Department of Orthopaedics, Xinqiao Hospital, Third Military Medical University, No. 2 Xinqiao Street, Shapingba District, Chongqing, 400037, China,
Knee Surg Sports Traumatol Arthrosc. 2014 Jul;22(7):1536-40. doi: 10.1007/s00167-013-2547-3. Epub 2013 Jun 6.
Our purpose was to evaluate the effectiveness of intra-articular injections of hyaluronic acid (HA) into immobilized joints for reducing rigidity and formation of joint adhesions following surgery and prolonged joint immobilization.
Twenty-four New Zealand white rabbits were randomly divided into experimental (n = 12) and control groups (n = 12). A model of knee injury was created in the right hind leg, and external plaster fixation was performed for 8 weeks. The experimental and control groups received weekly intra-articular injections of 0.3 mL HA solution or normal saline, respectively, in the knee joint. The degree of adhesions, range of motion (ROM), and collagen content of the synovium of the knee joint were observed after 8 weeks.
At the end of 8 weeks, the experimental compared with control group had significantly higher mean ROM (70.3° ± 11.1° vs. 54.6° ± 11.2°, respectively; P = 0.002) and mean adhesion score. The experimental group compared with the control group had significantly lower mean adhesion score (2.2 ± 0.9 vs. 3.1 ± 0.7, respectively; P = 0.012) and collagen content (32.4 ± 4.7 vs. 39.0 ± 4.2 μg/mg, P = 0.001).
In a rabbit model of knee injury, intra-articular injection of HA decreased adhesion formation and collagen content and increased ROM after prolonged immobilization. These results indicate that HA may be clinically useful to prevent adhesions and improve joint mobility in patients who require joint immobilization for up to 8 weeks.
本研究旨在评估关节内注射透明质酸（HA）对减少术后和长时间关节固定后关节僵硬和粘连形成的效果。
将 24 只新西兰白兔随机分为实验组（n=12）和对照组（n=12）。在右侧后腿创建膝关节损伤模型，并进行 8 周的外固定石膏固定。实验组和对照组分别每周在膝关节内注射 0.3 mL HA 溶液或生理盐水。8 周后观察膝关节粘连程度、关节活动度（ROM）和滑膜胶原含量。
8 周后，实验组的平均 ROM（70.3°±11.1°）明显高于对照组（54.6°±11.2°；P=0.002），且实验组的平均粘连评分也明显低于对照组（2.2±0.9 vs. 3.1±0.7；P=0.012）。实验组的平均胶原含量（32.4±4.7 μg/mg）也明显低于对照组（39.0±4.2 μg/mg；P=0.001）。
在兔膝关节损伤模型中，关节内注射 HA 可减少粘连形成和胶原含量，增加长时间固定后的 ROM。这些结果表明，HA 可能对预防粘连和改善需要关节固定长达 8 周的患者的关节活动度具有临床意义。
