Arthrofibrosis Prevention by Antibody against Vascular Endothelial Growth Factor (A Novel Use of Bevacizumab in Rabbits)

Prevention of arthrofibrosis by different drugs and surgical techniques is an essential issue in modern orthopaedics. This study investigated the effect of bevacizumab on intra-articular fibrosis in a rabbit animal model. Arthrofibrosis was induced in right stifle joint of thirty male white rabbits by removing the cortical bone of femoral condyle in medial gutter under general anesthesia. The rabbits were randomly divided into three equal groups. The control group received intra-articular injection of saline; the «one-injection» group received a single dose of bevacizumab (2. 5 mg/kg)، and the «two-injection» group received two intra-articular injections on the day of operation and 14 days later. Forty five days after the surgery، the animals were sacrificed. The severity of fibrosis was assessed by range of motion of the stifles، macroscopic adhesion score، and histopathologic variables. Although no statistical difference was seen between the control group and the «one-injection» group in terms of range of motion and macroscopic evaluation، the histopathologic variables in prevention of arthrofibrosis، except for the granulation tissue، were significantly better in the «one-injection» group. The «two-injection» group in comparison to the «one-injection» group was better not only in range of motion evaluation (p=. 001) and visual adhesion score (p=. 012)، but also in most of the histopathologic variables، except for the cell count and granulation tissue. Two injections of bevacizumab for prevention of arthrofibrosis resulted in better outcome than single injection.