Pathological Changes And Expression Of LOXs And MMP-1,-2,and -3 In Ligaments Of Patients With Haemophilic Arthritis

Aim we aim to compare the pathological changes of ligament tissues in patients with hemophilia arthritis（HA）and osteoarthritis（OA）,and to further elucidate the biological metabolic basis of the pathological changes by detecting the expression levels of key enzymes that control ligament tissue metabolism,such as lysine oxidase（LOXs）and matrix metalloproteinases（MMPs）.We hope to clarify the ligament tissue pathological change of HA,and at the same time we hope that the results of the study would be of some help in total knee arthroplasty for the reference of the medial collateral ligament release degree in HA patients with flexion contracture deformity,and useful in exploring early clinical protection strategy on ligament.Methods The ligament tissues of male patients who underwent initial total knee arthroplasty due to HA in the Second Affiliated Hospital of Anhui Medical University from April 2020 to January 2021 were collected,and the ligament tissues of male patients who underwent the same operation due to OA in our hospital during the same period were selected as the control.A random number table was used to randomly select the same number of patients from the OA group as from the HA group.HE,Masson and Verhoeff-Van Gieson staining methods were used to compare the basic pathological changes of the ligament tissues in the two groups.Western blot and q RT-PCR were further used to detect the expression levels of major components of ligament tissue,such as type I collagen,elastin and key enzymes controlling ligament metabolism,such as MMPs and LOXs.SPSS 24.0 was used for statistical analysis to determine the differences between groups..Results Compared with OA ligaments,HA ligaments were constructed more loosely with wider gaps,more breaks,haemocytodeposition and irregularity local hypertrophy among the fibres.LOXs and MMP m RNA expression levels were upregulated in the HA tissues,which was consistent with the western blot results.Collagen I and elastin levels were also higher in patients with HA.Conclusion Ligament tissue metabolism is a precise regulation process involving various cells,cytokines and signaling pathways.Compared with OA,the metabolic process of ligament tissue in HA is more complex.The ligament of patients with HA have strong repair metabolism and catabolism processes at the same time,leading to the unique pathological changes of the ligament which may be related to iron overload and inflammatory factor imbalance caused by repeated intra-articular bleeding.Our results suggest that for patients with HA,it may be safer and more effective to retain a certain flexion angle during the release of the medial collateral ligament of the knee during total knee replacement combined with subsequent functional rehabilitation exercise,which is of great significance to the intraoperative decision-making of clinical surgeons.