Remobilization Does Not Restore Immobilization-Induced Adhesion of Capsule and Restricted Joint Motion in Rat Knee Joints

Abstract

Joint immobilization, which is used in orthopaedic treatments and observed in bedridden people, usually causes restricted joint motion. Decreased joint motion diminishes activities of daily living and increases burden of nursing-care. The purpose of this study was to clarify the reversibility of immobilization-induced capsular changes and restricted joint motion in rat knee joints. The unilateral knee joints of adult male rats were immobilized with an internal fixator for 1, 2, 4, 8, and 16 weeks as a model of immobilization after surgery or disuse of the joint. After the fixation devices were removed, the rats were allowed to move freely for 16 weeks. Sham-operated rats were used as controls. Sagittal sections at medial midcondylar regions were made and assessed with histological, histomorphometric, and immunohistochemical methods. Joint motion was measured using a custom-made device under x-ray control after removal of the periarticular muscles. In the 1/16-week and 2/16-week immobilization-remobilization (Im-Rm) groups, cord-like structures connecting the superior and inferior portions of the posterior capsule (partial adhesion) were observed without restricted joint motion. In the 4/16-, 8/16-, and 16/16-week Im-Rm groups, global adhesion of the posterior capsule and restricted joint motion were observed. The restricted joint motion was not completely restored after incision of the posterior capsule. These data indicate that immobilization alone causes irreversible capsular changes and arthrogenic restricted joint motion. Besides the joint capsule, other arthrogenic factors such as ligaments might influence the restricted joint motion. Prolonged immobilization over 4 weeks should be avoided to prevent irreversible joint contracture.

Inflammatory cytokine expression in the quadriceps of rats with posttraumatic knee stiffness: A preliminary study

“…The room temperature and humidity were maintained at 18°C and 50-55%, respectively. Knee stiffness on the experimental side developed as the animals were kept in their cages for 4 weeks post-surgery [10]. The femorotibial wire was removed in a second surgery at the end of 4 weeks of immobilisation under the same anaesthesia described above.…”

Resistance exercise recovers the structure of cartilage and synovial membrane of the ankle joint of rats after sciatic compression

“…Common symptoms of these nervous injuries include dormancy, paresthesia, weakness and atrophy of the effector muscles, as well as the impairment of the normal functions and movements of the lower limbs, since this musculature affects the motricity of the joints 3, 4 , including the ankle, which is responsible for providing a stable base of support for the body, in addition to effectively propelling it during locomotion 5 . Thus, nerve lesions lead to the disuse of the limb and, as a consequence, there is a reduction in the mechanical stimulus necessary to maintain the morphological properties of the joint [6][7][8][9] , which can lead to rigidity of the joint capsule and consequent restriction in movement 10 , as well as atrophic changes in the articular cartilage with a reduction in its thickness and the number of chondrocytes 11,12 . Moreover, according to Hui, McCarty, Masuda, Firestein, Sah 13 , the composition and function of synovial fluid are also altered in cases of joint injury or disease.…”

Collagen types I and II distribution: a relevant indicator for the functional properties of articular cartilage in immobilised and remobilised rabbit knee joints

“…Loading and movement of the joint are of major importance for the maintenance of the morphologic and functional integrity of the articular cartilage [27]. Immobilisation of joint comprises a major component of treatment for various diseases whether for the purpose of stabilising fracture frequency or to rest inflamed or damaged tissues secondary to disease or traumatic injury [2,4,28]. The impact of immobilisation and unloading of joints on articular cartilage has been investigated in animal models [2,11] and humans [12,27,28].…”

“…Immobilisation of joint comprises a major component of treatment for various diseases whether for the purpose of stabilising fracture frequency or to rest inflamed or damaged tissues secondary to disease or traumatic injury [2,4,28]. The impact of immobilisation and unloading of joints on articular cartilage has been investigated in animal models [2,11] and humans [12,27,28]. Previous studies have demonstrated that joint immobilisation and unloading lead to functional adaptation of articular cartilage that involve morphologic changes of chondrocytes and cartilage matrix [13,15].…”

“…Previous studies have demonstrated that joint immobilisation and unloading lead to functional adaptation of articular cartilage that involve morphologic changes of chondrocytes and cartilage matrix [13,15]. Articular cartilage changes were detected as early as one week following immobilisation of rat knee joint [2,3]. Studies performed on animals have also investigated the effect of remobilisation on the immobilisation-induced cartilage changes to detect the reversibility of these changes.…”