Ozawa Junya, Kaneguchi Akinori, Tanaka Ryo, Kito Nobuhiro, Moriyama Hideki
Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Kurose- Gakuendai 555-36, Higashi-Hiroshima, Hiroshima, 739-2695, Japan.
Graduate School of Medical Technology and Health Welfare Sciences, Hiroshima International University, Higashi-Hiroshima, Hiroshima, Japan.
BMC Musculoskelet Disord. 2016 Oct 24;17(1):446. doi: 10.1186/s12891-016-1303-5.
The aim of this study is to clarify the following two points: First, whether a cyclooxygenase-2 mediated pathway is involved in the formation of immobilization-induced joint contracture and, second, the effectiveness of oral administration of non-steroidal anti-inflammatory drug celecoxib (CBX) for the prevention of myogenic and arthrogenic contracture following immobilization in a rat model.
Thirty male rats were randomly divided into three groups: immobilization (Im), Im + CBX, and control (n = 10 each). External fixation immobilized the right knee joint of Im and Im + CBX groups in flexion for 3 weeks. 50 mg/kg of CBX was administrated daily to the Im + CBX group during this period. The passive range of motion (ROM) of knee joints was measured before and after transection of knee flexor muscles and myogenic and arthrogenic ROM restrictions were calculated. The semitendinosus muscles and knee joints were investigated histologically to elucidate factors responsible for contracture.
Myogenic ROM restrictions were exhibited both in Im and Im + CBX groups (44 ± 5 and 36 ± 8 °, respectively), but restrictions significantly decreased in the Im + CBX group compared to the Im group. Significant reductions of the muscle length ratios (Rt/Lt) and sarcomere number ratios (Rt/Lt) in knee flexor semitendinosus muscle, which are responsible for myogenic contracture, were also seen both in Im group (92 ± 5 and 92 ± 4 %, respectively) and Im + CBX group (97 ± 3 and 97 ± 3 %, respectively), but were inhibited by CBX administration (P < 0.05). Im and Im + CBX groups exhibited arthrogenic ROM restrictions with no significant differences (82 ± 3 and 83 ± 5 °, respectively). Posterior synovial length shortening and pathological changes (hemorrhage in joint cavities and capsule edema) in the knee joints were comparable between Im and Im + CBX groups.
Oral administration of celecoxib partially reduced myogenic ROM restriction concomitantly with knee flexor muscle shortening following immobilization. These results imply that inflammation and nociception are involved in myogenic contracture formation independently of joint immobilization, and that CBX is effective in preventing joint contracture following immobilization in rats.
本研究旨在阐明以下两点:第一,环氧化酶-2介导的途径是否参与制动诱导的关节挛缩的形成;第二,在大鼠模型中,口服非甾体抗炎药塞来昔布(CBX)预防制动后肌源性和关节源性挛缩的有效性。
30只雄性大鼠随机分为三组:制动组(Im)、Im+CBX组和对照组(每组n = 10)。外固定将Im组和Im+CBX组的右膝关节固定于屈曲位3周。在此期间,每天给Im+CBX组大鼠灌胃50 mg/kg的CBX。在切断膝屈肌前后测量膝关节的被动活动范围(ROM),并计算肌源性和关节源性ROM限制。对半腱肌和膝关节进行组织学研究,以阐明导致挛缩的因素。
Im组和Im+CBX组均出现肌源性ROM限制(分别为44±5°和36±8°),但与Im组相比,Im+CBX组的限制明显降低。在负责肌源性挛缩的膝屈肌半腱肌中,肌长度比(Rt/Lt)和肌节数比(Rt/Lt)在Im组(分别为92±5%和92±4%)和Im+CBX组(分别为97±3%和97±3%)均有显著降低,但CBX给药可抑制这种降低(P<0.05)。Im组和Im+CBX组均出现关节源性ROM限制,且无显著差异(分别为82±3°和83±5°)。Im组和Im+CBX组膝关节后滑膜长度缩短以及病理变化(关节腔出血和关节囊水肿)相当。
口服塞来昔布可部分减轻制动后伴随膝屈肌缩短的肌源性ROM限制。这些结果表明,炎症和伤害感受独立于关节制动参与肌源性挛缩的形成,并且CBX对预防大鼠制动后的关节挛缩有效。