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The effect on the extracellular matrix of the deep fascia in response to leg lengthening.

Wang HQ, Li XK, Wu ZX, Wei YY, Luo ZJ - BMC Musculoskelet Disord (2008)

Bottom Line: The changes in collagen distribution and composition occur in deep fascia during leg lengthening.Although different lengthening schemes resulted in varied matrix changes, the most comparable collagen composition to be demonstrated under the scheme of a distraction rate of 1 mm/day and 20% increase in tibia length.Efficient fascia regeneration is initiated only in certain combinations of the leg load parameters including appropriate intensity and duration time, e.g., either low density distraction that persist a relatively short time or high distraction rates.

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Affiliation: Institute of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi'an, People's Republic of China, 710032. wanghaiqiangfmmu@hotmail.com

ABSTRACT

Background: Whereas the alterations of diverse tissues in cellular and molecular levels have been investigated during leg lengthening via microscopy and biochemical studies, little is known about the response of deep fascia. This study aims to investigate the changes of the extracellular matrix in deep fascia in response to leg lengthening.

Methods: Animal model of leg lengthening was established in New Zealand white rabbits. Distraction was initiated at a rate of 1 mm/day and 2 mm/day in two steps, and preceded until increases of 10% and 20% in the initial length of tibia had been achieved. Alcian blue stain and picrosirius-polarization method were used for the study of the extracellular matrix of deep fascia samples. Leica DM LA image analysis system was used to investigate the quantitative changes of collagen type I and III.

Results: Alcian blue stain showed that glycosaminoglycans of fascia of each group were composed of chondroitin sulphate and heparin sulphate, but not of keratan sulphate. Under the polarization microscopy, the fascia consisted mainly of collagen type I. After leg lengthening, the percentage of collagen type III increased. The most similar collagen composition of the fascia to that of the normal fascia was detected at a 20% increase in tibia length achieved via a distraction rate of 1 mm/d.

Conclusion: The changes in collagen distribution and composition occur in deep fascia during leg lengthening. Although different lengthening schemes resulted in varied matrix changes, the most comparable collagen composition to be demonstrated under the scheme of a distraction rate of 1 mm/day and 20% increase in tibia length. Efficient fascia regeneration is initiated only in certain combinations of the leg load parameters including appropriate intensity and duration time, e.g., either low density distraction that persist a relatively short time or high distraction rates.

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Fascia distracted at 1 mm/d with 10% increase in tibia length under the polarization microscopy (Original magnification 10 × 10). The deep fascia mainly consisted of collagen type I (red), and a basal collagen type II (yellow) distribution was detected in layers D1 and D2.
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Figure 2: Fascia distracted at 1 mm/d with 10% increase in tibia length under the polarization microscopy (Original magnification 10 × 10). The deep fascia mainly consisted of collagen type I (red), and a basal collagen type II (yellow) distribution was detected in layers D1 and D2.

Mentions: In contrast to comparable percentages of collagen type I in the matrixes of control and distraction group, the picrosinus staining showed that the relative abundance of collagen type III increased dramatically in the deep fascia matrix of rabbits subjected to 2 mm/day distraction (group C and D, Fig 1). A much lower but significant increase in collagen type III level was also observed in the fascia following continuous 1 mm/day distraction until 10% leg lengthening (group A, Fig 2). The matrix composition assay revealed slightly decreased percentages of collagen type I in groups C and D, which might result from relatively elevated collagen type III levels. Collagen type III was mainly distributed in layers D1 and D2. Given that 3 layers, including 2 dense layers and 1 loose layer, were defined in deep fascia microscopy, layers D1 and D2 refers to the microscopic dense layer of deep fascia, as demonstrated in a previous study [14]. The relative abundances of collagen type I and III of fascia of each group were shown in table 2.


The effect on the extracellular matrix of the deep fascia in response to leg lengthening.

Wang HQ, Li XK, Wu ZX, Wei YY, Luo ZJ - BMC Musculoskelet Disord (2008)

Fascia distracted at 1 mm/d with 10% increase in tibia length under the polarization microscopy (Original magnification 10 × 10). The deep fascia mainly consisted of collagen type I (red), and a basal collagen type II (yellow) distribution was detected in layers D1 and D2.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2483275&req=5

Figure 2: Fascia distracted at 1 mm/d with 10% increase in tibia length under the polarization microscopy (Original magnification 10 × 10). The deep fascia mainly consisted of collagen type I (red), and a basal collagen type II (yellow) distribution was detected in layers D1 and D2.
Mentions: In contrast to comparable percentages of collagen type I in the matrixes of control and distraction group, the picrosinus staining showed that the relative abundance of collagen type III increased dramatically in the deep fascia matrix of rabbits subjected to 2 mm/day distraction (group C and D, Fig 1). A much lower but significant increase in collagen type III level was also observed in the fascia following continuous 1 mm/day distraction until 10% leg lengthening (group A, Fig 2). The matrix composition assay revealed slightly decreased percentages of collagen type I in groups C and D, which might result from relatively elevated collagen type III levels. Collagen type III was mainly distributed in layers D1 and D2. Given that 3 layers, including 2 dense layers and 1 loose layer, were defined in deep fascia microscopy, layers D1 and D2 refers to the microscopic dense layer of deep fascia, as demonstrated in a previous study [14]. The relative abundances of collagen type I and III of fascia of each group were shown in table 2.

Bottom Line: The changes in collagen distribution and composition occur in deep fascia during leg lengthening.Although different lengthening schemes resulted in varied matrix changes, the most comparable collagen composition to be demonstrated under the scheme of a distraction rate of 1 mm/day and 20% increase in tibia length.Efficient fascia regeneration is initiated only in certain combinations of the leg load parameters including appropriate intensity and duration time, e.g., either low density distraction that persist a relatively short time or high distraction rates.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institute of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi'an, People's Republic of China, 710032. wanghaiqiangfmmu@hotmail.com

ABSTRACT

Background: Whereas the alterations of diverse tissues in cellular and molecular levels have been investigated during leg lengthening via microscopy and biochemical studies, little is known about the response of deep fascia. This study aims to investigate the changes of the extracellular matrix in deep fascia in response to leg lengthening.

Methods: Animal model of leg lengthening was established in New Zealand white rabbits. Distraction was initiated at a rate of 1 mm/day and 2 mm/day in two steps, and preceded until increases of 10% and 20% in the initial length of tibia had been achieved. Alcian blue stain and picrosirius-polarization method were used for the study of the extracellular matrix of deep fascia samples. Leica DM LA image analysis system was used to investigate the quantitative changes of collagen type I and III.

Results: Alcian blue stain showed that glycosaminoglycans of fascia of each group were composed of chondroitin sulphate and heparin sulphate, but not of keratan sulphate. Under the polarization microscopy, the fascia consisted mainly of collagen type I. After leg lengthening, the percentage of collagen type III increased. The most similar collagen composition of the fascia to that of the normal fascia was detected at a 20% increase in tibia length achieved via a distraction rate of 1 mm/d.

Conclusion: The changes in collagen distribution and composition occur in deep fascia during leg lengthening. Although different lengthening schemes resulted in varied matrix changes, the most comparable collagen composition to be demonstrated under the scheme of a distraction rate of 1 mm/day and 20% increase in tibia length. Efficient fascia regeneration is initiated only in certain combinations of the leg load parameters including appropriate intensity and duration time, e.g., either low density distraction that persist a relatively short time or high distraction rates.

Show MeSH