Benefits of Ilizarov automated bone distraction for nerves and articular cartilage in experimental leg lengthening

doi:10.5312/wjo.v8.i9.688

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World Journal of Orthopedics

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Basic Study

World J Orthop. Sep 18, 2017; 8(9): 688-696
Published online Sep 18, 2017. doi: 10.5312/wjo.v8.i9.688

Table 1 M-response amplitudes in leg muscles

t-points of EMG-testing	M. gastrocnemius		M. tibialis anterior
t-points of EMG-testing	mean ± SE (mV)	Difference vs initial (%)	mean ± SE (mV)	Difference vs initial (%)
Initial (before experiment)	32.0 ± 2.9	-	22.6 ± 1.3	-
M-group - manual distraction (1 mm/d in 4 steps)
28 d of distraction	13.4 ± 3.1	-58.1	8.8 ± 1.9	-61.1
30 d of fixation	10.6 ± 4.6	-66.9	8.3 ± 1.3	-63.3
30 d without apparatus	16.3 ± 5.8	-49.1	8.9 ± 0.1	-60.6
A-group - automatic distraction (1 mm/d in 60 steps)
28 d of distraction	12.0 ± 1.7	-62.5	12.7 ± 1.6^a	-43.8
30 d of fixation	11.9 ± 1.2^a	-62.8	10.5 ± 0.5^a	-53.5
30 d without apparatus	18.3 ± 4.6^a	-42.8	14.0 ± 2.0^a	-38.1

^aP < 0.05 vs group M.

Table 2 Areas of nerves histologic transverse sections (A_n)

Nerves/group and t-points	Tibial nerve		Peroneal nerve
Nerves/group and t-points	(mean ± SD) (10⁴ mKm²)	Difference vs contra-lateral (%)	(mean ± SD) (10⁴ mKm²)	Difference vs contra-lateral (%)
M-group - manual distraction (1 mm/d in 4 steps)
28 d of distraction	353.7 ± 34.8	3	41.6 ± 9.4	-2
30 d of fixation	291.6 ± 26.2	-4	63.6 ± 1.1	-11^a
30 d without apparatus	248.7 ± 29.2	3	53.3 ± 8.8	-3
A-group - automatic distraction (1 mm/d in 60 steps)
28 d of distraction	287.3 ± 60.0	-2	56.2 ± 3.4	-1
30 d of fixation	306.8 ± 76.7	15^a^c	75.8 ± 16.3	-1^c
30 d without apparatus	224.8 ± 31.1	10^c	46.5 ± 1.1	1

^aP < 0.05 vs contralateral;

^cP < 0.05 vs group M.

Table 3 Summary fascicular areas (A_f) in transverse histologic sections of nerves

Nerves/group and t-points	Tibial nerve		Peroneal nerve
Nerves/group and t-points	(mean ± SD) (10⁴ mKm²)	Difference vs contra-lateral (%)	(mean ± SD) (10⁴ mKm²)	Difference vs contra-lateral (%)
M-group - manual distraction (1 mm/d in 4 steps)
28 d of distraction	68.7 ± 6.9	-8	18.8 ± 8.1	-15
30 d of fixation	73.5 ± 5.8	-7	40.1 ± 2.3	-1
30 d without apparatus	54.2 ± 4.8	9^a	27.8 ± 9.5	14^a
A-group - automatic distraction (1 mm/d in 60 steps)
28 d of distraction	83.7 ± 13.5	-9^a	25.7 ± 2.5	-16^a
30 d of fixation	86.8 ± 13.5	-4	29.6 ± 7.0	1
30 d without apparatus	82.0 ± 6.4	5	25.9 ± 0.6	0^c

^aP < 0.05 vs contralateral;

^cP < 0.05 vs group M.

Table 4 Numerical densities of microvessels (N_Amv) in endoneurium

Nerves/group andt-points	Tibial nerve		Peroneal nerve
Nerves/group andt-points	mean ± SE (mm^-2)	Difference vs intact (%)	mean ± SE (mm^-2)	Difference vs intact (%)
Intact	182 ± 22	-	141 ± 8	-
M-group - manual distraction (1 mm/d in 4 steps)
28 d of distraction	180 ± 11	-1.1	192 ± 47^a	36.17
30 d of fixation	203 ± 3^a	11.54	157 ± 36	11.35
30 d without apparatus	187 ± 10	2.75	197 ± 52^a	39.72
A-group - automatic distraction (1 mm/d in 60 steps)
28 d of distraction	135 ± 21^a	-25.8^c	164 ± 8^a	16.31^c
30 d of fixation	181 ± 30	-0.5^c	171 ± 29^a	21.28^c
30 d without apparatus	219 ± 22^a	20.3^c	164 ± 28^a	16.31^c

^aP < 0.05 vs intact;

^cP < 0.05 vs group M.

