| Objective to study the impact to osteoarthritis SOD and NO level and the curative effect of the continual irrigation after arthroscopy operation to the knee OA patients,and supply the fundation of the theory for relieving knee osteoarthritis patients'ache during the early time after arthroscope operation and improving knuckle function.Methods Animal experiment:eighteen experimental rabbits to make bilateral knee OA model in Hulth way.Later one month after operation , four of 18 rabbits were extracted at random to judge whether the operation succeed or not.And then,the other fourteen experimental rabbits were divided into two groups.One group of the rabbits were irrigated on bilateral knees with 500mlsaline at room temperature for 4 hours at the first and eighth day, as irrigation group. The other group of the rabbits were not irrigated ,and as non-irrigation group.All experimental rabbits were killed one week later after the irrigation and then examined the vitality of SOD,and the content of NO of bilateral knee synovium.At the same time,knee weight-bearing area of articular cartilage was dyed with HE,to observe the histology change of specimen under light microscope.Clinic trial: Forty diagosed patients with knee OA were divided into two groups,20 per group.One group was irrigated continually with 2000ml normal saline and lasted 6 hours after arthroscope operation,as the contiunal irrigation group. In contrary ,the other group wasn't, and as the non-contiunal irrigation group.Both of the two groups were extracted knee fluid 2ml at the before operation and on the first and the second week after the operation , examined SOD vitality of every joint fluid specimens and the content of NO by Xanthine oxidase and Nitrate reductase . It had to score according to JOA treatment of knee osteoarthritis determining standard on the before and the first ,second weeks after the operation .Results with analysis of variance,two-samplest and paired-samplest test was used for statistical analysis .Results The 14 rabbits and 40 patients all entered the result analysis of data. Animal experiment results:â‘ synovium SOD , NO:knee joint synovium in the irrigation group SOD activity was stronger than that of the non- irrigation group (p<0.01),but the content of NO was smaller than hat of the non-irrigation group(p<0.01).â‘¡Cartilage specimens: Irrigation group cartilage clearly see the level of the cells slightly reduced but morphologically normal. Tangent layer of cartilage destruction of the non-irrigation group, cell numbers, significantly reducing clutter, cartilage surfaces angiogenesis. Results of clinical trials:â‘ synovial fluid SOD, NO: In the postoperative 1 week, the group continued to irrigate the vitality of SOD in synovial fluid was significantly higher than the non-continual irrigation group (P <0.05). And the two groups at 1 week after surgery, synovial fluid SOD activity was also higher than the preoperative joint fluid when the SOD activity (P <0.01); while continuing to irrigate group and the non-irrigation group sustained after 1 week concentration levels of NO significantly decreased, with a significant difference in preoperative (P <0.05), and the two groups 1 week after surgery have a marked difference (P <0.05).â‘¡efficacy Rating: there were no score differences between continual irrigation group and non-continual irrigation Group on the first week, .At the second week, the continual irrigation Group score results must be significantly higher than non-continued irrigation group to score (P <0.05) the two groups also scored significantly higher than preoperative score (P <0.05).Conclusionsâ‘ Continual irrigation can significantly reduce the intra-articular concent- ration of inflammatory mediators. after continual irrigation to rabbit knee osteoarthritis and clinical paitents with knee osteoarthritis after arthroscope operation, and intra-articular SOD, NO has different degrees of change, there by reducing the inflammatory mediators of articular cartilage damage.â‘¡knee arthroscopy-assisted surgery of the continual irrigation can significantly reduce the symptoms of patients with knee OA. Through the treatment of knee arthroscopic surgery to remove the harmful elements in the joints, and then by continuing after irrigation, further reduction of intra-articular inflammation of the media and the bleeding caused by surgery, debris and to improve the therapy of the arthroscope operation.â‘¢NO sensitivity much better than SOD. The same period of time, NO change in amplitude was significantly better than SOD, shows the condition of NO in the process of change in OA should be sensitive to SOD, therefore, NO can serve as a monitoring of OA changes in the preferred indicators of disease progression. |
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