Ozkan Cenk, Sarpel Yaman, Biçer O Sunkar
Cukurova Universitesi Tip Fakültesi Ortopedi ve Travmatoloji Anabilim Dali, Adana, Turkey.
Acta Orthop Traumatol Turc. 2007;41 Suppl 2:13-8.
The effect of exercise on articular cartilage has been assessed on animal models and on humans using various imaging techniques. Joint cartilage, whose water content decreases itself thanks to its unique permeable medium, maintains load distribution and joint function together with the synovial fluid under physiologic conditions and sports activities. The adaptive capacity of joint cartilage is limited under various conditions such as excessive load bearing or prolonged immobilization; however, when these factors are reversed deformed cartilage returns to its former state under normal conditions. Due to its adverse effect on joint cartilage, immobilization period following cartilage damage or operation should be as short as possible for wound healing. It is reported that exercise contributes to cartilage healing and reduces risk for injury, and that moderate exercise can even decrease the number of cases requiring arthroplasty. Conversely, excessive (harsh) exercise may be associated with increased cartilage damage or degenerative changes. Despite the presence of osteophytic changes in joint cartilage of athletes performing mild sports activities, these may not result in osteoarthritis due to the adaptive feature of joint cartilage. In contrast, the risk for osteoarthritis is increased in professional sportsmen exposed to acute repetitive impact and torsional loading. This article reviews the influence of controlled, passive-active exercise on healing, and on the development of osteoarthritis and the short- and long-term changes in articular cartilage associated with exercise and participation in sports of different duration and intensity.
运动对关节软骨的影响已在动物模型和人体上通过各种成像技术进行了评估。关节软骨由于其独特的渗透介质,其含水量会自行降低,在生理条件和体育活动下,它与滑液一起维持负荷分布和关节功能。在诸如过度承重或长期固定等各种条件下,关节软骨的适应能力是有限的;然而,当这些因素得到扭转时,变形的软骨在正常条件下会恢复到原来的状态。由于固定对关节软骨有不利影响,软骨损伤或手术后的固定期应尽可能短,以促进伤口愈合。据报道,运动有助于软骨愈合并降低受伤风险,适度运动甚至可以减少需要进行关节置换术的病例数量。相反,过度(剧烈)运动可能与软骨损伤增加或退行性改变有关。尽管进行轻度体育活动的运动员的关节软骨存在骨赘变化,但由于关节软骨的适应特性,这些变化可能不会导致骨关节炎。相比之下,暴露于急性重复性冲击和扭转负荷的职业运动员患骨关节炎的风险会增加。本文综述了有控制的被动 - 主动运动对愈合、骨关节炎发展以及与不同持续时间和强度的运动及参与体育活动相关的关节软骨短期和长期变化的影响。