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Ti6Al4V/PEEK 假体全膝关节置换术治疗骨关节炎大鼠模型:行为学和神经生理学分析。

Total Knee Arthroplasty with a Ti6Al4V/PEEK Prosthesis on an Osteoarthritis Rat Model: Behavioral and Neurophysiological Analysis.

机构信息

Aix-Marseille Université, CNRS, Institut des Sciences du Mouvement: Etienne-Jules MAREY (UMR 7287), Equipe « Plasticité des Systèmes Nerveux et Musculaire » (PSNM), Parc Scientifique et Technologique de Marseille-Luminy, CC910, avenue de Luminy, F-13288, Marseille, Cedex 09, France.

Aix-Marseille Université, CNRS, Institut des Sciences du Mouvement: Etienne-Jules MAREY (UMR 7287), Equipe « Conception Bio-Inspirée » (CBI), Parc Scientifique et Technologique de Marseille-Luminy, CC910, avenue de Luminy, F-13288, Marseille, Cedex 09, France.

出版信息

Sci Rep. 2020 Mar 24;10(1):5277. doi: 10.1038/s41598-020-62146-0.

Abstract

Arthroplasty is a surgical procedure to restore the function of the joint of patient suffering from knee osteoarthritis. However, postoperative functional deficits are reported even after a rehabilitation program. In order to determine the origin of functional deficits of patient suffering from knee osteoarthritis and total knee arthroplasty, we developed a rodent model including a chemically-induced-osteoarthritis and designed a knee prosthesis (Ti6Al4V/PEEK) biomechanically and anatomically adapted to rat knee joint. Dynamic Weight-Bearing, gait kinematics, H-reflex from vastus medialis muscle and activities from metabosensitive III and IV afferent fibers in femoral nerve were assessed at 1 and 3 months post-surgery. Results indicate that knee osteoarthritis altered considerably the responses of afferent fibers to their known activators (i.e., lactic acid and potassium chloride) and consequently their ability to modulate the spinal sensorimotor loop, although, paradoxically, motor deficits seemed relatively light. On the contrary, results indicate that, after the total knee arthroplasty, the afferent responses and the sensorimotor function were slightly altered but that motor deficits were more severe. We conclude that neural changes attested by the recovery of the metabosensitive afferent activity and the sensorimotor loop were induced when a total knee replacement was performed and that these changes may disrupt or delay the locomotor recovery.

摘要

关节成形术是一种手术程序,用于恢复患有膝骨关节炎的患者关节的功能。然而,即使在康复计划后,仍会报告术后功能缺陷。为了确定患有膝骨关节炎和全膝关节置换术后患者功能缺陷的起源,我们开发了一种包括化学诱导性骨关节炎的啮齿动物模型,并设计了一种在生物力学和解剖学上适应大鼠膝关节的膝关节假体(Ti6Al4V/PEEK)。在手术后 1 个月和 3 个月时,评估了动态负重、步态运动学、股直肌的 H 反射以及股神经中代谢敏感 III 和 IV 传入纤维的活动。结果表明,膝骨关节炎极大地改变了传入纤维对其已知激活剂(即乳酸和氯化钾)的反应,因此它们调节脊髓感觉运动回路的能力,尽管矛盾的是,运动缺陷似乎相对较轻。相反,结果表明,在全膝关节置换术后,传入反应和感觉运动功能仅略有改变,但运动缺陷更为严重。我们得出结论,当进行全膝关节置换时,传入活动和感觉运动功能的恢复证明了神经变化,这些变化可能会破坏或延迟运动恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da70/7093407/cfaaf4a585c2/41598_2020_62146_Fig1_HTML.jpg

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