| Objective: Adhesion is an abnormal attachment between connective tissue band and surrounding tissue or organs. Adhesion development is a major thorny complications in the knee joint postoperation. They can lead to far less ROM(range of motion). The surface of operative wound is protested against adhesions with a kind of resorbable polymeric material for wound heal ing, surgical anti-adhesions, and at the same time ROM increases. Chitosan is of well biocompatibility, Biodegradability and hemostasis then is suggested to be used in the knee operation. The aim of study of this animal experiment is to observe the effects of chitosan used against postoperative adhesions in and after a knee operation model of rabbits.Method: 16 healthy mature white rabbits were randomly divided into two groups. The experiment group is chitosan group, the other is the control one. All animals underwent a same synovium excision of the right knee joint under a same stict sterile condition. Chitosan were put inside the suprapatellar pouch area and fixed with soft tissue aroud in the expriment group, while none were put inside in the control one. then the knee jiont were limited in the flexed position with a plaster cast for 4 weeks .At the same time,the left knee underwent nothing. in observation under the general anesthesia, removing the plaster cast, the right thigh was firmly fixed on the table while the right lower legs was attached a length measure showed 500mg. ROM was measured. macroscopic findings,the joint was opened and aunknowing doctor observed the adhesions in the suprapatellar pouch area evaluated them semiquantiatively on a severity score of 0-4.Evaluation standard:0, no adhesions; l,filmly, weak adhesions;2,mid adhesions;3, moderately dense adhesions;4, dense, fibrous adhesions. 50mg weight of the adhesion tissue sample were obtained from the suprapatellar capsula area, then were lyophilized and store at - 20 centgrade and Biochemical analyses, as total collagen was determined on the basis of hydroxyproline content, lmg collagen content 0. 125mg hydroxyproline. According to hydroxyproline standard concentration ultraviolet rays ABS at 560um by spectrophotometer, make a ABS/concentration standartd curve, each sample ABS match a concentration mass, collagen mass= hydroxyproline massX8. After above, the right joints were excisied with soft tissue around, the sample were decalcification in 10% formaldehyde-10% nitric acid mixed solution until 1 week later, a needle can stick into bone tissue easily and watered before made up sample sections, then picric acid - sirius red stainning and polarized microscope were employed to investigate the collagen type I and III.The result were photoed and collagen I/III(square) were analysed by LERCA QWin V3 system. For collagen types was determined by analysis of the date expressed as a ratio type I collagen to type III collagen. All data were done ststistical analysis with SPSS10. 0 software, The grades are reprensented as the MEAN ± SD. All data were analyzed by t test and /X0. 05 was set as significant. Result: One rabbits in experiment and control group died,one in experiment can not be evaluated because of having pressure ulcer from the cast. Remaining 13 were studied. Six rabbits in experiment group and seven in control group were used for biomechanical data revealed that in the experiment group ROM angle was44. 33° ±5. 125° and that was30. 29° ±5. 438° in the control group. The contral group was significantly smaller than the experiment group(/X0. 01). As macroscopically finding,control ones expressdense fibrous adhesions, while experiment ones express little adhesions. The scrores for adhesions in experiment group was grades 2. 16 + 0. 408, the other was 3. 14±0. 556, the control group was significantly higher than the experiment group(p<0. 01). Through biochemical analysis, the adhesions in the experiment group contained 80. 06+10.13 ug of total collagen in 1 mg dry weight of tissue while control groupl34. 03+11. 68ug. The control group was significantly higher than the other. (p<0.01). Histological observation showed collagen type I/III in the experiment group was 1.396 ±0.082 while 1. 860 +0. 115 in the control group, there was a significant different between two groups(p<0. 01).Conclusion: Through the right knee joint adhesions observation of rabbits were assessed biomechanically, macroscopically, biochemically and histologically. Gross study and all data for statistical analysis show that adhesion strength, grades, and density in the chitosan group were significantly lower than the control group.It can effectively reduce postoperative adhesions in the knee operations. General speaking, Chitosan is suggested to preventing postoperation adhesions of the knee joints.
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