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兔髋臼骨折后创伤性骨关节炎模型:宏观和影像学评估的初步研究。

A Post-Traumatic Osteoarthritic Model of Hip Following Fracture of Acetabulum in Rabbit: A Preliminary Study by Macroscopic and Radiographic Assessment.

机构信息

College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, China.

Department of Orthopaedic Surgery, PLA Middle Military Command General Hospital, Wuhan, China.

出版信息

Orthop Surg. 2021 Feb;13(1):296-305. doi: 10.1111/os.12882. Epub 2021 Jan 4.

Abstract

OBJECTIVE

To develop a post-traumatic osteoarthritic model of hip following fracture of acetabulum in rabbit for revealing biochemical mechanism of post-traumatic osteoarthritis.

METHODS

A total of 36 mature male New Zealand white rabbits were equally divided into sham group (n = 12), non-ORIF group (n = 12), and open reduction and internal fixation (ORIF) group (n = 12). Except for the sham group, rabbits had survival surgeries to create acetabular fractures of dorsal wall for simulating dashboard impaction mechanism. The ORIF group received open reduction and internal fixation, while fractures in the non-ORIF group were left as displaced but transverse fracture and dislocation was reduced. Besides intraoperative appearance and postoperative recovery, macroscopic and radiographic characteristics of the hips were recorded and assessed by a radiographic scoring scale at 3 weeks, 6 weeks, and 6 months, respectively.

RESULTS

Out of 24 modeled acetabula, 21 (87.5%) were pure dorsal wall fractures as proposed and the remaining three were associated fractures (dorsal wall plus transverse fracture) accompanied by dorsal dislocation or not. All hips were stable, and no sciatic nerve injury was observed. One rabbit in the ORIF group died of deep infection 4 days after surgery. Rabbits in the sham and ORIF groups returned to normal gait in 2 weeks, but animals in the non-ORIF group suffered from limping and restricted movement. As the time progressed, the hips in the non-ORIF group experienced progressive and severe degeneration which exhibited dramatically malformed and hypertrophic joints at 6 months, but the ORIF group maintained much better morphological structure. Corresponding to morphological changes, the average radiographic scores of the non-ORIF group increased from 1.25 at 3 weeks to 2.75 at 6 months and showed statistically significant difference when compared to the sham group at all three time points (P = 0.011, 0.011, 0.015, respectively, <0.0167). Although the scores of the ORIF group showed apparent improvements (increased from 0.67 at 3 weeks to 2.00 at 6 months), there was no significant difference between the two modeled groups at all three time points.

CONCLUSION

The fracture model with high consistency and reproducibility showed progressive post-traumatic osteoarthritic changes which could be improved by open reduction and internal fixation surgery and provided an alternative selection for investigating potential pathogenesis and pathology of post-traumatic osteoarthritis following fracture of acetabulum.

摘要

目的

建立兔髋臼骨折后创伤性骨关节炎模型,以揭示创伤性骨关节炎的生化机制。

方法

36 只成熟雄性新西兰大白兔被平均分为假手术组(n = 12)、非手术复位内固定组(n = 12)和切开复位内固定组(n = 12)。除假手术组外,其余各组均进行生存手术造成髋臼后侧壁骨折,模拟汽车仪表盘撞击机制。切开复位内固定组进行切开复位内固定,而非手术复位内固定组则保持横向骨折脱位。记录各组术中表现和术后恢复情况,并分别在术后 3 周、6 周和 6 个月时采用放射学评分标准评估髋关节的大体和放射学特征。

结果

24 个建模髋臼中,21 个(87.5%)为单纯后侧壁骨折,其余 3 个为伴后侧壁骨折的复合骨折(后侧壁加横向骨折),伴或不伴后脱位。所有髋关节均稳定,未发生坐骨神经损伤。切开复位内固定组 1 只兔子术后 4 天死于深部感染。切开复位内固定组和假手术组的兔子在 2 周内恢复正常步态,但非手术复位内固定组的动物出现跛行和运动受限。随着时间的推移,非手术复位内固定组的髋关节逐渐出现进行性严重退变,6 个月时关节明显畸形和肥大,但切开复位内固定组保持了更好的形态结构。与形态变化相对应,非手术复位内固定组的平均放射学评分从 3 周时的 1.25 分增加到 6 个月时的 2.75 分,与假手术组在所有三个时间点均有统计学差异(P = 0.011、0.011、0.015,均<0.0167)。虽然切开复位内固定组的评分明显改善(从 3 周时的 0.67 分增加到 6 个月时的 2.00 分),但在所有三个时间点,两组模型之间均无显著差异。

结论

该骨折模型具有较高的一致性和可重复性,表现出进行性创伤性骨关节炎变化,切开复位内固定手术可改善这种变化,为研究髋臼骨折后创伤性骨关节炎的潜在发病机制和病理学提供了另一种选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/35c0/7862151/830d5c86f321/OS-13-296-g001.jpg

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