髋臼骨折后股骨头软骨变性的转归
摘要
目的:本文研究髋臼骨折后股骨头软骨的变化,探讨髋臼骨折后骨性关节炎及股骨头坏死的发生情况。
方法:将15只新西兰兔随机分成3组,人工造模后分期观察股骨头情况。临床选取17例髋臼骨折后发生骨性关节炎及股骨头坏死病人,通过MRI观察髋部情况。
结果:新西兰兔均出现不同程度懿关节骨性关节炎,7只出现股骨头坏死。17例病人中1例出现股骨头坏死。
结论:髋臼骨折后,因应力及磨损原因,易发生骨性关节炎及股骨头坏死,临床治疗中应积极争取骨折解剖复位,以预防或减轻骨性关节炎及股骨头坏死的发生。
Objective To study the development of the cartilage of femoral head after acetabulum fracture, and the connection of osteoarthritis and osteonecrosis of femoral head.
Methods 15 rabbits were allocated into 3 groups. Each suffered acetabulum fracture on one side. The cartilage of femoral head was observed by stages. 17 cases suffered osteoarthritis or osteonecrosis of femoral head. Their states of an illness were studied by MRI images.
Results All the rabbits suffered osteoarthritis, and 7 suffered osteonecrosis of femoral head finally. All cases suffered osteoarthritis, and 1 suffered osteonecrosis of femoral head finally.
Conclusion It is familiar of osteoarthritis and osteonecrosis of femoral head after acetabulum fracture. The diaplasis should be anatomic for reducing the happen of osteoarthritis and osteonecrosis of femoral head.
方法:将15只新西兰兔随机分成3组,人工造模后分期观察股骨头情况。临床选取17例髋臼骨折后发生骨性关节炎及股骨头坏死病人,通过MRI观察髋部情况。
结果:新西兰兔均出现不同程度懿关节骨性关节炎,7只出现股骨头坏死。17例病人中1例出现股骨头坏死。
结论:髋臼骨折后,因应力及磨损原因,易发生骨性关节炎及股骨头坏死,临床治疗中应积极争取骨折解剖复位,以预防或减轻骨性关节炎及股骨头坏死的发生。
Objective To study the development of the cartilage of femoral head after acetabulum fracture, and the connection of osteoarthritis and osteonecrosis of femoral head.
Methods 15 rabbits were allocated into 3 groups. Each suffered acetabulum fracture on one side. The cartilage of femoral head was observed by stages. 17 cases suffered osteoarthritis or osteonecrosis of femoral head. Their states of an illness were studied by MRI images.
Results All the rabbits suffered osteoarthritis, and 7 suffered osteonecrosis of femoral head finally. All cases suffered osteoarthritis, and 1 suffered osteonecrosis of femoral head finally.
Conclusion It is familiar of osteoarthritis and osteonecrosis of femoral head after acetabulum fracture. The diaplasis should be anatomic for reducing the happen of osteoarthritis and osteonecrosis of femoral head.
引文
[1] Broom ND, Myers DB. A study of the structural response of wet hyaline cartilage to various loading situations. Connect Tissue Res 1980;7:227-37.
[2] Freeman PM, Natarjan RN, Kimura JH, Andriacchi TP. Chondrocyte cells respond mechanically to compressive loads. J Orthop Res 1994; 12:311-20.
[3] Guilak F. Compression-induced changes in the shape and volume of the chondrocyte nucleus. J Biomechics 1995; 28: 1529-42.
[4] Hayami T, Pickarski M, Zhuo Y, et al. Characterization of articular cartilage and subchondral bone changes in the rat anterior cruciate ligament transection and meniscectomized models of osteoarthritis. Bone.2006 Feb; 38(2):234-43.
[5] Urban, J. P, Hall, AC. The effects of hydrostatic and osmotic pressure on chondrocyte metabolism. In: Mow V. C, Guilak, F, Tran-son-Tay, R. (Eds),Cell Mechanics and cellular Engineering. Springer, New York, pp.398-419.
[6] Trickey, W, Vail, T, and Guilak, F. The role of the cytoskeleton in the viscoelastic properties of human articular chondrocytes. Journal of Orthopaedic Research, 2004, 22, 131-139.
[7] Sato M, Theret D. P, Wheeler L. T, et al. Application of the micropipette technique to the measurement of cultured porcine aortic endothelial cell viscoelastic properties. J. Biomech Engng, 1990,112 (3):263～268.
[8] Konrath GA, Hamel AJ, Sharkey NA, et al. Biomechanical consequences of anterior column fracture of the acetabulum. J Orthop Trauma, 1998,12:547-552.