Table 5 Average morphometric parameters of tibial myelinated nerve fibers (mean ± SE)

Parameters/group and t-points	Share of degenerated nerve fibers (%)	Nerve fibers diameters (mKm)	Axonal diameters (mKm)	Myelin sheath thickness (mKm)
Intact control	1.6 ± 0.2	6.75 ± 0.01	4.63 ± 0.13	1.06 ± 0.02
M-group - manual distraction (1 mm/d in 4 steps)
28 d of distraction	5.0 ± 0.7^a	6.91 ± 0.17	4.57 ± 0.19	1.16^a ± 0.01
30 d of fixation	4.0 ± 0.9^a	6.77 ± 0.47	4.44 ± 0.28^a	1.17 ± 0.10
30 d without apparatus	4.4 ± 2.4	6.61 ± 3.19	4.37 ± 2.10^a	1.12 ± 0.64
A-group - automatic distraction (1 mm/d in 60 steps)
28 d of distraction	2.4 ± 0.7^b	6.29 ± 0.13	4.63 ± 0.10	0.83 ± 0.02^a
30 d of fixation	0.5 ± 0.2^a^c	6.88 ± 0.11	4.99 ± 0.10^a	0.95 ± 0.12
30 d without apparatus	0.9 ± 0.1^a^c	7.26 ± 0.13^a	5.05 ± 0.09^a	1.11 ± 0.05

^aP < 0.05 vs intact;

^cP < 0.05 vs group M.

Table 6 Average morphometric parameters of peroneal myelinated nerve fibers (mean ± SE)

Parameters/group andt-points	Share of degenerated nerve fibers (%)	Nerve fibers diameters (mKm)	Axonal diameters (mKm)	Myelin sheath thickness (mKm)
Intact control	1.9 ± 0.3	6.46 ± 0.07	4.39 ± 0.08	1.04 ± 0.04
M-group - manual distraction (1 mm/d in 4 steps)
28 d of distraction	6.0 ± 1.4^a	5.37 a ± 0.41	3.69 ± 0.29^a	0.84 ± 0.09^a
30 d of fixation	4.3 ± 1.3^a	6.09 ± 0.63	4.44 ± 0.57	0.98 ± 0.06
30 d without apparatus	4.2 ± 0.4^a	5.90 ± 0.43	4.10 ± 0.10^a	0.90 ± 0.17^a
A-group - automatic distraction (1 mm/d in 60 steps)
28 d of distraction	4.0 ± 0.8^a^c	5.56 ± 0.26^a	3.70 ± 0.53^a	0.92 ± 0.13
30 d of fixation	3.3 ± 0.1^a^c	5.62 ± 0.07^a	3.91 ± 0.09^a	0.85 a ± 0.07
30 d without apparatus	2.4 ± 0.6^c	6.17 ± 0.45	4.14 ± 0.16	1.01 ± 0.06

^aP < 0.05 vs intact;

^cP < 0.05 vs group M.

Table 7 Average morphometric parameters of articular cartilage (mean ± SD)

Parameters/group and t-points	Cartilage thickness (mKm)	Chondrocytes volumetric density (%)	Isogenic groups	Empty lacunas
Parameters/group and t-points	Cartilage thickness (mKm)	Chondrocytes volumetric density (%)	(% of chondrocyte sample)
Intact control	475.5 ± 1.31	9.03 ± 1.51	14.5	13.6
M-group - manual distraction (1 mm/d in 4 steps)
28 d of distraction	710.3 ± 7.16^a	4.13 ± 0.28^a	24.7	29.97
30 d of fixation	421.1 ± 4.81^a	5.1 ± 0.27^a	20.18	20.85
30 d without apparatus	416.9 ± 4.37^a	5.6 ± 0.19^a	16.1	21.12
A-group - automatic distraction (1 mm/d in 60 steps)
28 d of distraction	356.45 ± 1.55^a^c	8.34 ± 0.48^a^c	25.6	24.3
30 d of fixation	392.7 ± 2.12^a^c	6.8 ± 0.45^a^c	28.8	16.3
30 d without apparatus	464.6 ± 6.51^c	7.96 ± 0.37^a^c	29.9	15.4

^aP < 0.05 vs intact;

^cP < 0.05 vs group M.

Table 8 Content of sulfur and calcium in articular cartilage (mean ± SD, weight %)

Parameters/group and t-points	ωS	ωCa
Intact control	1.26 ± 0.02	0.15 ± 0.02
M-group - manual distraction (1 mm/d in 4 steps)
28 d of distraction	0.71 ± 0.01^a	0.19 ± 0.02^a
30 d of fixation	0.96 ± 0.02^a	0.39 ± 0.03^a
30 d without apparatus	0.94 ± 0.02^a	0.27 ± 0.02^a
A-group - automatic distraction (1 mm/d in 60 steps)
28 d of distraction	0.79 ± 0.01^a	0.16 ± 0.01^c
30 d of fixation	1.09 ± 0.02^a^c	0.18 ± 0.02^c
30 d without apparatus	1.15 ± 0.02^c	0.20 ± 0.02^a^c

^aP < 0.05 vs intact;

^cP < 0.05 vs group M.

Citation: Shchudlo N, Varsegova T, Stupina T, Shchudlo M, Saifutdinov M, Yemanov A. Benefits of Ilizarov automated bone distraction for nerves and articular cartilage in experimental leg lengthening. World J Orthop 2017; 8(9): 688-696
URL: https://www.wjgnet.com/2218-5836/full/v8/i9/688.htm
DOI: https://dx.doi.org/10.5312/wjo.v8.i9.688