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Journal of Chinese Integrative Medicine ›› 2009, Vol. 7 ›› Issue (4): 372-378.doi: 10.3736/jcim20090413

• Original Experimental Research • Previous Articles     Next Articles

Effects of manipulation therapy in repairing rabbit articular cartilage defects

 Ling-hui Daia,Yong Xua,Yan-hao Xionga,Feng Gaob,Jiong Hua,Ning Duc   

  1. a Department of Traumatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
    b Department of Orthopedics, Guanghua Hospital, Shanghai 200052, China
    c Department of Orthopedics and Traumatology, Paincare Hospital, Shanghai 200030, China
  • Accepted:2009-01-04 Online:2009-04-20 Published:2009-04-15

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Objective

To evaluate the efficacy of manipulation therapy in repairing thin-layer and thick-layer articular cartilage defects in rabbits.
Methods

Twenty-four rabbits were randomly divided into manipulation group and control group. Chondral defects in the center of condylus medialis femoris (punch diameter 2.0 mm, thin-layer defect, without damaging the subchondral bone) and the center of facies patellaris femoris (punch diameter 3.0 mm, thick-layer defect, without damaging the subchondral bone) were made in both side knee joints of the rabbits. Four weeks after chondral defect, the rabbits in the manipulation group were treated with manipulation therapy, while the rabbits in the control group didn't take any therapeutic measure. The rabbits were sacrificed after 4-, 8- and 12-week manipulation treatment to obtain the distal femur. The appearance of the chondral defect was first assessed, and then regenerated tissues were stained respectively with hematoxylin and eosin (HE), safranin O and immunohistochemical methods to observe the changes in pathology. The regenerated tissue O'Driscoll score system was also used to evaluate the efficacy of manipulation therapy.
Results

After manipulation treatment, although the thin-layer articular cartilage defects of the control group were partly repaired, a sharp gap between the regenerated tissue and the normal cartilage was visible. The range of the thick-layer articular cartilage defect in the control group became smaller, and the regenerated tissue only consisted of fiber tissue. On the contrary, both the thin-layer defects and the thick-layer defects in the manipulation group were well repaired. The appearance of the regenerated tissues was close to the normal cartilage. The gap between regenerated tissue and normal tissue was disappeared and the regenerated tissue was well integrated with around tissues. HE staining showed that the regenerated tissues in the manipulation group were similar to hyaline cartilage. Safranin O staining showed that matrix stain of the regenerated tissues in the manipulation group was similar to the normal cartilage, but no stain was observed in the control group. The type Ⅱ collagen immunohistochemical staining showed that the color of the regenerated tissues was a little darker than that of the normal cartilage in the two kinds of defects in the manipulation group, and the two kinds of defects in the control group were little stained. The O'Driscoll cartilage scores of the two kinds of defects in the manipulation group were higher than those in the control group at different time points (P<0.01), but there were no differences in O'Driscoll scores in the manipulation group among the different time points.
Conclusion

Manipulation therapy is effective in repairing the thick-layer and thin-layer articular cartilage defects. The regenerated tissue is constructed with hyaline cartilage.

Key words: Cartilage, Articular, Manipulations, Musculoskeletal, Injury, Rabbits

Figure 1

Regenerated tissues after treatment A: Manipulation group, thin-layer defect; B: Manipulation group, thick-layer defect; C: Control group, thin-layer defect; D: Control group, thick-layer defect."

Figure 2

Regenerated tissues after 4-week treatment (Light microscopy, ×4) A: Manipulation group, thin-layer defect; B: Manipulation group, thick-layer defect; C: Control group, thin-layer defect; D: Control group, thick-layer defect. R in the figures refers to regenerated tissue; N in the figures refers to normal tissue."

Figure 3

Regenerated tissues after 8-week treatment（Light microscopy, ×4） A: Manipulation group, thin-layer defect; B: Manipulation group, thick-layer defect; C: Control group, thin-layer defect; D: Control group, thick-layer defect. R in the figures refers to regenerated tissue; N in the figures refers to normal tissue."

Figure 4

Regenerated tissues after 12-week treatment (Light microscopy, ×4) A: Manipulation group, thin-layer defect; B: Manipulation group, thick-layer defect; C: Control group, thin-layer defect; D: Control group, thick-layer defect. R in the figures refers to regenerated tissue; N in the figures refers to normal tissue."

Figure 5

Immunohistochemical staining of type Ⅱ collagen in the regenerated tissue after treatment (Light microscopy, ×10) A: Manipulation group, thin-layer defect; B: Manipulation group, thick-layer defect; C: Control group, thin-layer defect; D: Control group, thick-layer defect. R in the figures refers to regenerated tissue; N in the figures refers to normal tissue."

