Kocaoglu Baris, Akgun Umut, Nalbantoglu Ufuk, Poyanlı Oguz, Karahan Mustafa
Department of Orthopaedics and Traumatology, Acibadem University Faculty of Medicine, Barbaros mah, Kentplus 1, Etap, C1 blok D:52, Yenisahra, Istanbul, Turkey.
Knee Surg Sports Traumatol Arthrosc. 2011 Jan;19(1):94-8. doi: 10.1007/s00167-010-1154-9. Epub 2010 May 8.
The purpose of this study was to investigate the effect of Mitomycin C on reduction in intra-articular fibrotic adhesion formation after knee surgery. Twenty female Wistar Albino rats were divided into two equal study groups. After skin incision, the right knees of animals were opened through a medial parapatellar approach, and the medial and lateral sides of the femoral condyle were exposed. A partial capsulotomy and synovectomy were performed. In group I, Mitomycin C was applied in the articular cavity of rats after hemostasis. An identical volume of sterile normal saline was applied in group II, which served as controls. All rats received weekly (6 weeks) intra-articular both Mitomycin C and saline starting from the day of operation. Animals were killed at 45 days after surgery. The presence and severity of osteo-capsular adhesion was assessed with both macroscopic and microscopic adhesion scoring systems. Results of macroscopic observations showed a significant reduction in both incidence and severity of adhesions in group I compared to group II. Histologically, adhesions in group I were thinner with less collagenic fibers. Microscopic determination of adhesion formation was less in group I, and the difference between groups was statistically significant. Our results suggest that post-operative administration of Mitomycin C may be considered a promising preventive therapy for the reduction in fibro-adhesive scars and consequent stiffness after knee surgery.
本研究的目的是探讨丝裂霉素C对膝关节手术后关节内纤维性粘连形成减少的影响。将20只雌性Wistar白化大鼠分为两个相等的研究组。皮肤切开后，通过髌旁内侧入路打开动物的右膝，暴露股骨髁的内侧和外侧。进行部分关节囊切开术和滑膜切除术。在第一组中，止血后在大鼠关节腔内应用丝裂霉素C。在作为对照的第二组中应用相同体积的无菌生理盐水。所有大鼠从手术当天开始每周（共6周）进行关节腔内注射丝裂霉素C和生理盐水。术后45天处死动物。采用宏观和微观粘连评分系统评估骨-关节囊粘连的存在情况和严重程度。宏观观察结果显示，与第二组相比，第一组粘连的发生率和严重程度均显著降低。组织学上，第一组的粘连较薄，胶原纤维较少。第一组中粘连形成的微观测定较少，两组之间的差异具有统计学意义。我们的结果表明，术后给予丝裂霉素C可能被认为是一种有前景的预防疗法，可减少膝关节手术后的纤维粘连瘢痕及随之而来的僵硬。
