School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore.
SG Med International Pte Ltd, Singapore.
Injury. 2019 Mar;50(3):633-638. doi: 10.1016/j.injury.2019.01.054. Epub 2019 Feb 2.
Surgery or trauma may induce extensive arthrofibrosis around joints and tendon for the restrictive range of motion. Although some approaches were proposed, this problem is not solved satisfactorily. Extracorporeal shock wave therapy (ESWT) has been used for orthopedic, musculoskeletal, and fibrotic disorders. Whether it could prevent the formation of arthrofibrosis during the joint repair is unknown.
Intra-articular adhesions were created in the right knee of the rabbit by cortical bone shaving and subsequent cast immobilization. Arthrofibrosis in the control and ESWT group was evaluated and compared at week 4.
Macroscopic score of arthrofibrosis and contracture angle of the control group are significantly higher. Histologically, the apparent gap between patella and tibia, loose connective tissue, and much less density of the blood vessel are found in the ESWT group.
ESWT could noninvasively, effectively, and safely prevent the formation of arthrofibrosis during the knee repair.
手术或创伤可能会导致关节和肌腱周围广泛的关节纤维性黏连,从而限制运动范围。虽然已经提出了一些方法,但这个问题仍未得到满意解决。体外冲击波疗法(ESWT)已被用于骨科、肌肉骨骼和纤维性疾病的治疗。但尚不清楚其是否能预防关节修复过程中关节纤维性黏连的形成。
通过皮质骨削磨和随后的石膏固定在兔的右膝关节内造成关节内粘连。在第 4 周时评估和比较对照组和 ESWT 组的关节纤维性黏连程度。
对照组的关节纤维性黏连和挛缩角度的宏观评分明显更高。组织学上,ESWT 组的髌骨关节和胫骨之间有明显的间隙,疏松结缔组织较多,血管密度较低。
ESWT 可无创、有效、安全地预防膝关节修复过程中关节纤维性黏连的形成。