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

Special Issue: Massages

• 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


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

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.

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.

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
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)
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)
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