Schlegel Theodore F, Faber Kenneth J, Chen Andrew L, Hawkins Richard J
Steadman Hawkins Denver Clinic, Denver, Colorado 80111, USA.
Orthopedics. 2008 Feb;31(2):134. doi: 10.3928/01477447-20080201-30.
The effect of postoperative immobilization on the length, stiffness, and structure of connective tissue after radiofrequency probe shrinkage was examined in a rabbit patellar tendon model. Tendon lengths were measured before, immediately following, and 2, 4, and 8 weeks following heat application, with the contralateral tendon as a control. The animals were randomly assigned to three groups. In Group I, the controls, the animals were allowed free caged activity for 8 weeks. In Groups II and III, the experimental limb was immobilized at 15 degrees of knee flexion for 2 and 4 weeks, respectively, after which the animals were allowed 6 and 4 weeks of free caged activity. Changes in tendon length, stiffness, and cross-sectional area were compared using repeated measures ANOVA and differences between groups examined using Tukey's post-hoc analysis. Patellar tendon lengths were increased in all 3 groups at 8 weeks (P< .001). Tissue elongation was less extensive in group III compared to group I at 8 weeks (P< .001), while tissue cross-sectional area was decreased in both groups II and III compared to group I at 8 weeks (P< .001). All groups demonstrated decreases in tensile strength when compared to controls (P< .001). These findings suggest that postoperative immobilization is important following thermal shrinkage of connective tissue, as early activity can lead to stretching of the heat-modified tissue.
在兔髌腱模型中,研究了术后固定对射频探头收缩后结缔组织长度、刚度和结构的影响。在加热前、加热后即刻以及加热后2周、4周和8周测量腱的长度,以对侧腱作为对照。将动物随机分为三组。第一组为对照组,动物在笼中自由活动8周。第二组和第三组为实验组,实验肢体分别在膝关节屈曲15度位固定2周和4周,之后动物在笼中自由活动6周和4周。使用重复测量方差分析比较腱长度、刚度和横截面积的变化,并使用Tukey事后分析检查组间差异。所有三组在8周时髌腱长度均增加(P<0.001)。与第一组相比,第三组在8周时组织伸长程度较小(P<0.001),而与第一组相比,第二组和第三组在8周时组织横截面积均减小(P<0.001)。与对照组相比,所有组的抗张强度均降低(P<0.001)。这些发现表明,结缔组织热收缩后术后固定很重要,因为早期活动会导致热改性组织拉伸。
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