Jiang Shihai, Yi Xiaoyou, Luo Yuansen, Yu Dongjie, Liu Yuangao, Zhang Fei, Zhu Lei, Wang Kun
Department of Joint and Trauma Surgery, The Third Affiliated Hospital of Sun Yat-sen University.
Department of Bone Surgery, Tungwah Hospital of Sun Yat-sen University.
J Vis Exp. 2019 May 20(147). doi: 10.3791/59260.
Joint contracture, resulting from a prolonged joint immobilization, is a common complication in orthopedics. Currently, utilizing an internal fixation to restrict knee joint mobility is a widely accepted model to generate experimental contracture. However, implanting application will inevitably cause surgical trauma to the animals. Aiming to develop a less invasive approach, we combined a muscle-gap separation modus with a previously reported mini-incision skill during the surgical procedure: Two mini skin incisions were made on the lateral thigh and leg, followed by performing muscle-gap separation to expose the bone surface. The rat knee joint was gradually immobilized by a preconstructed internal fixation at approximately 135° knee flexion without interfering essential nerves or blood vessels. As expected, this simple technique permits rapid postoperative rehabilitation in animals. The correct position of the internal fixation was confirmed by an x-ray or micro-CT scanning analysis. The range of motion was significantly restricted in the immobilized knee joint than that observed in the contralateral knee joint demonstrating the effectiveness of this model. Besides, histological analysis revealed the development of fibrous deposition and adhesion in the posterior-superior knee joint capsule over time. Thus, this mini-invasive model may be suitable for mimicking the development of immobilized knee joint contracture.
关节挛缩是骨科常见的并发症,由关节长期固定引起。目前,利用内固定限制膝关节活动是一种广泛接受的产生实验性挛缩的模型。然而,植入操作不可避免地会对动物造成手术创伤。为了开发一种侵入性较小的方法,我们在手术过程中将肌肉间隙分离方式与先前报道的小切口技术相结合:在大腿外侧和小腿上做两个小皮肤切口,然后进行肌肉间隙分离以暴露骨表面。通过预先构建的内固定在膝关节屈曲约135°时逐渐固定大鼠膝关节,而不干扰重要神经或血管。正如预期的那样,这种简单的技术使动物术后能够快速康复。通过X射线或微型CT扫描分析确认内固定的正确位置。与对侧膝关节相比,固定膝关节的活动范围明显受限,证明了该模型的有效性。此外,组织学分析显示,随着时间的推移,膝关节后上关节囊出现纤维沉积和粘连。因此,这种微创模型可能适合模拟固定膝关节挛缩的发展。