Quantitative analysis of the reversibility of knee flexion contractures with time: an experimental study using the rat model

BMC Musculoskeletal Disorders

Odette Laneuville³  Louis Goudreau²  Hans K Uhthoff¹  Guy Trudel⁴ 

[1] Division of Orthopedic Surgery, Faculty of Medicine, University of Ottawa, 451 Smyth Rd., Ottawa, ON K1H 8M5, Canada;Biomedical Engineering, The Ottawa Hospital Rehabilitation Centre, 505 Smyth Road, Ottawa, ON K1H 8M2, Canada;Department of Biology, Faculty of Science, University of Ottawa, 30 Marie Curie, Ottawa, ON K1N 6N5, Canada;Bone and Joint Research Laboratory, Faculty of Medicine, University of Ottawa, 451 Smyth Rd., Ottawa, ON K1H 8M5, Canada

关键词: Temporal study;    Reversibility;    Biomechanics;    Knee joint;    Contracture;   

Others  :  1121978
DOI  :  10.1186/1471-2474-15-338

 received in 2014-05-26, accepted in 2014-09-29,  发布年份 2014

【 摘 要 】

Background

Knee flexion contractures prevent the full extension of the knee joint and cause disability. The etiology is not well defined. Extended periods of immobilization of joints lead to contractures difficult to completely reverse by rehabilitation treatments. Recovery of the complete range of motion without intervention has not been studied but is of importance to optimize clinical management. This study was designed to quantify the spontaneous reversibility of knee flexion contractures over time.

Methods

Knee flexion contractures of increasing severities were induced by internally fixing one knee of 250 adult male rats for 6 increasing durations. The contractures were followed for four different durations of spontaneous recovery up to 48 weeks (24 groups, target n = 10 per group). The angle of knee of extension at a standardized torque was measured. Contralateral knees constituted controls.

Results

Full reversibility characterized by knee extension similar to controls was only measured in the lowest severity group where 4 weeks of spontaneous recovery reversed early-onset contractures. Spontaneous recovery of 2, 4 and 8 weeks caused partial gain of knee extension in longer-lasting contractures (P ≤ 0.05; all 4 comparisons). Extending the durations of spontaneous recovery failed to further improve knee extension (P > 0.05, all 12 comparisons). No reversal occurred in the highest severity group (32 week; P > 0.05).

Conclusions

Reversibility of knee flexion contractures was dependent on their severity. Full spontaneous recovery was limited to the least severe contractures. While contractures initially improved, a plateau was reached beyond which additional durations of spontaneous recovery led to no additional gain of knee extension. These results support our view that without treatment, permanent losses in knee mobility must be anticipated in immobility-induced contractures.

【 授权许可】

   
2014 Trudel et al.; licensee BioMed Central Ltd.

【 图 表 】

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