Salter R B, Simmonds D F, Malcolm B W, Rumble E J, MacMichael D, Clements N D
J Bone Joint Surg Am. 1980 Dec;62(8):1232-51.
A new concept, continuous passive motion of a synovial joint in vivo, was investigated to determine its biological effect on the healing of full-thickness articular cartilage defects that penetrate the subchondral bone of knee joints of adolescent and adult rabbits. The effect of continuous passive motion was compared with the effects of immobilization and of intermittent active motion. This investigation included assessment of 480 defects in the knees of 120 adolescent rabbits and assessment of 108 defects in the knees of twenty-seven adult rabbits. The continuous passive motion was well tolerated by these animals, whose general well-being was undisturbed. The healing of the defects at weekly intervals up to four weeks was assessed by gross examination and by an analysis of two indices of healing determined by light microscopy: (1) the nature of the reparative tissue, and (2) the degree of metachromasia of the matrix as demonstrated by toluidine-blue staining. At three weeks this assessment revealed that in the adolescent rabbits, healing of the defects by hyaline articular cartilage was present in 8 per cent of forty defects in ten animals whose knees were immobilized, in 9 per cent of forty defects in ten animals whose knees were permitted intermittent active motion, and in 52 per cent of forty defects in ten animals whose knees were managed immediately after operation by continuous passive motion. At three weeks, in the adult animals, healing of the defects by hyaline articular cartilage was present in 3 per cent of thirty-six defects in nine animals whose knees were immobilized, in 5 per cent of thirty-six defects in nine animals whose knees were permitted intermittent active motion, and in 44 per cent of thirty-six defects in nine animals whose knees were managed immediately after operation by continuous passive motion. Thus, the metaplasia of the healing tissue within the defects from undifferentiated mesenchymal tissue to hyaline articular cartilage was not only much more rapid but also much more complete with continuous passive motion than with either immobilization or intermittent active motion.
研究了一个新的概念，即滑膜关节在体内的持续被动运动，以确定其对青春期和成年兔膝关节穿透软骨下骨的全层关节软骨缺损愈合的生物学效应。将持续被动运动的效果与固定和间歇性主动运动的效果进行了比较。这项研究包括对120只青春期兔膝关节的480个缺损进行评估，以及对27只成年兔膝关节的108个缺损进行评估。这些动物对持续被动运动耐受良好，其总体健康状况未受干扰。通过大体检查以及对光镜下确定的两个愈合指标进行分析，评估了长达四周的每周间隔缺损愈合情况：（1）修复组织的性质，以及（2）甲苯胺蓝染色显示的基质异染程度。在三周时，该评估显示，在青春期兔中，在10只膝关节固定的动物的40个缺损中，8%的缺损通过透明关节软骨愈合；在10只膝关节允许间歇性主动运动的动物的40个缺损中，9%的缺损通过透明关节软骨愈合；而在10只膝关节术后立即采用持续被动运动处理的动物的40个缺损中，52%的缺损通过透明关节软骨愈合。在三周时，在成年动物中，在9只膝关节固定的动物的36个缺损中，3%的缺损通过透明关节软骨愈合；在9只膝关节允许间歇性主动运动的动物的36个缺损中，5%的缺损通过透明关节软骨愈合；而在9只膝关节术后立即采用持续被动运动处理的动物的36个缺损中，44%的缺损通过透明关节软骨愈合。因此，缺损内愈合组织从未分化间充质组织向透明关节软骨的化生，与固定或间歇性主动运动相比，不仅速度要快得多，而且在持续被动运动时要完整得多。
