摘要
膝关节挛缩是临床上十分常见的病症,在疾病进展的早期骨骼肌发生萎缩及纤维化,而中晚期关节囊纤维化改变是导致关节挛缩治疗棘手的重要因素。其关键机制系关节制动后骨骼肌蛋白周转异常及转化生长因子-β(transforming growth factor-β,TGF-β)/Smad信号转导激活。近年来,体外冲击波作为一种新的非侵入性疗法,被广泛用于骨关节及软组织相关疾病的治疗,其作用已得到肯定。体外冲击波对不同组织可产生不同的机械效应和空化效应,在各组织吸收冲击波能量的同时,增强细胞代谢功能,改善局部缺氧微环境。因此,本文对膝关节挛缩发生机制、康复评定以及康复治疗策略进行了系统回顾,以膝关节挛缩发生机制提出体外冲击波治疗关节挛缩的设想,并进行了一系列相关研究,以期为膝关节挛缩的治疗提供新的思路。
Knee joint contracture is a very common clinical disease.Skeletal muscle atrophy and fibrosis occur at the early stage of the progression.Furthermore,joint capsule fibrosis is an important factor that makes the treatment of joint contracture difficult at the middle and late stages.The key mechanism is the abnormal turnover of skeletal muscle protein and the activation of TGF-β/Smad signaling after joint immobilization.In recent years,extracorporeal shock wave,as a new noninvasive therapy,has been widely used in the treatment of bone,joint and soft tissue related diseases,and its role has been affirmed.Extracorporeal shock wave can produce different mechanical effect and cavitation effect on different tissues.While each tissue absorbs the energy of shock wave,it can enhance the metabolic function of cells and improve the local hypoxic microenvironment.Therefore,this article systematically reviewed the mechanism of knee contracture,rehabilitation assessment and rehabilitation treatment strategies.In order to provide new treatment methods,we proposed the hypothesis of extracorporeal shock wave therapy for joint contracture based on the mechanism of knee joint contracture and carried out a series of related studies.
作者
周云
王锋
张全兵
王华
Zhou Yun;Wang Feng;Zhang Quanbing;Wang Hua(Department of Rehabilitation Medicine,The Second Hospital of Anhui Medical University,Hefei 230601,Anhui,China;Department of Toxicology,School of Public Health,Anhui Medical University,Hefei 230032,Anhui,China)
出处
《中国医学前沿杂志（电子版）》
2022年第11期28-33,共6页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
基金
安徽省重点研究和开发计划项目(人口健康领域)(201904a07020067)
安徽医科大学2021年临床医学学科建设项目(2021 lcxk 031)
安徽医科大学2022年临床医学学科建设项目(2022 lcxkEFY010)
安徽省2020年高等学校省级质量工程项目(2020jyxm0903)。
关键词
膝关节挛缩
体外冲击波
关节囊纤维化
肌萎缩
肌纤维化
Knee joint contracture
Extracorporeal shock wave
Joint capsule fibrosis
Muscle atrophy
Myofibrosis
