Kim H K, Kerr R G, Cruz T F, Salter R B
Division of Orthopaedic Surgery and Research Institute, Hospital for Sick Children, University of Toronto, Canada.
J Rheumatol. 1995 Sep;22(9):1714-21.
To determine the effects of continuous passive motion (CPM) and immobilization on synovitis and cartilage degradation in an experimental model of chronic inflammatory, antigen-induced arthritis.
After bilateral arthritis induction of knee joints in 22 NZW rabbits, one knee was immobilized with a flexion splint while the opposite knee received CPM.
After 2 weeks (n = 10), the CPM treated knees had significantly greater joint swelling, synovial effusion, and histologic synovitis scores compared to its opposite immobilized knees. However, the total cartilage degradation score showed no statistically significant difference between the two treatments. When the treatments were discontinued after 2 weeks and animals were allowed intermittent active motion of both knees in cages for 4 weeks (n = 12), no statistically significant difference in joint swelling, synovial effusion, and histologic synovitis score was observed between the 2 treatments. The articular cartilage degradation, however, was significantly greater in the immobilized knees compared to its opposite CPM treated knees. Five of 12 immobilized knees had articular surface erosion compared to none in the CPM treated knees. Loss of cellularity was also significantly greater in the immobilized knees.
Although CPM produced greater synovitis at 2 weeks, articular cartilage was better preserved in the knees treated with CPM than immobilization at 6 weeks.
在慢性炎症、抗原诱导性关节炎的实验模型中,确定持续被动运动(CPM)和固定对滑膜炎及软骨降解的影响。
在22只新西兰白兔双侧膝关节诱导关节炎后,一侧膝关节用屈曲夹板固定,而另一侧膝关节接受CPM治疗。
2周后(n = 10),与对侧固定的膝关节相比,接受CPM治疗的膝关节关节肿胀、滑膜积液及组织学滑膜炎评分明显更高。然而,两种治疗方法之间的总软骨降解评分无统计学显著差异。2周后停止治疗,让动物在笼中双侧膝关节进行间歇性主动活动4周(n = 12),两种治疗方法之间在关节肿胀、滑膜积液及组织学滑膜炎评分方面未观察到统计学显著差异。然而,与对侧接受CPM治疗的膝关节相比,固定的膝关节关节软骨降解明显更严重。12只固定的膝关节中有5只出现关节表面侵蚀,而接受CPM治疗的膝关节中无一例出现。固定的膝关节细胞丢失也明显更多。
尽管CPM在2周时产生了更严重的滑膜炎,但在6周时,接受CPM治疗的膝关节软骨比固定的膝关节保存得更好。