Abstract
When the tibialis anterior muscle of the rabbit is progressively stretched during surgical limb distraction, the muscle fibres lengthen by addition of new serial sarcomeres, provided that stretch is carried out at an appropriate rate. However, in spite of the apparent adaptation to the new functional length, range of joint movement is greatly decreased. In this study we have first, made measurements of the passive tension developed by distracted muscles over the range of joint movement and secondly made quantitative measurements of endomysial and perimysial connective tissue content. It was found that at all ankle joint angles greater than 90°, the passive tension developed by the distracted muscles was greater than both contralateral and sham-operated controls. Image analysis showed that the ratio of collagen to contractile material was increased in distracted muscles compared with muscles from sham-operated controls, due to increased deposition of collagen type III. Scanning electron microscopy showed the presence of a dense perimysial weave surrounding the distracted muscle fibres. These quantitative and qualitative changes in the connective tissue component could account for the increased stiffness demonstrated by the physiological measurements. It would seem that in distracted muscle the connective tissue element adapts less readily than the contractile component, with prolonged stretch leading to damage to the perimysial and endomysial network, with subsequent fibrosis and loss of muscle compliance. Such changes could help explain the loss of range of movement noted in the distracted limbs of patients undergoing surgical limb-lengthening and in other conditions that result in muscle contractures.
Keywords: Connective tissue, collagen, fibrosis, muscle contracture
Full Text
The Full Text of this article is available as a PDF (523.8 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Borg T. K., Caulfield J. B. Morphology of connective tissue in skeletal muscle. Tissue Cell. 1980;12(1):197–207. doi: 10.1016/0040-8166(80)90061-0. [DOI] [PubMed] [Google Scholar]
- Day C. S., Moreland M. S., Floyd S. S., Jr, Huard J. Limb lengthening promotes muscle growth. J Orthop Res. 1997 Mar;15(2):227–234. doi: 10.1002/jor.1100150211. [DOI] [PubMed] [Google Scholar]
- Fitch R. D., Thompson J. G., Rizk W. S., Seaber A. V., Garrett W. E., Jr The effects of the Ilizarov distraction technique on bone and muscle in a canine model: a preliminary report. Iowa Orthop J. 1996;16:10–19. [PMC free article] [PubMed] [Google Scholar]
- Foidart M., Foidart J. M., Engel W. K. Collagen localization in normal and fibrotic human skeletal muscle. Arch Neurol. 1981 Mar;38(3):152–157. doi: 10.1001/archneur.1981.00510030046006. [DOI] [PubMed] [Google Scholar]
- Heerkens Y. F., Woittiez R. D., Kiela J., Huijing P. A., Huson A., van Ingen Schenau G. J., Rozendal R. H. Mechanical properties of passive rat muscle during sinusoidal stretching. Pflugers Arch. 1987 Aug;409(4-5):438–447. doi: 10.1007/BF00583799. [DOI] [PubMed] [Google Scholar]
- Ilizarov G. A. The tension-stress effect on the genesis and growth of tissues. Part I. The influence of stability of fixation and soft-tissue preservation. Clin Orthop Relat Res. 1989 Jan;(238):249–281. [PubMed] [Google Scholar]
- Lee D. Y., Choi I. H., Chung C. Y., Chung P. H., Chi J. G., Suh Y. L. Effect of tibial lengthening on the gastrocnemius muscle. A histopathologic and morphometric study in rabbits. Acta Orthop Scand. 1993 Dec;64(6):688–692. doi: 10.3109/17453679308994599. [DOI] [PubMed] [Google Scholar]
- Lowry A., Wilcox D., Masson E. A., Williams P. E. Immunohistochemical methods for semiquantitative analysis of collagen content in human peripheral nerve. J Anat. 1997 Oct;191(Pt 3):367–374. doi: 10.1046/j.1469-7580.1997.19130367.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Matano T., Tamai K., Kurokawa T. Adaptation of skeletal muscle in limb lengthening: a light diffraction study on the sarcomere length in situ. J Orthop Res. 1994 Mar;12(2):193–196. doi: 10.1002/jor.1100120207. [DOI] [PubMed] [Google Scholar]
- Paley D. Problems, obstacles, and complications of limb lengthening by the Ilizarov technique. Clin Orthop Relat Res. 1990 Jan;(250):81–104. [PubMed] [Google Scholar]
- Pickering J. G., Boughner D. R. Fibrosis in the transplanted heart and its relation to donor ischemic time. Assessment with polarized light microscopy and digital image analysis. Circulation. 1990 Mar;81(3):949–958. doi: 10.1161/01.cir.81.3.949. [DOI] [PubMed] [Google Scholar]
- SOFIELD H. A., BLAIR S. J., MILLAR E. A. Leg-lengthening; a personal follow-up of forty patients some twenty years after the operation. J Bone Joint Surg Am. 1958 Apr;40-A(2):311–322. [PubMed] [Google Scholar]
- SWEAT F., PUCHTLER H., ROSENTHAL S. I. SIRIUS RED F3BA AS A STAIN FOR CONNECTIVE TISSUE. Arch Pathol. 1964 Jul;78:69–72. [PubMed] [Google Scholar]
- Simpson A. H., Williams P. E., Kyberd P., Goldspink G., Kenwright J. The response of muscle to leg lengthening. J Bone Joint Surg Br. 1995 Jul;77(4):630–636. [PubMed] [Google Scholar]
- Trotter J. A., Purslow P. P. Functional morphology of the endomysium in series fibered muscles. J Morphol. 1992 May;212(2):109–122. doi: 10.1002/jmor.1052120203. [DOI] [PubMed] [Google Scholar]
- Williams P., Watt P., Bicik V., Goldspink G. Effect of stretch combined with electrical stimulation on the type of sarcomeres produced at the ends of muscle fibers. Exp Neurol. 1986 Sep;93(3):500–509. doi: 10.1016/0014-4886(86)90170-6. [DOI] [PubMed] [Google Scholar]