| PurposeThis study using the method of surgical model rabbit tibia platform fracture internal fixation,using simple needle knife,simple CPM and needle knife combined CPM intervention,and establish the model group compared with the blank group,observe the changes of rabbit weight,diameter,the risk of knee joint of knee joint mobility(swelling),inflammatory factors in knee joint fluid,periarticular ductile band histomorphology,degree of fibrosis and content of mmp-13 and timp-1 in ligament tissues.To verify the effectiveness of needle-knife alone,CPM alone and CPM combined with CPM in the treatment of joint adhesion after internal fixation of tibial plateau fracture in rabbits,and to explore the mechanism of action,so as to provide experimental basis for the treatment of this disease with needle-knife.methodsThe random number table method was used to select 6 New Zealand rabbits as the blank group among 30 healthy normal rabbits at the age of 6 months.The remaining 24 rabbits were placed in the passive flexion and extension training 3d of the knee joint,and then the modeling was carried out.After successful modeling,random number table method was used to randomly divide the model group,needle-knife group,CPM group,and needle-knife +CPM group.After successful modeling,the SDE group did not have any intervention,and the needle-knife group received acupotomotherapy treatment one week after modeling,once a week for 4 weeks,for 4 times in total.The CPM group began to intervene on the first day after modeling,with the passive motion Angle of 40° ~ 110°.Weight monitoring was performed on day 7,14,21 and 28 before and after surgery,and the degree of motion and swelling of the knee joint were measured before and on day 1,7,14,21 and 28 after surgery.And at the end of the treatment and after completion of the measurement,extraction of five groups of rabbit knee joint fluid,then put to death,take a right knee medial collateral ligament and lateral collateral ligament,ligament surrounding connective tissue by the scissors,cut into appropriate size of each specimen after specimen collection,put in neutral fixative fixed,H&E staining,mason trichromatic staining to observe the morphological structure of ligament tissue and fibrosis degree,at last,by immunohistochemical method to detect the expression of MMP-13 and TIMP-1.The results of1.Except for the blank group,the rabbits in the other four groups gradually began to regain weight in the third week after the experiment.At the end of the study,there was no statistically significant difference between the four groups.However,there were significant differences in body weight between the four groups and the blank group(n=6,p<0.01).Compared with the blank group(n=6),the passive maximum flexion Angle,the passive maximum elongation Angle and the range of motion of joints were significantly decreased or increased after modeling(p<0.01).Compared with SED group(n=6),after 14 days of intervention,CPM group(n=6)and needle-knife +CPM group(n=6)had significantly increased the passive maximum elongation Angle and range of motion,while the passive maximum buckling Angle significantly decreased(p<0.05,p < 0.01).On the 28 th day of the intervention,the range of motion in the acupuncture group(n=6)was significantly improved compared with that in the model group(p<0.05),and the range of motion in the needleknife +CPM group was significantly increased compared with that in the CPM group and the needle-knife group(p<0.05).Compared with the SED group(n=6),the degree of joint swelling in other groups increased significantly from the 14 th day of intervention(p<0.01).Compared with other groups,the needle-knife +CPM group(n=6)had a significant difference from day 21 of intervention(p<0.01).On the 28 th day of the intervention,there were significant differences in joint swelling in each group(p<0.01).2.The expression levels of IL-1β,IL-6 and TNF-α in the knee joint solution were significantly increased in the right knee joint of rabbits in the control group compared with the control group(n=6,p<0.01).The expression levels of IL-1β,IL-6 and TNF-αin the knee joint fluid were significantly reduced in the right knee joint of rabbits in the needle-knife group and CPM group compared with the right knee joint of rabbits in the SED group(n=6,p<0.05).There was no significant change in the expression levels of IL-1β,IL-6 and TNF-α in the knee fluid of the affected knee(right knee)between the needle-knife group and the CPM group.The expression levels of IL-1β,IL-6 and TNF-α in the knee fluid of the affected knee(right knee)were significantly reduced in the needle-knife +CPM group compared with the SED group,CPM group and the needle-knife group(n=6,p<0.01).3.The changes of medial and lateral collateral ligaments before and after the intervention were observed by H&E staining and masson tricolor staining.H&E staining showed that after modeling,there was no intervention in the medial and lateral collateral ligaments in rabbits,with large and disordered ligaments,swollen ligamentous cells,deformed ligamentous nuclei,widened interstitium and fibrosis.After treatment,the above symptoms were relieved to varying degrees.Masson trichromatic staining showed that the elastic fibers of the medial and lateral collateral ligaments(red)decreased significantly after modeling,while the collagen fibers(blue)increased significantly.The medial collateral ligament is more serious than the lateral collateral ligament.After the intervention,different degrees of increase in elastic fibers were observed.4.Compared with the blank group(n=6),the expression level of mmp-13 and the expression level of timp-1 were significantly increased in the SED group(n=6,p<0.01).After treatment with needle-knife and CPM,the expression levels of mmp-13 and timp-1 in ligaments in the needle-knife group,CPM group and needleknife +CPM group were significantly lower than those in the SED group(n=6,p<0.01).There was no significant difference between needle-knife group and CPM group.There were significant differences in protein expression in some ligament tissues between the needle-knife +CPM group,the blank group,with the needle-knife group and the CPM group(n=6,p<0.05).There was no significant difference between the needle-knife +CPM group and the blank group.conclusion1.Needle-knife combined with CPM treatment can significantly improve the range of motion and joint swelling of rabbits after modeling,and the simple two treatments also have an effect,but it is not as obvious as the combination of the two.2.Needle-knife combined with CPM treatment can significantly reduce the inflammation in the right knee joint of model rabbits.The simple two treatments also have an effect,but it is not as obvious as the combination of the two.3.Joint CPM Needle knife therapy can obviously improve the ligament tissue morphology,structure and the degree of fibrosis and its mechanism may be on the surrounding ligament tissue release,stimulus to one of the mechanical stimulation pathway,with benign adjustment ligament tissue,the content of MMPs and TIMPs in improved knee Zhou Ren with fibrosis,and adjust the secretion of joint inflammation factors,so as to protect joints,joint normal activities. |
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