悬吊式外固定支具有限制动建立的兔膝骨关节炎模型

目的运用不依赖加压固定的体外关节制动造模方式,制备皮肤软组织健康的兔膝骨关节炎模型。方法选用雄性新西兰大白兔18只,按照随机数字表法随机分为正常组、传统Videman法造模组(简称Videman组)、悬吊式外固定法造模组(简称悬吊组),各6只。正常组不予任何处理,Videman组单纯采用管型高分子石膏完全制动兔左膝关节于伸直位,悬吊组采用悬吊式外固定支具有限制动兔左膝关节于伸直位。6周后解除关节制动,观察兔皮肤软组织和左膝关节情况,用Bates-Jensen伤口评估工具(the Bates-Jensen wound assessment tool,BWAT)对皮肤软组织健康情况进行评估,用Lequesne MG评分对左膝关节功能进行评估;空气栓塞法处死动物,对左膝关节软骨行大体观察和HE染色病理学观察,并用Pelletier评分及Mankin评分对软骨损伤情况进行评估。结果(1)皮肤软组织健康情况比较,与正常组和悬吊组相比,Videman组BWAT评分升高(P<0.05);悬吊组与正常组BWAT评分比较,差异无统计学意义(P>0.05)。(2)左膝关节功能比较,与正常组相比,Videman组和悬吊组Lequesne MG评分均显著升高(P<0.01);Videman组和悬吊组Lequesne MG评分比较,差异无统计学意义(P>0.05)。(3)正常组左膝关节软骨大体观察和HE染色观察结果均正常,Videman组和悬吊组均见典型的软骨破坏,符合膝骨关节炎病理学改变。与正常组相比,Videman组和悬吊组Pelletier评分及Mankin评分均显著升高(P<0.01),达到轻中度骨关节炎的评分等级;Videman组和悬吊组Pelletier评分及Mankin评分比较,差异均无统计学意义(P>0.05)。结论悬吊式外固定支具有限制动膝关节于伸直位的造模方式可成功制备皮肤软组织健康的兔膝骨关节炎模型,其造模效果与传统Videman造模法效果一致,但对皮肤软组织的保护能力强于后者。

Rabbit Knee Osteoarthritis Model Established by Hanging External Fixator with Limited Immobilization

Objective To establish the model of knee osteoarthritis in rabbits with healthy skin and soft tissue by using the method of external joint braking with unpressurized fixation.Methods A total of 18 male New Zealand white rabbits were selected and randomly divided into the normal group,the traditional Videman model group(Videman group)and the suspension external fixation model group(suspension group)according to random number table method,with 6 rabbits in each group.The normal group did not do any treatment,the Videman group simply used tube type polymer gypsum to completely fix the left knee joint in the extension position,and the suspension group used suspension external fixator to restrict the movement of the left knee joint in the extension position.After 6 weeks,the joint external fixation was removed.The condition of skin soft tissue and the left knee joint were observed.The health status of skin soft tissue was evaluated by the Bates-Jensen wound assessment tool(BWAT).The function of left knee joint was evaluated by Lequesne MG score.Then killed the rabbits by air embolization.The cartilage of the left knee joint was observed by gross observation and pathological observation by HE staining.The Pelletier score and Mankin score were usd to evaluate the cartilage injury.Results(1)Comparison of skin and soft tissue health,compared with the normal group and the suspension group,BWAT score in the Videman group was increased(P<0.05);there was no statistically significant difference in BWAT scores between the suspension group and the normal group(P>0.05).(2)Comparison of left knee joint function,Lequesne MG score in the Videman group and the suspension group was significantly higher than that in the normal group(P<0.01);there was no statistically significant difference in Lequesne MG score between the Videman group and the suspension group(P>0.05).(3)Gross observation and HE staining observation of left knee articular cartilage in the normal group were all normal,the Videman group and the suspension group all showed typical pathological changes of knee osteoarthritis.Compared with the normal group,Pelletier and Mankin scores in the Videman group and the suspension group were significantly increased(P<0.01),reaching the scoring level of mild to moderate osteoarthritis;there were no statistically significant difference in Pelletier score and Mankin score between the Videman group and the suspension group(P>0.05).Conclusion The rabbit model of knee osteoarthritis with healthy skin and soft tissue can be successfully established by the method of hanging external fixator with limited immobilization the knee joint to extension position,its modeling effect is consistent with that of traditional Videman modeling method,but the protection ability to the skin soft tissue is stronger than the latter.