Table 1

O'Driscoll score of thin- and thick-layer defect after 4-, 8- and 12-week treatment (x±s)"

Group O'Driscoll score
4-week 8-week 12-week
Control
Thin-layer defect 4.62±1.40 (n=8) 8.25±3.77△ (n=8) 8.87±2.74△ (n=8)
Thick-layer defect 4.25±1.03 (n=8) 7.71±1.80△△ (n=7) 8.62±1.40△△ (n=8)
Manipulation
Thin-layer defect 18.25±1.90** (n=8) 18.87±1.95** (n=8) 19.25±2.12** (n=8)
Thick-layer defect 14.42±4.85** (n=7) 17.62±3.37**(n=8) 18.42±1.71**(n=7)
[1] Gao G, Wei XC . The rabbit articular cartilage defects model[J]. Zhonghua Shi Yan Wai Ke Za Zhi, 2005,22(2):253-254
高刚, 卫小春 . 关节软骨损伤修复的动物模型[J]. 中华实验外科杂志, 2005,22(2):253-254
[2] Du N, Shi RT . A therapeutic-effect observation of 37 cases of primary osteoarthrosis of knee treated by maneuvers[J]. Zhong Yi Zheng Gu, 1994,6(4):9-11
杜宁, 施荣庭 . 手法治疗原发性膝关节骨关节病37例疗效观察[J]. 中医正骨, 1994,6(4):9-11
[3] Zhang H, Du N, Ren F, Zhang FH, Shi WB . Electronmicroscopic study of mamipulation on experimental model of osteoarthritis[J]. Zhongguo Zhong Yi Gu Shang Ke Za Zhi, 2000,8(2):1-3
张昊, 杜宁, 任峰, 张凤华, 史炜镔 . 手法治疗实验性膝骨关节炎扫描电镜研究[J]. 中国中医骨伤科杂志, 2000,8(2):1-3
[4] Hui JH, Chan SW, Li J, Goh JC, Li L, Ren XF, Lee EH . Intra-articular delivery of chondroitin sulfate for the treatment of joint defects in rabbit model[J]. J Mol Histol, 2007,38(5):483-489
doi: 10.1007/s10735-007-9120-7
[5] O'Driscoll SW, Keeley FW, Salter RB .Durability of regenerated articular cartilage produced by free autogenous periosteal grafts in major full-thickness defects in joint surfaces under the influence of continuous passive motion follow-up report at one yearA follow-up report at one year[J]. J Bone Joint Surg Am, 1988,70(4):595-606
doi: 10.2106/00004623-198870040-00017
[6] O'Driscoll SW .Preclinical cartilage repair: current status and future perspectives[J].Clin Orthop Relat Res, 2001, 391: 397-401
doi: 10.1097/00003086-200110001-00036
[7] Smith GD, Knutsen G, Richardson JB . A clinical review of cartilage repair techniques[J]. J Bone Joint Surg Br, 2005,87(4):445-449
[8] Olofsson LB, Svensson O, Lorentzon R, Lindstrom I, Alfredson H . Periosteal transplantation to the rabbit patella[J]. Knee Surg Sports Traumatol Arthrosc, 2007,15(5):560-563
doi: 10.1007/s00167-006-0201-z
[9] Nugent-Derfus GE, Takara T, O'neill JK, Cahill SB, Gortz S, Pong T, Inoue H, Aneloski NM, Wang WW, Vega KI, Klein TJ, Hsieh-Bonassera ND, Bae WC, Burke JD, Bugbee WD, Sah RL .Continuous passive motion applied to whole joints stimulates chondrocyte biosynjournal of PRG4[J]. Osteoarthritis Cartilage, 2007,15(5):566-574
doi: 10.1016/j.joca.2006.10.015
[10] Bavornrit C, Eric MB, George H . Microfracture for osteochondral lesions of the ankle: Outcome analysis and outcome predictors of 105 cases[J]. Arthroscopy, 2008,24(1):106-112
doi: 10.1016/j.arthro.2007.07.022
[11] Djouad F, Delorme B, Maurice M, Bony C, Apparailly F, Louis-Plence P, Canovas F, Charbord P, Noel D, Jorgensen C . Microenvironmental changes during differentiation of mesenchymal stem cells towards chondrocytes[J]. Arthritis Res Ther, 2007,9(2):R33
doi: 10.1186/ar2153
[12] Schumann D, Kujat R, Nerlich M, Angele P . Mechanobiological conditioning of stem cells for cartilage tissue engineering[J]. Biomed Mater Eng, 2006,16(4):S37-S52
[13] Mauck RL, Nicoll SB, Seyhan SL, Ateshian GA, Hung CT . Synergistic action of growth factors and dynamic loading for articular cartilage tissue engineering[J]. Tissue Eng, 2003,9(4):597-611
doi: 10.1089/107632703768247304
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