Top

Archives of Orthopaedic and Trauma Surgery

Published in:

01-01-2009 | Orthopaedic Surgery

Effects of hyperbaric oxygen therapy on rabbit skeletal muscle during extremity lengthening

Authors: A. Sabri Atesalp, Yuksel Yurttas, Ozkan Kose, Bahtiyar Demiralp, Cemil Yildiz, Mustafa Kurklu, Bulent Kurt, Ozgur Karacalioglu, Taner Ozgurtas, Emin Oztas, Mustafa Basbozkurt

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 1/2009

Abstract

Introduction

Extremity lengthening through distraction osteogenesis is limited by the surrounding skeletal muscle and neurovascular structures rather than the bone itself. The purpose of this study is to evaluate the effects of hyperbaric oxygen therapy on skeletal muscle during distraction osteogenesis.

Materials and methods

Twenty New Zealand white rabbits were randomly divided into two groups. Right tibia of all rabbits was distracted at a rate of 0.125 mm per 6 h (0.5 mm/day) for 10 days with circular external fixator. Experimental group rabbits (N = 10) underwent 2.5 ATA hyperbaric oxygen therapy for 2 h everyday for 20 days, control group rabbits (N = 10) did not receive any corresponding treatment. Skeletal muscle perfusion was evaluated with scintigraphy before and after the distraction period. Serum CPK, LDH and AST levels were measured before and after the distraction period. All animals were killed on the 27th day. The right tibias of all animals were removed and tibialis posterior muscle was harvested for histopathologic and histomorphometric assessment with light and electron microscopy.

Results

Skeletal muscle perfusion was decreased in the control group in comparison with pre-distraction level (P = 0.008). However, no significant decrease was observed in the experimental group (P = 0.678). There were no statistical differences in serum CPK, LDH and AST levels between groups (P = 0.340, P = 0.077, P = 0.796). The mean area of the muscle fibers was measured as 398.66 ± 9.16 μ² in the experimental group and 349.44 ±5.76 μ² in the control group (P = 0.000) with light microscopy. Mild fibrosis was observed in connective tissue component of muscle tissue in control group. An average of 26 myofibrils (20–32) was counted in a 16-cm² unit area in experimental group and 50 myofibrils (35–65) in the control group with electron microscopy. Enlargement in the sarcoplasmic reticulum, degenerative changes in nuclear cytoplasm and increase in myofibril diameter were observed in the control group, which was not observed in the experimental group

Conclusion

Results of this study suggest that HBO treatment alleviates the detrimental effects of distraction on skeletal muscles and preserves its ultrastructure.

Aldegheri R (1999) Distraction osteogenesis for lengthening of the tibia in patients who have limb-length discrepancy or short stature. J Bone Joint Surg Am 81(5):624–634PubMed

Asano T, Kaneko E, Shinozaki S, Imai Y, Shibayama M, Chiba T, Ai M, Kawakami A, Asaoka H, Nakayama T, Mano Y, Shimokado K (2007) Hyperbaric oxygen induces basic fibroblast growth factor and hepatocyte growth factor expression, and enhances blood perfusion and muscle regeneration in mouse ischemic hind limbs. Circ J 71(3):405–411PubMedCrossRef

Atesalp AS, Komurcu M, Basbozkurt M, Kurklu M (2002) The treatment of infected tibial nonunion with aggressive debridement and internal bone transport. Mil Med 167(12):978–981PubMed

Borg TK, Caulfield JB (1980) Morphology of connective tissue in skeletal muscle. Tissue Cell 12:197–207PubMedCrossRef

Calandriello B (1975) The behaviour of muscle fibers during surgical lengthening of a limb. Ital J Orthop Traumatol 1:231–247

Day CS, Moreland MS, Floyd SS Jr, Huard J (1997) Limb lengthening promotes muscle growth. J Orthop Res 15(2):227–234PubMedCrossRef

