Progression of an arthrogenic motion restriction after immobilization in a rat experimental knee model

Abstract

Background. Contracture is defined as a decrease in both active and passive ranges of motion after immobilization. A fibrotic change of a capsule is suggested to be one of the main causes of the joint contracture. The goal of this study is to determine the effect of capsule on limiting the range of motion after immobilization.

Materials and Methods. We immobilized the knee joint of 35 rats with an internal fixator with the knee joint flexed at 150 degrees. The rats were sacrificed at 1, 2, 4, 6, 8, 12, and 16 weeks after surgery and the lower extremities were disarticulated at the hip joint. After extra-articular myotomies around the tibia and femur, x-rays were taken to measure the angles of extension of the knee joint under 3 different torques. The measurements were repeated after releasing the posterior capsule in order to observe their effects on knee motion.

Results. Joint contracture was rapidly progressed until 8 weeks and advanced slowly after 8 weeks. After releasing the posterior capsule, both the immobilized and the control groups gained the angle of knee extension. The acquired angle in the immobilized group was significantly greater than in the control group after 4 weeks and became plateau after 8 weeks.

Conclusion. Joint contracture develops at the early stage of immobilization and progresses over time. The posterior capsule significantly contributes to the limitation in extension.