Capsule release surgery temporarily reduces contracture in a rat elbow model of arthrofibrosis.

Autor: Scholp AJ; Roy J. Carver Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa, USA., Jensen JA; Roy J. Carver Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa, USA., Fowler TP; Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa, USA., Petersen E; Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa, USA., Fredericks D; Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa, USA., Salem AK; Department of Pharmaceutical Science, University of Iowa, Iowa City, Iowa, USA., Seol D; Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa, USA., Coleman M; Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa, USA., Lake SP; Department of Mechanical Engineering & Materials Science, Washington University in St. Louis, St. Louis, Missouri, USA.; Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, Missouri, USA., Martin JA; Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa, USA., Sander EA; Roy J. Carver Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa, USA.; Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa, USA.
Jazyk: angličtina
Zdroj: Journal of orthopaedic research : official publication of the Orthopaedic Research Society [J Orthop Res] 2024 Sep 15. Date of Electronic Publication: 2024 Sep 15.
DOI: 10.1002/jor.25967
Abstrakt: Elbow trauma can lead to joint contracture and reduced range of motion (ROM). Nonsurgical interventions can improve ROM, but in some cases capsule release surgery is required. Although surgery can improve ROM, it often does not restore full ROM. Thus, alternatives are needed. One approach is to target activated myofibroblasts, which are commonly associated with fibrotic tissue. Mechanical and biochemical cues drive a feedback loop that can result in normal or pathological healing. We hypothesize that this feedback loop exists in joint contracture and can be manipulated so that myofibroblast activity is reduced, normal healing is achieved, and ROM is improved. We previously demonstrated that blebbistatin can inhibit myofibroblast contractile forces and reduce collagen synthesis in vitro. Thus, the purpose of this study was to assess the use of blebbistatin in an animal model of elbow contracture, which was induced in 7 groups of 4 rats each (n = 28). All elbows were mechanically and histologically tested. The uninjured contralateral elbows of each rat were used as a control group. Capsule release surgery significantly improved (p < 0.01) outcomes 1 week after surgery compared to injury alone and was not significantly different from uninjured elbows. Three weeks after surgery, outcomes worsened, indicating joint stiffening consistent with what is observed clinically. The addition of blebbistatin did not significantly improve outcomes. Future work will investigate relationships among treatment, fibrotic tissue deposition, myofibroblast activity, and biomechanics to determine if blebbistatin is a useful adjunctive therapy for treating joint contracture.
(© 2024 The Author(s). Journal of Orthopaedic Research® published by Wiley Periodicals LLC on behalf of Orthopaedic Research Society.)
Databáze: MEDLINE
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