Progression and Direction of Contractures of Knee Joints Following Spinal Cord Injury in the Rat

Joint contractures following central nervous system injuries remain a prevalent and significant complication, but no reports are available on evidence of contracture formation over time. The objective of this study was to determine the rate of contracture progression and the direction of loss in joint movement following spinal cord injuries (SCI). Forty-eight female Wistar rats were used. Twenty-four experimental rats underwent a spinal cord transection at the level of T8 and 24 control rats underwent a sham-operation. The animals were studied at each of 5 time points: 2, 4, 8, 12, 16, and 24 weeks after surgical intervention. The degree of contractures was assessed by measuring the femorotibial angle on both hindlimbs with the use of a goniometer. Knee joint motion was measured for flexion and extension direction. Knee flexion contractures developed in all experimental rats. The restriction in motion progressed during the first 12 weeks and plateaued thereafter. The contractures were produced almost exclusively by a loss in the extension range of motion. This study defined the time course that contracture progression was more rapid in the early stage after SCI and stabilized in the later stage of injury. Contractures following SCI occurred in flexion at the knees and resulted from a loss of extension. These findings should help guide timely treatment and provide a better understanding of contracture development.