1997 Fiscal Year Final Research Report Summary
Immunohistological analysis of synovial fibrosis in the knee after injury or surgery
| Project/Area Number |
08671641
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Orthopaedic surgery
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| Research Institution | Tokyo Medical and Dental University |
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Principal Investigator |
YAMAMOTO Haruyasu Tokyo Medical and Dental University, Department of Orthopaedics, Associate Professor, 医学部, 助教授 (10092446)
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| Co-Investigator(Kenkyū-buntansha) |
MUNETA Takeshi Tokyo Medical and Dental University, Department of Orthopaedics, Assistant Profe, 医学部, 講師 (50190864)
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| Project Period (FY) |
1996 – 1997
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| Keywords | Joint contracture / Synovial fibrosis / Fibrogenetic cytokines / Anterior cruciate ligament injury |
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| Research Abstract |
Contracture of joint (arthrofibrosis), which often occurs after injury of joint or surgery of bone and joint disease, is difficult to treat, because the genesis of contracture remains unknown. The purpose of this study was to investigate the genesis of contracture.
We analyzed immunohistoligically synovial fibrosis in the infrapatellar fat pad in 12 patients with isolated anterior cruciate ligament (ACL) injuries who underwent arthroscopically assisted ACL reconstructions. The results demonstrated that synovitis in the infrapatellar fat pad subsided within 3 months after injury with the progression of fibrosis. Fibrogenic cytokines, platelet-derived growth factor and transforming growth factor-B,were detected at fibrotic sites, suggesting their involvement in arthrofibrosis.
We performed quantitative analysis of synovial fibrosis in the infrapatellar fat pad in 26 patients undergoing ACL reconstructions (12 ; patellar tendon autografts (BTB), 14 ; semitendinosus and gracilis tendon autog
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rafts (ST)). Synovial samples were obtained at the time of arthroscopy from 10 patients and at second-look arthroscopy from all 26 patients. We used sodium hydroxide in absolute methanol to elute the fast green and Sirius red stains of samples, and the total collagen content of each section was estimated by measuring the optimal density of the eluted solution. Median collagen content was 15.3mug/mm^3 for the preperative samples, 25.1mug/mm^3 for the BTB group, and 27.1mug/mm^3 for the ST group.
Analysis of preoperative and postoperative paired samples revealed a significant increase in synovial collagen after ACL reconstruction. We observed increased fibrosis in patients who had pain on exertion or stiffness after reconstruction. These results demonstrated that the mechanism of arthrofibrosis after injury or surgery was similar to the mechanism of fibrosis which was reported in pulmonary fibrosis and scleroderma. Control of fibrogenic cytokines after injury or surgery was speculated to prevent from arthrofibrosis. Less
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