Department of Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Rehabilitation, Hubei Provincial Hospital of Integrated Chinese and Western Medicine, Wuhan, China.
J Orthop Res. 2021 Jun;39(6):1227-1235. doi: 10.1002/jor.24791. Epub 2020 Jul 31.
Posttraumatic osteoarthritis (PTOA) is a subset of osteoarthritis (OA) resulting from the integrated outcome of joint injury, accounting for more than 12% of the overall OA cases. Although current therapies restore joint kinematics and alleviate inflammation, more than 20% patients undergo the unexpected progression of PTOA. Exercise is widely recommended to patients with OA and treadmill training is effective in preventing osteoarthritic changes in PTOA animals. However, the understanding gap of modified treadmill exercise models with different exercise dose and loading weight still exists. To evaluate the effects of body weight-supported treadmill training on PTOA, 30 rats were divided into the sham group (n = 6) and the PTOA group (n = 24) which were further assigned into three subgroups including the sedentary, the treadmill walking (TW), and the body weight-supported treadmill training (BWSTT) groups. The training groups were subjected to 4-week treadmill training at the speed of 15 m/min for 30 min/d, 5 d/wk. Then the tibias were elevated by histological staining, immunohistochemical staining, and micro-computed tomography. In our results, the significant OA-relevant changes in cartilage-subchondral bone unit were observed in the PTOA groups after surgery, characterized by cartilage degradation and subchondral bone remodeling. After 4-week treadmill training, the OA-relevant changes in cartilage-subchondral bone unit were alleviated and BWSTT is more efficient to maintain cartilage integrity and attenuate the subchondral bone loss and remodeling than TW. In conclusion, BWSTT is a promising and favorable treatment of PTOA slowing down the development of PTOA by reprogramming the cartilage-subchondral unit.
创伤后骨关节炎（PTOA）是由关节损伤综合结果引起的骨关节炎（OA）的一个亚组，占总体 OA 病例的 12%以上。虽然目前的治疗方法可以恢复关节运动学并缓解炎症，但仍有超过 20%的患者出现 PTOA 的意外进展。运动广泛推荐给 OA 患者，跑步机训练在预防 PTOA 动物的骨关节炎变化方面是有效的。然而，不同运动剂量和负重的改良跑步机运动模型的理解差距仍然存在。为了评估体重支撑跑步机训练对 PTOA 的影响，将 30 只大鼠分为假手术组（n=6）和 PTOA 组（n=24），进一步分为静息组、跑步机行走组（TW）和体重支撑跑步机训练组（BWSTT）。训练组以 15m/min 的速度进行 4 周的跑步机训练，每天 30min，每周 5 天。然后通过组织学染色、免疫组织化学染色和微计算机断层扫描来评估胫骨。在我们的结果中，手术后 PTOA 组观察到软骨-软骨下骨单位的显著 OA 相关变化，特征为软骨降解和软骨下骨重塑。经过 4 周的跑步机训练，软骨-软骨下骨单位的 OA 相关变化得到缓解，BWSTT 比 TW 更有效地维持软骨完整性，减轻软骨下骨丢失和重塑。总之，BWSTT 是一种有前途的、有利的 PTOA 治疗方法，通过重新编程软骨-软骨下单元来减缓 PTOA 的发展。
