Continue Irrigation after Arthroscopy Impact the Knee OA on SOD, NO Levels in Animal Experiment and Clinical Research
|School||Guilin Medical College,|
|Keywords||Joint continuous irrigation Osteoarthritis Nitric oxide Superoxide dismutase|
Objective To investigate the continuous irrigation of osteoarthritis (osteoarthritis, OA) joint superoxide dismutase (active ted superoxide dismutase, SOD), nitric oxide (nitrogen monoxide, NO) and arthroscopic surgery and give continuous irrigation The efficacy of knee osteoarthritis patients. Relieve the pain of knee OA patients, and provide a theoretical basis for improving knee function early after arthroscopy. Method of animal experiments: 18 experimental rabbit to Hulth prepared knees OA model, after a four rabbits were randomly selected to determine the modeling success. The remaining 14 rabbits were randomly divided into two groups, one after the success of the model given 1,8 days at room temperature saline 500ml double knee line four hours continuous irrigation as the rinse group. Another group knees without rinsing, the group as a non-flushing. All rabbits were sacrificed flush finish one week after The bilateral knee synovial tissue detection of SOD activity, NO content at the same time take the knee weight-bearing area articular cartilage HE staining light microscope histological changes observed specimens. Clinical trial: 40 patients diagnosed with knee OA patients were randomly divided into 2 groups of 20 cases each. The group row after arthroscopic given room temperature saline 2000ml continuous irrigation, Flush 6 hours, as continuous irrigation group. Another group arthroscopic surgery not to rinse, non-continuous irrigation group. Both groups were taken in the preoperative and postoperative weeks 1, 2 knee joint fluid 2 ml of SOD in synovial fluid specimens were measured by xanthine oxidase (hydroxylamine Act) and nitrate reductase method, the content of NO . Preoperative, 1 and 2 weeks after the JOA knee osteoarthritis treatment effect criteria for ratings. The results of the analysis of variance, two-sample t-test and paired samples t-test was used for statistical analysis. Results 14 rabbits and 40 patients, data analysis of results. Results of animal experiments: ① synovial tissue SOD, NO: Knee synovial tissue, the rinse group SOD activity was significantly stronger than the control group (P <0.01) of NO were significantly less than the control group (P <0.01) . ② The histological changes: the rinse group cartilage see a clear hierarchy, but morphologically normal cells decreased slightly. Tangent layer of cartilage damage non-flushing group, significantly reduced the number of cells, angiogenesis the messy, cartilage surface. The results of clinical trials: ① synovial fluid SOD, NO: 1 week after surgery, continuous irrigation group synovial fluid of SOD activity was significantly higher than the non-continuous irrigation group (P <0.05). And the two groups after 1 week synovial fluid SOD in SOD activity (P <0.01) higher than the preoperative group and the non-continuous irrigation group in the NO concentration level decreased significantly after 1 week; continuous irrigation with preoperative significant differences (P <0.05), and between the two groups, significant differences (P <0.05) after 1 week. ② efficacy ratings: one week after continuous irrigation group and the non-continuous irrigation group rated no difference to two weeks continuous irrigation group rated the results to be significantly higher than the ratings of non-continuous flushing group (P <0.05) , two sets of scores were also significantly higher than the preoperative score (P <0.05). Conclusion ① joint cavity continual washing can significantly improve the content of cytokines in OA joints. The given continuous irrigation after the rabbit knee OA continuous flushing and clinical patients with knee OA line after arthroscopy, intra-articular SOD, NO has a different degree of change to reduce damage to the articular cartilage of cytokines. ② after knee arthroscopy continual washing can significantly reduce the symptoms of patients with knee OA. Treatment by arthroscopic knee surgery, the elimination of harmful factors in the intra-articular postoperative continuous irrigation, further improve the intra-articular cytokines and washed away the surgery bleeding, debris and improve the efficacy of arthroscopic knee. ③ NO sensitivity is much better than SOD. The same period of time, NO variations to be significantly better than SOD, the description NO to be sensitive to the process of change in the condition of OA in SOD, therefore, NO can be used as the preferred indicator for monitoring OA disease development and changes.