Acta Orthopaedica et Traumatologica Turcica
Research Articles

The effect of collagenase clostridium histolyticum on adhesion reduction in a rat knee arthrofibrosis model

1.

Clinic of Orthopaedic and Traumatology, Çorlu State Hospital, Tekirdağ, Turkey

2.

Department of Orthopaedic and Traumatology, Marmara University, School of Medicine, İstanbul, Turkey

3.

Department of Orthopaedic and Traumatology, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey

4.

Department of Pathology, Bahceşehir University, School of Medicine, İstanbul, Turkey

5.

Bahceşehir University, School of Medicine, İstanbul, Turkey

AOTT 2021; 55: 385-390
DOI: 10.5152/j.aott.2021.20364
Read: 345 Downloads: 135 Published: 22 September 2021

Objective: The aim of this study was to investigate whether collagenase clostridium histolyticum (CCH) reduces intra-articular fibrotic adhesion formation in a rat model of arthrofibrosis.

Methods: A total of 24 male Wistar rats (7 months old, weighing 220 –275 g) were randomly and equally assigned to one of two groups: the collagenase group and the control group (n = 12 each). In each group, a partial capsulotomy, and synovectomy were performed in knee. After a partial capsulotomy and synovectomy were performed in each group, the collagenase group received intra-articular CCH of 0.008 mg in 0.1 mL saline solution while the control group received the equal volume of intra-articular saline solution alone. After 6 weeks of surgery, the rats were sacrificed by decapitation, and the following outcome measures were collected. Knee range of motion (ROM) was measured using with a goniometer under 20 g force. Adhesion formation was rated using the macroscopic visual scoring system after the knee joint was exposed through a lateral parapatellar approach. Histological evaluation was performed on samples including connective tissue and fibrotic adhesions, and fibroblast cell numbers were measured performed per square. Levels of interleukin 1 (IL-1) and fibroblast growth factor (FGF) were assayed by ELISA from the intra-articular fluid.

Results: The macroscopic visual scoring system was significantly lower in the collagenasegroup (median = 1, range = 0–2) than in the control group (median = 2, range = 1–3)(< 0.001).ROMwas significantly higher in the collagenase group (102° ± 12.1°) than in the control group (77° ±8.94°) (P <0.001). The number of fibroblasts obtained from the scar tissue were considerably lower in the collagenase group (mean = 16.5 ± 2.74) compared tothe control group (mean = 30.1± 4.89) (P < 0.001). Levels of IL-1 andFGF were significantly lower in the collagenase group (mean = 18.6 ng/l ± 4.39,mean = 36.3 ng/l ± 2.03; respectively) compared to the control group (mean = 31.7ng/l ± 3.75, mean = 38.7 ng/l ± 2.19; respectively) (P < 0.001).

Conclusion: Evidence from this study has revealed that CCH injection can inhibit the development ofarthrofibrosis, decreasing the precursor inflammatory cytokines (IL-1 and FGF-1) and histologic fibrosis in a rat knee arthrofibrosis model.

Level of Evidence: Level IV, Therapeutic study

Cite this article as: Karahan N, Kaya M, Yılmaz B, et al. The effect of collagenase clostridium histolyticum on adhesion reduction in a rat knee arthrofibrosis model. [published online ahead of print, 2021 September 17] Acta Orthop Traumatol Turc; 10.5152/j.aott.2021.20364. 55(5): 385–390..

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ISSN 1017-995X EISSN 2589-1294