Immobility effects on synovial joints. The pathomechanics of joint contracture 1

Abstract

The purpose of this paper is to review the present knowledge of the effects of immobility on fibrous connective tissue and to outline present theories about the pathogenesis of joint contracture. A severe disordering of connective tissue homeostasis appears when the diarthrodial joints are subjected to prolonged immobilization. Not only are bone, muscle and cartilage affected by disuse, but the fibrous connective tissue structures are functionally disturbed. We found that the tissues lose significant lubricating and buffering volume of water and glycosaminoglycan in concert with increased inter- and intra-molecular cross-links of collagen which resulted in joint stiffness. The potential application of D-penicillamine and 17β-estradiol in pharmacological doses are being investigated for the therapeutic manipulation of reduction of strength of contracture.