Ando Akira, Hagiwara Yoshihiro, Chimoto Eiichi, Hatori Kouki, Onoda Yoshito, Itoi Eiji
Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan.
Tohoku J Exp Med. 2008 Aug;215(4):321-31. doi: 10.1620/tjem.215.321.
Joint immobilization is a useful and common treatment modality in orthopedics. However, it also causes unfavorable outcome such as articular cartilage degeneration. Intra-articular injection of hyaluronan has been accepted as a treatment of osteoarthritis, but its effects on immobilized joint remain to be clarified. Hyaluronan is a polysaccharide, distributed ubiquitously in various tissues. In this study, we examined the effect of hyaluronan on the articular cartilage in immobilized joints. The unilateral knee joints of adult male rats were immobilized at 150 degrees in flexion with an internal plate and screws for 1, 2, 4, 6, 8, 12, or 16 weeks (n = 84). Hyaluronan or saline (50 microl/each injection) was administered intra-articularly on the day of surgery and once a week. The articular cartilage from the medial midcondylar region of the knee was obtained, and divided into non-contact, contact and transitional areas (between the non-contact and the contact areas). In each area, a degree of degeneration was evaluated by histomorphometric grading, and measurements of thickness and number of chondrocytes. Histological grading scores in the hyaluronan group were smaller at 12 and 16 weeks compared with those in the saline group. The thickness of the articular cartilage increased in the transitional area in both groups. The number of chondrocytes in the contact and transitional areas gradually decreased, but their number in the hyaluronan group was greater at 12 and 16 weeks compared with that in the saline group. Hyaluronan showed chondroprotective effects on the articular cartilage in a rat immobilized-knee model.
关节固定术是骨科中一种常用且有效的治疗方式。然而,它也会导致诸如关节软骨退变等不良后果。关节内注射透明质酸已被公认为骨关节炎的一种治疗方法,但其对固定关节的影响仍有待阐明。透明质酸是一种多糖,广泛分布于各种组织中。在本研究中,我们研究了透明质酸对固定关节中关节软骨的影响。成年雄性大鼠的单侧膝关节用内固定板和螺钉固定于150度屈曲位,分别固定1、2、4、6、8、12或16周(n = 84)。在手术当天及之后每周一次向关节腔内注射透明质酸或生理盐水(每次注射50微升)。获取膝关节内侧髁中部区域的关节软骨,并分为非接触区、接触区和过渡区(非接触区与接触区之间)。在每个区域,通过组织形态计量学分级以及软骨细胞厚度和数量的测量来评估退变程度。与生理盐水组相比,透明质酸组在12周和16周时的组织学分级评分更低。两组过渡区的关节软骨厚度均增加。接触区和过渡区的软骨细胞数量逐渐减少,但透明质酸组在12周和16周时的软骨细胞数量比生理盐水组更多。在大鼠膝关节固定模型中,透明质酸对关节软骨具有软骨保护作用。