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American Journal of Pathology, Vol 136, 1407-1416, Copyright © 1990 by American Society for Investigative Pathology

REGULAR ARTICLES

Immobilization aggravates cartilage damage during antigen-induced arthritis in mice. Attachment of polymorphonuclear leukocytes to articular cartilage

PL van Lent, L van den Bersselaar, LB van de Putte and WB van den Berg
Department of Rheumatology, University Hospital St. Radboud, Nijmegan, The Netherlands.

The early and late effects of short-term immobilization on arthritic joints have been studied. Knee joints of mice in which an antigen- induced unilateral arthritis was elicited were immobilized in extension for 3, 5, and 7 days. After 5 and 7 days' immobilization, arthritis was significantly more severe. More leukocytes infiltrated the periarticular tissues and more cellular exudate was found in the joint space. A striking observation was that large numbers of polymorphonuclear leukocytes (PMN) attached to the surface of the cartilage, a phenomenon not found in mobile arthritic joints. Electron- microscopy confirmed PMN adhesion and showed severe ruffling of the cartilage surface under immobilized conditions. Further examination of factors determining PMN sticking revealed that attachment is rapid when the cartilage surface is already damaged, and that retained immune complexes and complement play a pivotal role. The late effects of immobilization were studied after a remobilization period of 2 weeks. Enhanced matrix depletion and chondrocyte death persisted in arthritic joints that were previously immobilized for 5 and 7 days, and the latter also showed significantly increased osteophyte formation. Although these results are speculative for the human situation, this study indicates that treatment of arthritic joints by complete rest should be applied with caution.

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