[9] Yueqing W, Siquan L.Direct protective effect of interleukin 10 on articular chondrocytes in vitro[J]. Chinese Medical Journal, 2001, 144:723.
[10] Aixin C, Siquan L, Hao weiZ, etal. Expression of PDCD5, A novel apoptosis related protein, in human osteoarthriticcartilage[J]. Acta Pharmacol Sin, 2004, 25:685.
[11] Hangody L, Fules P. Autologous osteochondral mosaicplasty for the treatment of full thickness defects of weight bearing joints: tenyears of experimental and clinical experience[J]. J Bone Joint Surg(Am), 2003,85(2) : 25-32.
[12] Yao L, Shiha S, Seeger L L. MR imaging of joints: analytic optimization of GRE techniques at 1.5T[J].Am J Roentgenol 1992,158:339-349.
[13]Recht M P,Kramer J,Marcelis S,etal.Abnormalities of articular cartilage in the knee[J].Radiology,1993,187:473-478.
[14]Hohe J,Faber S,Muchlbauer R,etal.Three-dimension alanalysis and visualization of regional MR signal intensity distribution of articular cartilage[J].MedEngPhys,2002,24:219-227.
[15]Frank L R,Brossmann J,Buxton RB,etal.MR imaging truncation artifacts can create a false laminar appearance in cartilage[J]Am J Roe(?)genol,1997,168:547-554.
[16]Daeman B R,Ferrara M A,Marcelis S,etal.Evaluation of patellar cartilage surface lesions:comparison of CT arthrography and fat suppressed FLASH 3D MR imaging[J].EurRadiol,1998,8:981-985.
[17]M U H L,Allmann K H,Tauer U,etal.Comparison of MR sequences in quantifying in vitro cartilage degeneration in osteoarthritis of the knee[J].BriJRadiology,1998,71:291-296.
[18]Oisler D G.Fat-suppression three dimensional spoiled gradieng-recalled MR imaging:assessment of articular and physeal hyaline cartilage[J].AJR,1997,169:1117-1123.
[19]Wang S F,Cheng H C,Chang C Y.Fat-suppressed three dimensional fast spoiled gradient-recalled echo imaging[J].Clin Imaging,1999,23:177.
[20]Lehner K B,Rechl H P,Gmeinwiester J K,etal.Structure,function and degeneration of bovine hyaline cartilage:assessment with MR imaging in vivo[J].Radiology,1989,170:495-499.
[21]Brossmann J,Frank L R,Pauly J M,etal.Short echo time projection reconstruction MR imaging of cartilage[J].Radiology,1997,203:501 507.
[22]Cova M,Toffanin R,Szomolanyi P,etal.Short-TE projection reconstruction MR microscopy in thee valuation of articular cartilage thickness[J].Eur Radiol,2000,10:1222-1225.
[23]姚秋英,陈克敏,韩洪杰.膝关节软骨MR成像的技术研究[J].诊断学理论与实践,2002,1:53-54.
[24]Grunder W,Biesold M,Wangner M,etal.Improved nuclear magnetic resonance microscopic visualization of joint cartilage using liposome entrapped contrast agents[J].InvestRadiol,1998,33:193 202.
[25] Navarro R, Cohen M, Filho MC, et al. The arthroscopic treatment of osteochondritis dissecans of the knee with autologous[J]. J Bone Sticks, Arthroscopy, 2002, 18:840-844.
[1]高仰贤.骨性关节炎发病机制的国内研究进展[J].中医正骨,2005,17(4):55.
[2]王卫国,娄思权,余华,等.T G F β 2转染关节软骨细胞的实验研究[J].中华骨科杂志,2003,23:434.
[3]俞强,曹国平,石仕元.得宝生关节腔冲洗玻璃酸钠注射治疗膝关节炎[J].中医正骨,2005,17(12):46.
[4]吴志宏,邱贵兴.骨关节炎髌骨软骨中Ⅱ型胶原的表达和超微结构研究[J].中华骨科杂志,2005,17(12):46.
[5]邓廉夫,柴本莆,齐进.损伤性和骨关节炎性滑膜细胞成骨作用的体积研究[J].中华骨科杂志,1997,25(5):311.
[6]蔡伟平,汤亭亭.骨关节炎的细胞生物学研究进展[J].国外医学·骨科分册,2004,25:18.
[7]孙永生,娄思权.骨性关节炎发病分子机制研究进展[J].中国骨与关节损伤杂志,2005,20(8):571.
[8]田华,党耕町,娄思权,等.基质金属蛋白酶及其抑制剂在软骨细胞中的表达及其意义[J].北京医科大学学报,1999,31:189.
[9]郭常安,陈峥嵘,张秀荣.骨性关节炎基质金属蛋白酶1、2、3及其抑制物的表达与软骨退变的关系[J].复旦学报(医学版),2002,29:244.
