Abstract:

BACKGROUND: Joint contracture is a difficult problem in the trauma treatment. Joint contracture during the treatment of joint trauma often results in lifelong dysfunction. The present study shows that joint contractures often occur in the synovium, and synovial tissue fibrosis is the main reason for the joint contractures. Previous studies suggest that transforming growth factor β plays a key role in the lung, liver, kidney and skin fibrosis, but the effect of transforming growth factor β in joint contracture is not clear.
OBJECTIVE: To review the effect and mechanism of the factors in joint contraction.
METHODS: The CNKI database and Medline database (2000/2010) were searched by the first author with the key words of “trauma, joint contracture” in Chinese and “joint contracture, synovium, fixation, transforming growth factor-β1” in English. We reviewed from the morphological changes of the joint contracture, the effect of the cytokines and the interaction of cytokines. We introduced from the aspects of morphological changes and the regulation mechanism in joint contracture. A total of 196 articles were obtained, and 39 articles were included according to the exclusion and inclusion criteria.
RESULTS AND CONCLUSION: Joint synovial tissue fibrosis is the biological basis of joint contractures, the cells and cytokines including transforming growth factor β, connective tissue growth factor, a-smooth muscle actin, matrix metalloproteinase and metalloproteinase tissue inhibitors participate in process of fibrosis, and transforming growth factor β is the center factors of the joint contracture. The mechanical effect on the regulation mechanism of transforming growth factor β is unclear, so the effect of time on the degree of joint contracture needs further study.