Experimental Study Of The Impact On Retrograde Intramedullary Needle Puncture With Articular Cartilage Damage And Repair

Background:Studies supports that the joint’s operation of retrograde intramedullary needle treatment of joint operation on the joint function, has a harmful effect on the joint function、 articular cartilage and repair cartilage injury, make the articular adhesion, stiffness, cartilage damage and repair difficult after injuried.Objective:(1) Observation the effects of retrograde intramedullary needle puncture and joint brake on joint function and the influence of the articular cartilage (2) observation the effects of retrograde intramedullary needle puncture and brake on the joint function after articular cartilage injury and repair of cartilage damage. Methods:(1)Rabbit braking model is made by joint was fixed by plaster, through the operation of rabbit knee joint circular cut、 bone needle biopsy retrograde intramedullary needle penetration model, in an operation body for blank control.Postoperative8weeks,12weeks by joint mobility, gross observation, soft tissue specimens score after comparing two treatment’s impact on joint function and cartilage.(2) Through joints incision removed a certain weight-bearing area of cartilage tissue to made articular cartilage damage model, at the same time, respectively give to different groups was a plaster cast, bone needle puncture treatment, preparation of articular cartilage defect after joint brake and retrograde intramedullary needle penetration model, and set up a simple contrast of articular cartilage injury group.Postoperative8weeks,12weeks by joint mobility, gross observation, soft tissue specimens score after comparing two treatment’s impact on joint function and cartilage. Results:(1) Mobility observeing postoperative in the first part experiment: After8weeks,12weeks, the joint motion was obviously reduced in braking group, retrograde intramedullary needle puncture group and the blank control group is obviously better than braking group (P<0.05), The retrograde intramedullary needle puncture group have no statistical difference to blank control group (P>0.05)(2) Gross and histological observation of articular cartilage: Postoperative8weeks,12weeks,the contact and non-contact areas joint cartilage in brake group were all degenerative, potential lacuna formed under the shallow layer of cartilage, through the tide line, deep in the subchondral bone, thinning of the cartilage surface, uneven, area of the cartilage cells reduce degeneration, appear even focal necrosis, and retrograde intramedullary needle puncture group and blank group cartilage surface smooth, full four layers structure clear, the tide line are clear and complete cartilage cells number, shape, size is normal, the layers of cartilage cells arranged orderly, no ulcer cartilage surface, crack, cyst formation, the area of puncture filled by scar healing.(3) The histologic grading:retrograde intramedullary needle puncture group besides fibrous cartilage healing of puncture, the weight-bearing area of articular cartilage has no significant difference to blank control group (P>0.05), the histologic grading has no statistical difference, and the braking performance group had obvious degeneration of articular cartilage injury, retrograde intramedullary needle puncture group and blank group is obviously better than the braking group (P<0.05),and histologic grading’s statistical differences significantly.(4) The second part experimental activity after surgery were observed: postoperative8weeks,12weeks, the joint motion was obviously reduced in braking group, the retrograde intramedullary needle puncture group and the simple injury group were obviously better than and braking group,the statistical differences were significantly (P<0.05), Retrograde intramedullary needle puncture group has no significant statistical differences to simple injury group (P>0.05)。(5) Gross and histological observation:postoperative8weeks,12weeks, the brake group and simple defect group’s cartilage defect parts packing tissue regeneration is less, covered only part of the connective tissue, connective tissue defect of retrograde intramedullary needle puncture group have not smooth organization is better filling, but has not formed completely transparent cartilage cells to repair (6) The histologic grading:retrograde intramedullary needle puncture group of damaged cartilage on the surface of the new filler is closer to the normal cartilage, which is superior to other two groups (P<0.05), And brake with simple injury group see no significant statistical difference (P>0.05). Conclusion:The experiment has proved that:joints brake makes articular cartilage loss normal stress stimulation, can not effectively update cycle, articular cartilage nutrition affected, appear secondary injury of articular cartilage, retrograde intramedullary needle puncture make no obvious adverse effect on healthy cartilage and joint function, retrograde intramedullary needle puncture release bone marrow mesenchymal stem cells and coagulation clot contain biological factors to repair articular cartilage injury,plays a positive role in promoting, joint damage repair. And a long time joint braking makes articular cartilage metabolism updating slows down, loses its normal stress stimulation, failure to repair articular cartilage to play an negative role, but also loss of joint function with simple injury group. So we think the retrograde intramedullary needle puncture made no bad influence to articular cartilage, and will exert positive effects on repair of articular cartilage injury, the bad joint function, cartilage damage repair in clinic, confirmed that is associated with joint braking for a long time.