Refior H J, Hübner G
Arch Orthop Trauma Surg (1978). 1978 Jul 25;91(4):305-14. doi: 10.1007/BF00389614.
Structural degenerative changes in the hyaline cartilage of joints induced by immobilization are well known. To find out whether these changes are reversible, the right knee-joint from rabbits was immobilized by extra-articular fixation for 2 or 4 weeks, respectively. In 8 animals the joints were then remobilized for 6 months. Cartilage of the joints was investigated by light microscopy, scanning- and transmission electron microscopy. Already after 2 weeks of immobilization changes in the superficial layer of the cartilage were obvious; after 4 weeks all components of the cartilage tissue were involved in a degenerative process. These changes progressed in the 6-month period in which the joint was remobilized. At the end of the experiment the morphology of the cartilage tissue was comparable to the structural aspect of a typical arthrosis. It is concluded that an external immobilization of a joint which comprises also a pressure on the surface of the cartilage cannot be considered as a harmless procedure. It is recommended to be very cautious with the indication of a therapeutical immobilization of a joint and, if necessary, to use it as short as possible.
固定导致关节透明软骨发生结构退行性改变，这是众所周知的。为了弄清楚这些变化是否可逆，分别对兔的右膝关节进行关节外固定2周或4周。然后，对8只动物的关节进行6个月的再活动。通过光学显微镜、扫描电子显微镜和透射电子显微镜对关节软骨进行研究。固定2周后，软骨表层的变化就很明显；4周后，软骨组织的所有成分都参与了退行性过程。这些变化在关节再活动的6个月期间持续进展。实验结束时，软骨组织的形态与典型关节炎的结构特征相当。得出的结论是，包括对软骨表面施加压力的关节外部固定不能被视为无害程序。建议在关节治疗性固定的适应症方面要非常谨慎，如有必要，应尽可能缩短使用时间。
