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负重运动对半月板切除关节软骨的影响。一项在绵羊身上的实验研究。

The influence of weight-bearing exercise on articular cartilage of meniscectomized joints. An experimental study in sheep.

作者信息

Ghosh P, Sutherland J, Bellenger C, Read R, Darvodelsky A

机构信息

Raymond Purves Research Laboratories, University of Sydney, Royal North Shore Hospital of Sydney, St. Leonards, Australia.

出版信息

Clin Orthop Relat Res. 1990 Mar(252):101-13.

PMID:2302875
Abstract

Unilateral medial meniscectomy was undertaken in 29 purebred adult merino sheep. Arthrotomy (without meniscectomy) was conducted in 11 animals, and six were used as nonoperated controls. All animals were followed with either three- or six-month active or passive postoperative management. Active animals traversed a total of 360 km after three months and 1040 km after six months. The passive group was housed in pens allowing limited weight-bearing exercise. After death, morphologic changes were recorded and cartilages from the medial and lateral joint regions were examined for water, collagen, and proteoglycan (as hexuronate) content. Proteoglycan aggregation and extractability under nondissociative (0.4 molar GuHCl) and dissociative (4.0 molar GuHCl) conditions were also determined. The collagen content of the medial cartilage of the passively maintained meniscectomized animals was reduced, relative to external controls. Although proteoglycan content was elevated in medial cartilage of the passive group three months postoperatively, these levels returned to the control range after six months. However, low-salt (0.4 molar GuHCl) extractability of proteoglycans still remained high. All cartilages of control and meniscectomized joints showed an elevation of proteoglycan content in the active groups three months postoperatively. The cartilages in the medial region of meniscectomized animals showed the largest increase, but these levels declined after six months. Proteoglycan aggregation and water content were still elevated relative to controls six months postoperatively. The collagen levels in the three-month or six-month actively maintained meniscectomized group were not distinguishable from control values. Morphologically, joints of the passively and actively maintained animals showed focal surface fibrillation and erosions. However, in the active group, osteophytes were common and well developed six months postoperatively. These studies indicate that, while weight-bearing exercise after meniscectomy appears to be beneficial to the quality of the cartilaginous matrix, it is also accompanied by osteophytosis and cartilage hyperplasia.

摘要

对29只纯种成年美利奴绵羊进行了单侧内侧半月板切除术。对11只动物进行了关节切开术(不切除半月板),6只作为未手术对照。所有动物术后均接受3个月或6个月的主动或被动管理。主动活动的动物在3个月后总共行走360公里,6个月后行走1040公里。被动组被关在围栏中,允许进行有限的负重运动。处死动物后,记录形态学变化,并检查内侧和外侧关节区域软骨的水、胶原蛋白和蛋白聚糖(以己糖醛酸计)含量。还测定了在非解离(0.4摩尔盐酸胍)和解离(4.0摩尔盐酸胍)条件下蛋白聚糖的聚集和可提取性。相对于外部对照,被动维持的半月板切除动物内侧软骨的胶原蛋白含量降低。虽然被动组术后3个月内侧软骨中的蛋白聚糖含量升高,但6个月后这些水平恢复到对照范围。然而,蛋白聚糖的低盐(0.4摩尔盐酸胍)可提取性仍然很高。对照组和半月板切除关节的所有软骨在术后3个月时,主动组的蛋白聚糖含量均升高。半月板切除动物内侧区域的软骨增加最为明显,但6个月后这些水平下降。术后6个月,蛋白聚糖聚集和水分含量相对于对照组仍然升高。在术后3个月或6个月主动维持的半月板切除组中,胶原蛋白水平与对照值无差异。形态学上,被动和主动维持的动物关节均出现局灶性表面纤维性颤动和糜烂。然而,在主动组中,术后6个月骨赘常见且发育良好。这些研究表明,虽然半月板切除术后负重运动似乎有利于软骨基质的质量,但也伴随着骨赘形成和软骨增生。

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