The Method Of Minimally Invasive Fixed Osteoarthritis IL-1β、TNF-α Influence And Preliminary Clinical Application

Objective:To understand minimally invasive external fixation the influence of osteoarthritis and with chinese medicine in clinical observation of preliminary application.Methods:Part I:30sheep randomly selected six, in the left knee cavity after injections of saline solution as blank control group; The rest only24,in the left knee after application papain made osteoarthritis model; Randomly divided into four groups, Three groups to wear the brackets, give different led by a fixed bracket; All of five groups in14weeks after death, general observation, collected blood, joint joint fluid detection IL-1β, TNF alpha content.Part Ⅱ:Use minimally invasive external fixation preliminary clinical applications with Chinese medicine, Observation, evaluation during treatment of patients with symptoms, signs, the quality of life, etc in,to see If this method is effective.ResultsPartⅠ:1Specimens general observation:Blank control group:joint fluid shows transparent, quantity is little, qualitative thick not sticky; Synovial was pink, color distribution, no marked hyperemia, uniform hyperplasia; Articular cartilage pale blue, colour and lustre is bright, edge neat, no crack and softening. Model control group:joint fluid shows deep yellow, is more, qualitative thick and sticky; Deep red color, in uneven distribution, marked hyperemia, edema, hyperplasia, thick; Articular cartilage lose original luster, show that rough, become dim, yellow, the touch is soft, margin not neat, existence and soften the crack. Normal clearance groups:joint fluid shows buff, quantity is little, qualitative thick and slightly sticky; Synovial was pink, color distribution uniformity, a few congestion, no edema, hyperplasia, thick; Articular cartilage lose luster, show that slightly rough, is faded, yellow, the touch is soft, margin not neat, no crack and softening. Middle clearance groups:the joint fluid shows buff, quantity is little, qualitative thick and slightly sticky; Synovial was pink, color distribution uniformity, a few congestion, edema, no hyperplasia, thick; Articular cartilage lose luster, show that slightly rough, is faded, yellow, the touch is soft, margin not neat, no crack and softening. Biggest clearance groups:joint fluid shows buff, quantity is little, qualitative thick and slightly sticky; Synovial was pink, color distribution uniformity, a few congestion, edema, no hyperplasia, thick; Articular cartilage lose luster, show that slightly rough, is faded, yellow, the touch is soft, margin not neat, no crack and softening.2Serum IL-1β, TNF alpha testing:each byte is6patients, the results are as follows:serum IL-1β, TNF alpha content (x±s, pg/ml) are:the blank control group:3.65±0.39、4.80±0.36; Model control group:22.75±2.14、32.83±1.57; Normal clearance groups:0.00±1.52、12.07±1.39; Middle clearance groups:13.87±0.69、17.58±0.95; Biggest clearance groups:17.87±0.76、21.82±1.69.3joint fluid IL-1β, TNF alpha testing:each byte is6patients, the results are as follows:joint fluid IL-1β, TNF alpha content (x±s, pg/ml) are:the blank control group:56.67±3.72、27.83±4.02; Model control group:183.50±5.17、101.50±3.39; Normal clearance groups:95.33±3.50、45.17±2.79; Middle clearance groups:114.67±4.08、83.83±3.43; Biggest clearance groups::131.33±1.86、89.67±1.75.Part Ⅱ:Preoperative,postoperative two weeks, the second day of postoperative eight weeks open external fixation, postoperative twelve weeks, postoperative sixteen weeks swelling score: The results were3points,1points,0points,0points,0points. Swelling ease results are:the invalid, effective, powerfully, powerfully, powerfully.Preoperativ-e,postoperative two weeks, the second day of postoperative eight weeks open external fixation,postoperative twelve weeks, postoperative sixteen weeks for AOFAS score:The scores were28points,43points,74points,87points,94points. The results are:the poor, poor, fair, good, excellent.Patients ankle swelling and pain disappears, and activities to improve, deformity correction, gradually normal gait, and gradually improve the ability to walk.Conclusions:minimally invasive external fixation can improve mechanical environment through the knee and stress balance to achieve the effect of treatment KOA; And may reduce the serum, joint in the fluid of IL-1β, TNF alpha, the content of the therapeutic mechanism can also be related to the. Three different led to a fixed knees arthritis sheep are curative effect but not the same good curative effect, When the knee joint gap in normal fixed, the best curative effect; When Knee fixed in the normal and the largest gap between, Curative effect center; Will the knee gap led to the maximum, the curative effect is the worst. For the clinical application of minimally invasive treatment to the external fixation method to provide the evidence that the osteoarthritis. In the clinical application of minimally invasive external fixation method with traditional Chinese medicine internal and treatment of Traumatic ankle osteoarthritis with equinovarus proved its in reducing the joint swelling and pain, improve joint activities, correction deformity, improve the ability to walk on exactly curative effect.