D’Hooghe P, Defoort K, Lammens J, Stuyck J (2006) Management of a large post-traumatic skin and bone defect using an Ilizarov frame. Acta Orthop Belg 72(2):214–218PubMed

Eralp L, Ozkan K, Kocaoglu M, Aktas S, Zihni M, Türker M, Ozkan FU (2007) Effects of hyperbaric oxygen therapy on distraction osteogenesis. Adv Ther 24(2):326–332PubMedCrossRef

Fink B, von Giesen HJ, Wilcke C, Lehmann J, Sager M, Schmielau G, Rüther W (2000) Electromyographically evident changes in skeletal muscles during tibial lengthening in dogs using the Ilizarov method. Arch Orthop Trauma Surg 120(1–2):79–83PubMed

10.

Garry JP, McShane JM (2000) Postcompetition elevation of muscle enzyme levels in professional football players. MedGenMed 2(1):E4PubMed

11.

Gregorevic P, Lynch GS, Williams DA (2000) Hyperbaric oxygen improves contractile function of regenerating rat skeletal muscle after myotoxic injury. J Appl Physiol 89(4):1477–1482PubMed

12.

Gregorevic P, Williams DA, Lynch GS (2002) Hyperbaric oxygen increases the contractile function of regenerating rat slow muscles. Med Sci Sports Exerc 34(4):630–636PubMedCrossRef

13.

Ilizarov GA (1989) The tension-stress effect on the genesis and growth of tissues. Part I: the in?uence of stability of ?xation and soft-tissue preservation. Clin Orthop Relat Res 238:249–281PubMed

14.

Ilizarov GA (1990) Clinical application of the tension-stress effect for limb lengthening. Clin Orthop Relat Res 250:8–26PubMed

15.

Janiki JS (1992) Myocardial remodelling and left ventricular diastolic function. Braz J Med Biol Res 25:975–982

16.

Kucukkaya M, Kabukcuoglu Y, Tezer M, Kuzgun U (2002) Management of childhood chronic tibial osteomyelitis with the Ilizarov method. J Pediatr Orthop 22(5):632–637PubMedCrossRef

17.

Lee DY, Choi IH, Chung CY, Chung PH, Chi JG, Suh YL (1993) Effect of tibial lengthening on the gastrocnemius muscle. A histopathologic and morphometric study in rabbits. Acta Orthop Scand 64(6):688–692PubMed

18.

Margaritis I, Tessier F, Verdera F, Bermon S, Marconnet P (1999) Muscle enzyme release does not predict muscle function impairment after triathlon. J Sports Med Phys Fitness 39(2):133–139PubMed

19.

Muhonen A, Haaparanta M, Grönroos T, Bergman J, Knuuti J, Hinkka S, Happonen RP (2004) Osteoblastic activity and neoangiogenesis in distracted bone of irradiated rabbit mandible with or without hyperbaric oxygen treatment. Int J Oral Maxillofac Surg 33(2):173–178PubMedCrossRef

20.

Nakase T, Yasui N, Kawabata H, Shimizu N, Ohzono K, Hiroshima K, Yoshikawa H (2007) Correction of deformity and shortening due to post traumatic epiphyseal arrest by distraction osteogenesis. Arch Orthop Trauma Surg 127(8):659–663PubMedCrossRef

21.

Nylander G, Nordström H, Franzén L, Henriksson KG, Larsson J (1988) Effects of hyperbaric oxygen treatment in post-ischemic muscle. A quantitative morphological study. Scand J Plast Reconstr Surg Hand Surg 22(1):31–39PubMedCrossRef

22.

Paley D, Catagni MA, Argnani F, Villa A, Benedetti GB, Cattaneo R (1989) Ilizarov treatment of tibial nonunions with bone loss. Clin Orthop Relat Res 241:146–165PubMed

23.

Paley D (1990) Problems, obstacles, and complications of limb lengthening by the Ilizarov technique. Clin Orthop Relat Res 250:81–104PubMed

24.

