用中国运动医学杂志.2007,Vol.5,26(3)：313-317
[34]焦晨,于长隆,敖英芳.单纯后交韧带断裂发关节内损伤的临床研究.中国运动医学杂志,2003,Vol.22,(4)：：337-343
[35]徐雁,敖英芳.前交叉韧带断裂继发软骨损伤的临床研究.中国运动医学杂志,2002,Vol.21.(1)：7-10
[36]刘祺,郭林,杨柳等.膝关节半月板及股骨髁软骨损伤关节镜下标准化分区法及其临床应用.创伤外科杂志2007,Vol.9(3)：203～205
[37]范宏斌,张春礼,李明全,等.前交义韧带断裂后半月板和软骨损伤的临床研究.中华创伤杂志,2004,Vol.20(2)：73～76
[38]Mankin HJ,Brandt KD,Shulman LE.Workship on etiopathogenesis of osteoarthritis:procceding andrecommendations.J Rheumanol,1986,13:1130-1160
[39]Najima H,Oberlin C,Alnot JY et al.Anatomi-cal and biomechanical studies of the pathogenesis on trapeziometacarpal degenerative arthritis.J Hand Surg Br,1997,22 (2):183~188
[40]Sah RL,Yang AS,Chen AC et al.Physical properties of rabbit articular cartilage after transection of the anterior crtuciate ligament. JOrthop Res,1997,15 (2):197~203
[41]Veltri DM,Warren RF,Wickiewicz TL et al. Cu-rrent status of allograft meniscal transplantation.Clin Orthop,1994,303:44-55
[42]顾迁,戴戎,裘世静等.异常高应力导致,关节软骨退变机理的形态学研究.中华外科杂志,1995,Vol.33(10)：597～600
[43]Bora FW Jr.Miller G.Joint physiology,carti-lage metablism, and the etiology ofosteoarthritis.Hand Clin,1987,3 (3):325-336
[44]Jacques C, Gosset M. Berenbaum F, et al. The role of IL-land IL-Ira in joint inflammation And cartilage degradation.Vitam Horm,2006,74:371~403
[45]Kiviranta I.Tammi M,Jruvelin J et al.Articular cartilage thinkness and glycosaminogl can distribution in the canine knee joint after strenuous running exercise.Clin Orthop,1991,283:302~308
[46]Amin AR.Di Cesare PE.Vyas P et al.The expression and regulation of nitric oxide synthase in human osteoarthritis-affceted chondrocytes. Evidence for up-regulated neuronal nitric oxide synthase.J Exper Med,1995,182:2097~2102
[47]Blanco FJ,Ochs RL,Schwarz H et al.Chondr-ocyte apoptosis induce by nitric oxide. Am .Pathol,1995,146:75~85
[48]Chevaliex X.Fibronectin,cartilage,and osteoa-rthritis.Sem Arthrit Rheumat,1993,22:3~18
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