| Objective: To explore the therapeutic effect of static progressive stretch with different parameters on knee stiffness rats and its therapeutic mechanism,in order to provide theoretical basis for clinical establishment of static progressive draft treatment standard.Methods: 1.Modeling: 8 of 56 SD male rats were randomly selected into the blank group,and the remaining 48 rats were anesthetized with 1% sodium pentobarbital intraperitoneally.The skin was incised to expose the femur and tibia,and a 0.6 mm Kirschner wire was penetrated.The femur and tibia are fixed to 135° of flexion.Then the 1.5mm bone needle was used to punch the non-articular cartilage part of the lateral femoral condyle of the knee with the depth of 3mm.After treatment,rinse the incision and suture the muscle,fascia and skin.Two days later,the fixation of Kirschner wire was examined by X-ray irradiation.2.Grouping and treatment: 42 successful model rats were randomly divided into 6 groups.The rats were divided into three groups: blank group: rats moved freely in cage;model group: killed immediately after successful modeling;natural recovery group: free movement after internal fixation was removed;T1 group: draft 20 minutes,once a day;T2 group: draft30 minutes,once a day;T3 group: draft 20 minutes,once per 2 days;T4 group,30 minutes,once per 2 days.The treatment period was 16 days.3.Evaluation methods: the range of motion of knee joint was measured in each group before and after treatment.The rats were killed on the second day after treatment,the muscles around the knee joint were amputated at the upper and lower 0.5cm of the knee joint,and the joint stiffness was tested,and then the whole knee joint was cut off at the upper and lower 2cm of the knee joint and put into the fixation fluid.4.Statistical methods: The distribution of experimental data was tested for Normality test and homogeneity of variance.Multiple Group data were compared using Anova,LSD afterwards,and factorial design Anova for comparison between different treatment regimens.The Wilcoxon rank sum test in nonparametric test is chosen if the data are seriously skewed.Results:(1)Range of Motion : The activity of the model group was significantly lower than that of the blank group.After treatment,both the natural recovery group and the stretching group increased,the activity of the stretching group improved more than that of the natural recovery group,and the T2 Group(Time: 30 min,frequency: 1 time/day)had the most obvious improvement effect Group T4(Duration: 30 min,frequency: 1/2 days)was larger than group T3(Duration: 20 Min,frequency: 1/2 days).(2)Stiffness:compared with other groups,the joint capsule stiffness of blank group was the lowest,and the difference was significant.The Model Group was the highest,and the difference was statistically significant compared with other groups.The stiffness of Group T2 was the lowest among the 4 different parameters,but there was no significant difference between group T1 and Group T2(Time: 20 Min,frequency: 1 time/day).(3)Joint Capsule Pathological Score: The pathological score of blank group was the lowest,except group T1 and T2,the difference between other groups was statistically significant.The Natural Recovery Group was the highest,and the difference was statistically significant compared with the 4 drafting groups.The pathological score of T2 group was the lowest among the 4 different drafting plans,and the difference was significant compared with T3 and T4 groups.(4)Myofibroblast Count:The number of fibroblasts in the right knee muscle was the lowest in the blank group,and there were significant differences between the two groups except the T2.The natural recovery group was the highest,but had no significant difference compared with the model group.The number of myofibroblast was the lowest in T2,which was significantly different from T3 and T4,but not significant compared with T1.(5)HE Pathological Staining: There was almost no pathological change in the blank group as a whole,while in the natural recovery group,the fibrous tissue proliferated,the synovium adhered,the joint space was narrow,and the overall lesion was the most severe.The four draft treatment groups were alleviated in varying degrees compared with the model group,especially in the T2.(5)Proportion of Positive Area of TGF-?1 Protein Expression: The positive rate of TGF-? 1 in articular capsule was the lowest in the blank group,but there was no significant difference compared with T1 and T2.The average positive rate in the natural recovery group and the four draft treatment groups was lower than that in the model group and there was significant difference.Among the 4 treatment groups,T2 was significantly lower than other draft treatments,but only compared with T3 and T4,there was no significant difference compared with T1.Conclusion:(1)Static progressive stretch is effective in the treatment of joint stiffness,and the treatment time is 30 min and the frequency is once a day.(2)Static progressive stretch therapy can reduce the expression of TGF-? 1,inhibit the excessive proliferation of myofibroblasts and alleviate the pathological changes of stiff joints.(3)After the release of fixation,the rats moved freely,and the range of motion was improved to some extent,but the degree of tissue lesion became more serious with time.(4)The duration of static progressive draft has a greater effect on the curative effect than frequency. |
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