不同的持续被动运动时间对软骨损伤后发生骨性关节炎的影响

Effect of continuous passive motion in prevention of osteoarthritis induced by experimental articular cartilage injury

目的研究关节软骨损伤后早期给予持续被动运动(CPM)治疗是否具有预防损伤后发生骨性关节炎(OA)的作用,以及不同的CPM治疗时间对结果的影响。方法将15只雄性新西兰大白兔的30个膝关节均通过手术造成关节软骨全层缺损模型,术后按不同的处理随机分为对照组(A组)、2hCPM组(B组)和8hCPM组(C组)。术后12周处死所有兔子,肉眼观察膝关节软骨状况,并取软骨及滑膜标本进行HE染色和免疫组织化学染色,分别进行病理学评分和MMP-3阳性细胞数比较。结果C组软骨病理评分和MMP-3阳性细胞分数都显著低于A、B组(P<0.05);B组关节软骨除浅层病理评分和软骨细胞缺失方面的病理学评分低于A组外,其它与A组无明显差异。结论软骨缺损后早期给予CPM治疗可有效减缓OA的发生,且每天8hCPM的效果优于每天2hCPM。

Objective To study whether the early continuous passive motion （CPM） can prevent the degeneration of articulation after the articular cartilage was experimentally defected, and the effect of the different durations of continuous passive motion therapy. Methods Fifteen New Zealand rabbits were used to establish the model of full-thickness defects of bilateral knee articular cartilage by operation. Then all the animals were divided into groups A, B and C ： Group A served as the control group, and groups B and C served as the observation groups and were administered with 2 hours of continuous passive motion a day （ group B） and 8 hours of continuous passive motion a day, respectively. All rabbits were sacrificed at the 12th week after operation, and their articular cartilage were observed. The cartilage and synovium were obtained to have the hematoxylin and eosin stain and immunohisto chemistry stain. After that, the pathological assessment and calculation of the ratio of MMP-3 positive cells were conducted and compared among groups. Results Group C was lower than groups A and B in terms of the scores with cartilage pathological assessment and the ratio of MMP-3 positive cells（ P 〈 0.05 ） ;Group B was not significantly different from group A except being lower than group A in the scores with superficial cartilage pathological assessment and the ratio of MMP-3 positive cells. Conclusion The early use of continuous passive motion after the damage of articular cartilage can help prevent osteoarthritis. The efficacy of CPM for 8 hours a day is superior to that for 2 hours a day.