Highlights
- •Joint contracture develops after anterior cruciate ligament reconstruction surgery.
- •Effects of immobilization duration on contractures after surgery are unknown
- •Two weeks of immobilization facilitated formation of joint contracture
- •Four weeks of immobilization further developed joint contractures
- •Periods of immobilization after surgery should be minimized to reduce contracture
Abstract
Background
Both myogenic and arthrogenic factors contribute to contracture formation after anterior
cruciate ligament reconstruction surgery. However, effects of immobilization duration
on myogenic and arthrogenic contractures after surgery are unknown. We examined the
effects of immobilization duration on contracture formation.
Methods
Rats were divided into groups according to treatment received: untreated control,
knee immobilization, anterior cruciate ligament reconstruction, and anterior cruciate
ligament reconstruction plus immobilization. Extension range of motion before and
after myotomy as well as histomorphological knee changes were assessed two or four
weeks after experiment commencement. Range of motion before myotomy mainly represents
contractures due to myogenic factors. Range of motion after myotomy represents arthrogenic
factors.
Findings
Range of motion before and after myotomy was decreased in the immobilization, reconstruction,
and reconstruction plus immobilization groups at both timepoints. In the reconstruction
plus immobilization group, range of motion before and after myotomy was significantly
smaller than in the immobilization and reconstruction groups. Shortening and thickening
of the posterior joint capsule was induced in the immobilization and reconstruction
groups. In the reconstruction plus immobilization group, capsule shortening was facilitated
via adhesion formation, as compared to the immobilization and reconstruction groups.
Interpretation
Our results indicate that immobilization after anterior cruciate ligament reconstruction
surgery facilitates contracture formation via exacerbation of both myogenic and arthrogenic
contractures within two weeks. Capsule shortening would be one of the main mechanisms
for severe arthrogenic contracture observed in the reconstruction plus immobilization
group. Periods of joint immobilization after surgery should be minimized to reduce
contracture.
Keywords
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Article info
Publication history
Published online: February 24, 2023
Accepted:
February 21,
2023
Received:
November 2,
2022
Identification
Copyright
© 2023 Elsevier Ltd. All rights reserved.
