摘要
目的探讨膝关节软骨下骨不同表面积缺损对关节软骨早期组织形态的影响。方法 30只成年大白兔,随机分为A、B、C组各10只,右侧胫骨内侧髁胫骨平台下开骨窗,分别钻取10、15、20mm深度后行软骨下骨刮除术(缺损表面积分别占膝关节软骨面全表面积的50%、75%、近100%),残腔灭活后植入同种异体骨。术后4周,处死动物后取右侧膝关节标本,观察内侧胫骨平台大体形态,行HE染色观察组织学形态变化,行软骨退变病理学Mankin评分,Pearson相关分析各组Mankin评分的相关性。结果 A组关节软骨面接近正常,粉红色,表面平整、光滑;B组软骨表面粗糙,呈灰黄色,滑膜增生较为明显;C组关节面粗糙无光泽,滑膜增生明显,可见明显裂隙、部分软骨面塌陷;B、C组Mankin评分[(5.80±1.48)、(6.00±1.50)分]均高于A组[(1.40±1.07)分](P<0.05),B组与C组Mankin评分比较差异无统计学意义(P>0.05);Pearson相关分析结果显示,A组Mankin评分与B、C组Mankin均呈正相关(r=0.88,P<0.001;r=0.87,P<0.001)。结论软骨下骨缺损表面积≤软骨面全表面积的50%时,关节软骨仅发生轻微退变,超过软骨面全表面积的50%时,软骨在早期阶段就已发生严重退变。
Objective To explore the influence of the different surface defects of subchondral bone on the early tissue morphology of articular cartilage. Methods Thirty adult rabbits were randomly divided into group A, B and C, with 10 rabbits in each group. A bone window was opened at right tibial entocondyle under tibia plateau, and excoehleation of subchondral bone was performed after drilling at coronal section in a depth of 10, 15 and 20 mm, respectively, with the defect superficial areas accounting for 50%, 75% and near 100% of total superficial area of knee cartilage. Allograft bone was transplanted after cavity inactivation. The rabbits were sacrificed to obtain the right knee specimen 4 weeks after operation. The histologic morphologic change was observed by HE staining. The Mankin score was evaluated and Pearson correlation analysis was adopted to analyze the correlation of Mankin scores among three groups. Results The cartilage surface was close to normal, pink in color, even and smooth surface in group A, was rough, grayish yellow in color, and obvious synovial hyperptasia in group B, and was rough and reluster, obvious synovial hyperplasia, a visible cleft and collapsed partial cartilage surface in group C. The Mankin score was significantly higher in group B （5. 80 ±1.48） and group C （6.00±1.50） than that in group A （1.40±1.07） （P〈0.05）, and there was no significant difference between group B and C （P〈0. 05）. Pearson correlation analysis result showed that the Mankin score in group A was positively correlated with Mankin score in group group 13 and C （r=0.88, P〈0. 001; r=0.87, P〈0. 001）. Conclusion When the defect surface of subchondral bone is ≤ 50%of total superficial area, the cartilage can only be found slight degeneration, and when the defect surface of subchondral bone exceeds 50 % of total superficial area, serious degeneration of cartilage in the earlier stage would occur.
作者
顾庆陟
陶开亮
高兴
李承铎
樊雪鹏
田征
GU Qing-zhi , TAO Kai-liang, GAO Xing, LI Cheng-duo, FAN Xue-peng, TIAN Zheng(Grade 2015, Xinjiang Medical University, Urumqi 830054, Chin)
出处
《中华实用诊断与治疗杂志》
2018年第3期222-225,共4页
Journal of Chinese Practical Diagnosis and Therapy
基金
新疆维吾尔自治区自然科学基金资助项目(2014211C034)
新疆维吾尔自治区自然科学基金资助项目(2015211C094)
关键词
软骨下骨
骨缺损
缺损表面积
关节软骨
退变
Subchondral bone
bone defect
defect area
articular cartilage
degeneration
