Bone and Joint Research Unit, Institute of Health Research (IIS-Fundación Jiménez Díaz), Madrid, Spain.
Madrid College of Chiropractic-Real Centro Universitario Escorial-María Cristina, Paseo de los Alamillos, 2, 28200, San Lorenzo de El Escorial, Madrid, Spain.
Sci Rep. 2020 Aug 6;10(1):13237. doi: 10.1038/s41598-020-70219-3.
Osteoarthritis (OA) is a degenerative disease characterized by injury of all joint tissues. Our previous study showed that in experimental osteoporosis, chiropractic manipulation (CM) exerts protective effects on bone. We here assessed whether CM might ameliorate OA by improving subchondral bone sclerosis, cartilage integrity and synovitis. Male New-Zealand rabbits underwent knee surgery to induce OA by anterior cruciate ligament injury. CM was performed using the chiropractic instrument ActivatorV 3 times/week for 8 weeks as follows: force 2 setting was applied to the tibial tubercle of the rabbit right hind limb (TM-OA), whereas the corresponding left hind limb received a false manipulation (FM-OA) consisting of ActivatorV firing in the air and slightly touching the tibial tubercle. After sacrifice, subchondral bone integrity was assessed in the tibiae by microCT and histology. Cartilage damage and synovitis were estimated by Mankin's and Krenn's scores, respectively, and histological techniques. Bone mineral density and content in both cortical and trabecular compartments of subchondral bone decreased in OA rabbits compared to controls, but partially reversed in the TM-OA group. Trabecular bone parameters in the latter group also showed a significant improvement compared to FM-OA group. Moreover RANKL, OPG, ALP and TRAP protein expression in subchondral bone significantly decreased in TM-OA rabbits with respect to FM-OA group. CM was associated with lower Mankin's and Krenn's scores and macrophage infiltrate together with a decreased protein expression of pro-inflammatory, fibrotic and angiogenic factors, in TM-OA rabbits with respect to FM-OA. Our results suggest that CM may mitigate OA progression by improving subchondral bone as well as cartilage and synovial membrane status.
骨关节炎（OA）是一种退行性疾病，其特征为所有关节组织损伤。我们之前的研究表明，在实验性骨质疏松症中，脊椎按摩疗法（CM）对骨骼具有保护作用。我们在此评估 CM 是否可以通过改善软骨下骨硬化、软骨完整性和滑膜炎来改善 OA。雄性新西兰兔接受膝关节手术，通过前交叉韧带损伤诱导 OA。CM 使用脊椎按摩仪 ActivatorV 每周进行 3 次，共 8 周，方法如下：将力设置为 2，施加于兔右后肢的胫骨结节（TM-OA），而相应的左后肢接受假手法（FM-OA），即 ActivatorV 在空气中发射并轻微触碰到胫骨结节。处死动物后，通过 microCT 和组织学评估胫骨软骨下骨的完整性。通过 Mankin 评分和 Krenn 评分分别评估软骨损伤和滑膜炎，并采用组织学技术。与对照组相比，OA 兔的软骨下骨皮质和小梁骨的骨矿物质密度和含量均降低，但 TM-OA 组部分恢复。与 FM-OA 组相比，后者的小梁骨参数也有显著改善。此外，与 FM-OA 组相比，TM-OA 兔软骨下骨中 RANKL、OPG、ALP 和 TRAP 蛋白表达显著降低。与 FM-OA 组相比，CM 与 TM-OA 兔的 Mankin 评分和 Krenn 评分较低、巨噬细胞浸润减少以及促炎、纤维化和血管生成因子的蛋白表达降低有关。我们的结果表明，CM 通过改善软骨下骨以及软骨和滑膜膜的状态，可能减轻 OA 的进展。
