针刀干预对中期膝骨关节炎兔软骨下骨压缩力学性能的影响

Effect of Acupotomy Intervention on Compressive Mechanical Properties of Subchondral Bone in Medium-term KOA Rabbits

目的研究针刀对中期膝骨关节炎(KOA)兔软骨下骨压缩力学性能的影响。方法24只新西兰雄兔随机分为空白组、模型组、针刀组和电针组。除空白组外,其余3组采用改良后Videman法制动9周建立模型,分别干预3周。采用蕃红O/固绿染色法光镜下观察各组兔膝关节软骨及软骨下骨病理改变,参照Mankin评分标准对软骨退变程度进行评分,对软骨下骨进行压缩力学性能测试,观察最大位移、最大载荷、压缩强度和弹性模量。结果1)蕃红O/固绿染色及Mankin评分:模型组显示软骨层明显变薄,结构紊乱破坏,软骨下骨板明显增厚,Mankin评分明显升高(P<0.01);针刀组、电针组染色情况改善,Mankin评分显著降低(P<0.01);针刀组与电针组相比,Mankin评分较低,两组间差异有统计学意义(P<0.01)。2)压缩力学测试:模型组软骨下骨最大位移、最大载荷、压缩强度和弹性模量显著降低(P<0.01);针刀组、电针组最大位移、最大载荷、压缩强度、弹性模量显著升高(P<0.01或P<0.05),针刀组和电针组之间差异无统计学意义(P>0.05),但针刀组趋势更接近正常。结论针刀干预可改善KOA兔软骨下骨承受压缩载荷和抗变形的能力,从而延缓KOA进程。

Objective:To study the effect of acupotomy on compressive mechanical properties of subchondral bone in rabbits with medium-term knee osteoarthritis(KOA).Methods:24 male New Zealand rabbits were randomly divided into the blank group,model group,acupotomy group and electroacupuncture group.Except for the blank group,the other 3 groups were treated with modified Videman method for 9 weeks to establish the model,and intervention for 3 weeks respectively.The pathological changes of knee cartilage and subchondral bone in each group were observed under a light microscope by safranin O/fast green method.The degree of cartilage degeneration was scored according to Mankin scoring standard.The compressive mechanical properties of subchondral bone were tested,and the maximum displacement,maximum load,compressive strength,and elastic modulus were observed.Results:1)Safranin O/fast green and Mankin score:the model group showed obvious thinning of cartilage layer,structural disorder and destruction,obvious thickening of subchondral bone plate and significant increase of Mankin score(P<0.01).Staining was improved in the acupotomy group and electroacupuncture group,and Mankin score was significantly decreased(P<0.01).Compared with the electroacupuncture group,Mankin score was lower in acupotomy group,and the difference between the two groups was statistically significant(P<0.01).2)Compression mechanics test:the maximum displacement,maximum load,compressive strength and elastic modulus of subchondral bone in the model group were significantly decreased(P<0.01);the maximum displacement,maximum load,compressive strength and elastic modulus of the acupotomy group and the electroacupuncture group were significantly increased(P<0.01 or P<0.05),and there was no statistical significance between the acupotomy group and the electroacupuncture group(P>0.05),but the trend of the acupotomy group was closer to normal.Conclusion:Acupotomy intervention can improve the ability of subchondral bone to bear compressive load and resist deformation in KOA rabbits,thus delaying the progress of KOA.