Schumacher B, Keller J, Hvid I (1994) Distraction effects on muscle. Leg lengthening studied in rabbits. Acta Orthop Scand 65:647–650PubMedCrossRef

25.

Simpson AH, Williams PE, Kyberd P, Goldspink G, Kenwright J (1995) The response of muscle to leg lengthening. J Bone Joint Surg Br 77(4):630–636PubMed

26.

Trotter JA, Purslow PP (1992) Functional morphology of the endomysium in series-fibred muscles. J Morphol 212:109–122PubMedCrossRef

27.

Tsuchiya H, Abdel-Wanis ME, Sakurakichi K, Yamashiro T, Tomita K (2002) Osteosarcoma around the knee. Intraepiphyseal excision and biological reconstruction with distraction osteogenesis. J Bone Joint Surg Br 84(8):1162–1166PubMedCrossRef

28.

Tsujimura T, Kinoshita M, Abe M (2006) Response of rabbit skeletal muscle to tibial lengthening. J Orthop Sci 11(2):185–190PubMedCrossRef

29.

Tüz HH, Kisnisci RS, Günhan O (2003) Histomorphometric evaluation of short-term changes in masseter muscle after lengthening the rabbit mandible by distraction osteogenesis. J Oral Maxillofac Surg 61(5):615–120PubMedCrossRef

30.

Vidigal J, Jose Fagundes D, De Jesus Simoes M, Oshima CT, Odashiro AN, Santos Simoes R, Negrini Fagundes AT, Taha MO, De Souza Montero EF (2007) Effect of different periods of hyperbaric oxygen on ischemia-reperfusion injury of rat skeletal muscle. Microsurgery 27(4):252–257PubMedCrossRef

31.

Wang IC, Wen-Neng Ueng S, Yuan LJ, Tu YK, Lin SS, Wang CR, Tai CL, Wang KC (2005) Early administration of hyperbaric oxygen therapy in distraction osteogenesis—a quantitative study in New Zealand rabbits. J Trauma 58(6):1230–1235PubMedCrossRef

32.

Wang J, Li F, Calhoun JH, Mader JT (2002) The role and effectiveness of adjunctive hyperbaric oxygen therapy in the management of musculoskeletal disorders. Postgrad Med 48(3):226–231

33.

Yamazaki H, Abe M, Kanbara K (2003) Changes of fiber type ratio and diameter in rabbit skeletal muscle during limb lengthening. J Orthop Sci 8(1):75–78PubMedCrossRef

Title: Effects of hyperbaric oxygen therapy on rabbit skeletal muscle during extremity lengthening
Authors: A. Sabri Atesalp
Yuksel Yurttas
Ozkan Kose
Bahtiyar Demiralp
Cemil Yildiz
Mustafa Kurklu
Bulent Kurt
Ozgur Karacalioglu
Taner Ozgurtas
Emin Oztas
Mustafa Basbozkurt
Publication date: 01-01-2009
Publisher: Springer-Verlag
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 1/2009
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-007-0525-2

At a glance: The STEP trials

Springer Medicine

Effects of hyperbaric oxygen therapy on rabbit skeletal muscle during extremity lengthening

Abstract

Introduction

Materials and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2009

Oncosurgical and reconstructive concepts in the treatment of soft tissue sarcomas: a retrospective analysis

Articular bone loss treated with a staged method using bone cement or beads as a spacer and subsequent autografting: a report of two cases

Aprotinin application has no negative effect on osseous implant integration: a biomechanical and histomorphometric investigation in a rat model

Functional assessment in patients with osteoporotic wrist fractures treated with external fixation: a review of randomized trials

Double-level posterior spinal shortening for paralytic osteoporotic vertebral collapse of two vertebral bodies with a normal vertebra in between: a case report

Upper lumbar burst fracture due to recreational high jumping into a river: report of five cases