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

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

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.

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References

  1. 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):624–634

    PubMed  CAS  Google Scholar 

  2. 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):405–411

    Article  PubMed  CAS  Google Scholar 

  3. 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):978–981

    PubMed  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

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

    Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  7. 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):214–218

    PubMed  Google Scholar 

  8. 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):326–332

    Article  PubMed  Google Scholar 

  9. 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):79–83

    PubMed  CAS  Google Scholar 

  10. Garry JP, McShane JM (2000) Postcompetition elevation of muscle enzyme levels in professional football players. MedGenMed 2(1):E4

    PubMed  CAS  Google Scholar 

  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):1477–1482

    PubMed  CAS  Google Scholar 

  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):630–636

    Article  PubMed  Google Scholar 

  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 238:249–281

    PubMed  Google Scholar 

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

    PubMed  Google Scholar 

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

    Google Scholar 

  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):632–637

    Article  PubMed  Google Scholar 

  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):688–692

    PubMed  CAS  Google Scholar 

  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):133–139

    PubMed  CAS  Google Scholar 

  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):173–178

    Article  PubMed  CAS  Google Scholar 

  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):659–663

    Article  PubMed  Google Scholar 

  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):31–39

    Article  PubMed  CAS  Google Scholar 

  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 241:146–165

    PubMed  Google Scholar 

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

    PubMed  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  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):630–636

    PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  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):1162–1166

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  Google Scholar 

  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):615–120

    Article  PubMed  Google Scholar 

  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):252–257

    Article  PubMed  Google Scholar 

  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):1230–1235

    Article  PubMed  CAS  Google Scholar 

  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

    CAS  Google Scholar 

  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):75–78

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopedics and Traumatology, Gulhane Military Medical Academy, Ankara, Turkey

    A. Sabri Atesalp, Yuksel Yurttas, Ozkan Kose, Bahtiyar Demiralp, Cemil Yildiz, Mustafa Kurklu & Mustafa Basbozkurt

  2. Department of Pathology, Gulhane Military Medical Academy, Ankara, Turkey

    Bulent Kurt

  3. Department of Nuclear Medicine, Gulhane Military Medical Academy, Ankara, Turkey

    Ozgur Karacalioglu

  4. Department of Histology and Embryology, Gulhane Military Medical Academy, Ankara, Turkey

    Taner Ozgurtas

  5. Department of Clinical Biochemistry, Gulhane Military Medical Academy, Ankara, Turkey

    Emin Oztas

  6. Muminderesi cd. Belediye Bloklari, 3, Blok Daire:10 Sayrayicedid, Kadiköy, Istanbul, Turkey

    Ozkan Kose

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  1. A. Sabri Atesalp
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Correspondence to Ozkan Kose.

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Atesalp, A.S., Yurttas, Y., Kose, O. et al. Effects of hyperbaric oxygen therapy on rabbit skeletal muscle during extremity lengthening. Arch Orthop Trauma Surg 129, 13–20 (2009). https://doi.org/10.1007/s00402-007-0525-2

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