[10]金伟,陈廖斌.生物自由基与骨性关节炎[J].湖北预防医学杂志,2002,13:13.
[11]田华,娄思权,党耕町,等.肿瘤坏死因子α导致软骨损伤的机制探讨[J].中华外科杂志,2000,38:76。
[12]谈志龙,邢国胜,李德达,等.细胞因子对关节软骨细胞作用的研究[J].骨与关节损伤杂志,2003,18(4):316.
[13]程爱新.趋化素样因子1(C K L F 1)对关节软骨细胞增殖及代谢的影响[J].北京大学学报(医学版),2003,35:399.
[14]Doherty P J,Zhang H,Manolopoulos V,etal.Adhesion of transplanted chondrocytes onto cartilage in vitro and in vivo.JRheumatol,2000,27:1725-1731.
[15]Oligino T,Ghivzzani S,Wolfe D,etal.Intra-articular delivery of a herpes simplex virus IL- 1Ra gerne vector trduces in flammation in a rabbit model of arthritis.Gene Ther,1999,6:1713-1720.
[14]Tomita T,Hashimoto H,Tomita Hetal.In vivo direct gene transfer into articular cartilage by intraariticularin jection mediated by HVJ(sendai) virus and liposomes.Arthritis Rheum,1997,40:901-906.
[15]Frisbie D D,Mcwraith C W.Evaluation of gene therapy as a treatment for equine traumatic arthritis and osteoarthritis.ClinOrthop,2000,379(Suppl):S273-S287.
[2] Freeman PM, Natarjan RN, Kimura JH, Andriacchi TP. Chondrocyte cells respond mechanically to compressive loads. J Orthop Res 1994; 12:311-20.
[3] Guilak F. Compression-induced changes in the shape and volume of the chondrocyte nucleus. J Biomechics 1995; 28: 1529-42.
[4] Hayami T, Pickarski M, Zhuo Y, et al. Characterization of articular cartilage and subchondral bone changes in the rat anterior cruciate ligament transection and meniscectomized models of osteoarthritis. Bone.2006 Feb; 38(2):234-43.
[5] Urban, J. P, Hall, AC. The effects of hydrostatic and osmotic pressure on chondrocyte metabolism. In: Mow V. C, Guilak, F, Tran-son-Tay, R. (Eds),Cell Mechanics and cellular Engineering. Springer, New York, pp.398-419.
[6] Trickey, W, Vail, T, and Guilak, F. The role of the cytoskeleton in the viscoelastic properties of human articular chondrocytes. Journal of Orthopaedic Research, 2004, 22, 131-139.
[7] Sato M, Theret D. P, Wheeler L. T, et al. Application of the micropipette technique to the measurement of cultured porcine aortic endothelial cell viscoelastic properties. J. Biomech Engng, 1990,112 (3):263～268.
[8] Konrath GA, Hamel AJ, Sharkey NA, et al. Biomechanical consequences of anterior column fracture of the acetabulum. J Orthop Trauma, 1998,12:547-552.
[9] Yueqing W, Siquan L.Direct protective effect of interleukin 10 on articular chondrocytes in vitro[J]. Chinese Medical Journal, 2001, 144:723.
[10] Aixin C, Siquan L, Hao weiZ, etal. Expression of PDCD5, A novel apoptosis related protein, in human osteoarthriticcartilage[J]. Acta Pharmacol Sin, 2004, 25:685.
[11] Hangody L, Fules P. Autologous osteochondral mosaicplasty for the treatment of full thickness defects of weight bearing joints: tenyears of experimental and clinical experience[J]. J Bone Joint Surg(Am), 2003,85(2) : 25-32.
[12] Yao L, Shiha S, Seeger L L. MR imaging of joints: analytic optimization of GRE techniques at 1.5T[J].Am J Roentgenol 1992,158:339-349.
[13]Recht M P,Kramer J,Marcelis S,etal.Abnormalities of articular cartilage in the knee[J].Radiology,1993,187:473-478.
[14]Hohe J,Faber S,Muchlbauer R,etal.Three-dimension alanalysis and visualization of regional MR signal intensity distribution of articular cartilage[J].MedEngPhys,2002,24:219-227.
[15]Frank L R,Brossmann J,Buxton RB,etal.MR imaging truncation artifacts can create a false laminar appearance in cartilage[J]Am J Roe(?)genol,1997,168:547-554.
[16]Daeman B R,Ferrara M A,Marcelis S,etal.Evaluation of patellar cartilage surface lesions:comparison of CT arthrography and fat suppressed FLASH 3D MR imaging[J].EurRadiol,1998,8:981-985.
