Yanjin Li1,2,3, Ruibing Feng1,2, Ximing Liu2, Guodong Wang2, Wei Wang2,4, Qilin Lu2,5, Wei Huang2,6, Haiyang Wu2, Xianhua Cai1,2. 1. College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, China. 2. Department of Orthopaedic Surgery, PLA Middle Military Command General Hospital, Wuhan, China. 3. Department of Orthopedics, Wuhan Hospital of Traditional Chinese Medicine, Wuhan, China. 4. Department of Orthopedics, Hubei Province hospital of Traditional Chinese Medicine, Wuhan, China. 5. Department of Spine Surgery, Hubei 672 Orthopaedics Hospital of Integrated Chinese & Western Medicine, Wuhan, China. 6. Department of Spine Surgery, Jingmen NO.2 People's Hospital, Jingmen, China.
Abstract
OBJECTIVE: To develop a post-traumatic osteoarthritic model of hip following fracture of acetabulum in rabbit for revealing biochemical mechanism of post-traumatic osteoarthritis. METHODS: A total of 36 mature male New Zealand white rabbits were equally divided into sham group (n = 12), non-ORIF group (n = 12), and open reduction and internal fixation (ORIF) group (n = 12). Except for the sham group, rabbits had survival surgeries to create acetabular fractures of dorsal wall for simulating dashboard impaction mechanism. The ORIF group received open reduction and internal fixation, while fractures in the non-ORIF group were left as displaced but transverse fracture and dislocation was reduced. Besides intraoperative appearance and postoperative recovery, macroscopic and radiographic characteristics of the hips were recorded and assessed by a radiographic scoring scale at 3 weeks, 6 weeks, and 6 months, respectively. RESULTS: Out of 24 modeled acetabula, 21 (87.5%) were pure dorsal wall fractures as proposed and the remaining three were associated fractures (dorsal wall plus transverse fracture) accompanied by dorsal dislocation or not. All hips were stable, and no sciatic nerve injury was observed. One rabbit in the ORIF group died of deep infection 4 days after surgery. Rabbits in the sham and ORIF groups returned to normal gait in 2 weeks, but animals in the non-ORIF group suffered from limping and restricted movement. As the time progressed, the hips in the non-ORIF group experienced progressive and severe degeneration which exhibited dramatically malformed and hypertrophic joints at 6 months, but the ORIF group maintained much better morphological structure. Corresponding to morphological changes, the average radiographic scores of the non-ORIF group increased from 1.25 at 3 weeks to 2.75 at 6 months and showed statistically significant difference when compared to the sham group at all three time points (P = 0.011, 0.011, 0.015, respectively, <0.0167). Although the scores of the ORIF group showed apparent improvements (increased from 0.67 at 3 weeks to 2.00 at 6 months), there was no significant difference between the two modeled groups at all three time points. CONCLUSION: The fracture model with high consistency and reproducibility showed progressive post-traumatic osteoarthritic changes which could be improved by open reduction and internal fixation surgery and provided an alternative selection for investigating potential pathogenesis and pathology of post-traumatic osteoarthritis following fracture of acetabulum.
OBJECTIVE: To develop a post-traumatic osteoarthritic model of hip following fracture of acetabulum in rabbit for revealing biochemical mechanism of post-traumatic osteoarthritis. METHODS: A total of 36 mature male New Zealand white rabbits were equally divided into sham group (n = 12), non-ORIF group (n = 12), and open reduction and internal fixation (ORIF) group (n = 12). Except for the sham group, rabbits had survival surgeries to create acetabular fractures of dorsal wall for simulating dashboard impaction mechanism. The ORIF group received open reduction and internal fixation, while fractures in the non-ORIF group were left as displaced but transverse fracture and dislocation was reduced. Besides intraoperative appearance and postoperative recovery, macroscopic and radiographic characteristics of the hips were recorded and assessed by a radiographic scoring scale at 3 weeks, 6 weeks, and 6 months, respectively. RESULTS: Out of 24 modeled acetabula, 21 (87.5%) were pure dorsal wall fractures as proposed and the remaining three were associated fractures (dorsal wall plus transverse fracture) accompanied by dorsal dislocation or not. All hips were stable, and no sciatic nerve injury was observed. One rabbit in the ORIF group died of deep infection 4 days after surgery. Rabbits in the sham and ORIF groups returned to normal gait in 2 weeks, but animals in the non-ORIF group suffered from limping and restricted movement. As the time progressed, the hips in the non-ORIF group experienced progressive and severe degeneration which exhibited dramatically malformed and hypertrophic joints at 6 months, but the ORIF group maintained much better morphological structure. Corresponding to morphological changes, the average radiographic scores of the non-ORIF group increased from 1.25 at 3 weeks to 2.75 at 6 months and showed statistically significant difference when compared to the sham group at all three time points (P = 0.011, 0.011, 0.015, respectively, <0.0167). Although the scores of the ORIF group showed apparent improvements (increased from 0.67 at 3 weeks to 2.00 at 6 months), there was no significant difference between the two modeled groups at all three time points. CONCLUSION: The fracture model with high consistency and reproducibility showed progressive post-traumatic osteoarthritic changes which could be improved by open reduction and internal fixation surgery and provided an alternative selection for investigating potential pathogenesis and pathology of post-traumatic osteoarthritis following fracture of acetabulum.
Authors: Dejan Milentijevic; Iván F Rubel; Allan S L Liew; David L Helfet; Peter A Torzilli Journal: J Orthop Trauma Date: 2005-08 Impact factor: 2.512