[17]M U H L,Allmann K H,Tauer U,etal.Comparison of MR sequences in quantifying in vitro cartilage degeneration in osteoarthritis of the knee[J].BriJRadiology,1998,71:291-296.
[18]Oisler D G.Fat-suppression three dimensional spoiled gradieng-recalled MR imaging:assessment of articular and physeal hyaline cartilage[J].AJR,1997,169:1117-1123.
[19]Wang S F,Cheng H C,Chang C Y.Fat-suppressed three dimensional fast spoiled gradient-recalled echo imaging[J].Clin Imaging,1999,23:177.
[20]Lehner K B,Rechl H P,Gmeinwiester J K,etal.Structure,function and degeneration of bovine hyaline cartilage:assessment with MR imaging in vivo[J].Radiology,1989,170:495-499.
[21]Brossmann J,Frank L R,Pauly J M,etal.Short echo time projection reconstruction MR imaging of cartilage[J].Radiology,1997,203:501 507.
[22]Cova M,Toffanin R,Szomolanyi P,etal.Short-TE projection reconstruction MR microscopy in thee valuation of articular cartilage thickness[J].Eur Radiol,2000,10:1222-1225.
[23]姚秋英,陈克敏,韩洪杰.膝关节软骨MR成像的技术研究[J].诊断学理论与实践,2002,1:53-54.
[24]Grunder W,Biesold M,Wangner M,etal.Improved nuclear magnetic resonance microscopic visualization of joint cartilage using liposome entrapped contrast agents[J].InvestRadiol,1998,33:193 202.
[25] Navarro R, Cohen M, Filho MC, et al. The arthroscopic treatment of osteochondritis dissecans of the knee with autologous[J]. J Bone Sticks, Arthroscopy, 2002, 18:840-844.
[1]高仰贤.骨性关节炎发病机制的国内研究进展[J].中医正骨,2005,17(4):55.
[2]王卫国,娄思权,余华,等.T G F β 2转染关节软骨细胞的实验研究[J].中华骨科杂志,2003,23:434.
[3]俞强,曹国平,石仕元.得宝生关节腔冲洗玻璃酸钠注射治疗膝关节炎[J].中医正骨,2005,17(12):46.
[4]吴志宏,邱贵兴.骨关节炎髌骨软骨中Ⅱ型胶原的表达和超微结构研究[J].中华骨科杂志,2005,17(12):46.
[5]邓廉夫,柴本莆,齐进.损伤性和骨关节炎性滑膜细胞成骨作用的体积研究[J].中华骨科杂志,1997,25(5):311.
[6]蔡伟平,汤亭亭.骨关节炎的细胞生物学研究进展[J].国外医学·骨科分册,2004,25:18.
[7]孙永生,娄思权.骨性关节炎发病分子机制研究进展[J].中国骨与关节损伤杂志,2005,20(8):571.
[8]田华,党耕町,娄思权,等.基质金属蛋白酶及其抑制剂在软骨细胞中的表达及其意义[J].北京医科大学学报,1999,31:189.
[9]郭常安,陈峥嵘,张秀荣.骨性关节炎基质金属蛋白酶1、2、3及其抑制物的表达与软骨退变的关系[J].复旦学报(医学版),2002,29:244.
[10]金伟,陈廖斌.生物自由基与骨性关节炎[J].湖北预防医学杂志,2002,13:13.
[11]田华,娄思权,党耕町,等.肿瘤坏死因子α导致软骨损伤的机制探讨[J].中华外科杂志,2000,38:76。
[12]谈志龙,邢国胜,李德达,等.细胞因子对关节软骨细胞作用的研究[J].骨与关节损伤杂志,2003,18(4):316.
[13]程爱新.趋化素样因子1(C K L F 1)对关节软骨细胞增殖及代谢的影响[J].北京大学学报(医学版),2003,35:399.
[14]Doherty P J,Zhang H,Manolopoulos V,etal.Adhesion of transplanted chondrocytes onto cartilage in vitro and in vivo.JRheumatol,2000,27:1725-1731.
[15]Oligino T,Ghivzzani S,Wolfe D,etal.Intra-articular delivery of a herpes simplex virus IL- 1Ra gerne vector trduces in flammation in a rabbit model of arthritis.Gene Ther,1999,6:1713-1720.
[14]Tomita T,Hashimoto H,Tomita Hetal.In vivo direct gene transfer into articular cartilage by intraariticularin jection mediated by HVJ(sendai) virus and liposomes.Arthritis Rheum,1997,40:901-906.
[15]Frisbie D D,Mcwraith C W.Evaluation of gene therapy as a treatment for equine traumatic arthritis and osteoarthritis.ClinOrthop,2000,379(Suppl):S273-S287.