Ilizarov技术对关节软骨病理改变的实验观察
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作者Author单位AddressE-Mail
韩大为 HAN Da-wei 福建中医学院附属人民医院骨科,福建 福州 350004 Department of Orthopaedics,the People's Hospital Affiliated to Fujian College of TCM,Fuzhou 350004,Fujian,China handawei@medmail.com.cn 
李良华 LI Liang-hua 福建中医学院附属人民医院骨科,福建 福州 350005 Department of Orthopaedics,the People's Hospital Affiliated to Fujian College of TCM,Fuzhou 350005,Fujian,China  
王清玉 WANG Qing-yu 福建中医学院附属人民医院骨科,福建 福州 350006 Department of Orthopaedics,the People's Hospital Affiliated to Fujian College of TCM,Fuzhou 350006,Fujian,China  
卢圣友 LU Sheng-you 福建中医学院附属人民医院骨科,福建 福州 350007 Department of Orthopaedics,the People's Hospital Affiliated to Fujian College of TCM,Fuzhou 350007,Fujian,China  
期刊信息:《中国骨伤》2009年,第22卷,第12期,第923-926页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz
基金项目:自然科学基金高校专项(编号:2006J0426)
中文摘要:

目的:了解在Ilizarov技术下,受牵拉的实验踝关节软骨之间的压力改变对关节软骨的影响,为临床提供理论依据。

方法:在18只实验狗左后足踝关节处分别装上Ilizarov外固定支架,采用1 mm/d的牵拉速度,先制造内翻畸形,时间3周,致踝关节内翻15°,摄X线片证实后,停止牵拉3周,再以相同的速度(1 mm/d)矫正畸形,时间3周。并于第3、7、9周(分组为:A组、B组、C组)取实验足内侧关节软骨和健足内侧关节软骨(D组),通过HE染色,观察内侧关节软骨形态学改变。通过免疫组织化学染色,应用软件Image-Pro Plus 6.0取得图像灰度值,用SPSS 13.0进行统计学处理。使用透射电镜观察软骨的显微结构。

结果:① Mankin得分:手术后A组和B组Mankin得分差异有统计学意义(P=0.043<0.05);手术后B组和C组Mankin得分差异有统计学意义(P=0.038<0.05).②灰度值:A组和B组比较,P=0.047<0.05,差异有统计学意义;B组和C组比较,P=0.045<0.05,差异有统计学意义;A组和D组比较,P=0.039<0.05,差异有统计学意义;C组和D组比较,P=1.23>0.05,差异无统计学意义。

结论:在Ilizarov牵张技术牵拉下,当踝关节软骨面之间压力增大时,关节软骨会发生压力性坏死;当关节软骨面之间压力逐渐减小后,关节软骨可逐渐恢复再生。
【关键词】踝关节  软骨  骨再生  病理学
 
Effects of Ilizarov technique on the histopathological changes of articular cartilage
ABSTRACT  

Objective: To study the effects of pressure changes on the experimental articular cartilage by utilizing Ilizarov distraction technique.

Methods: The Ilizarov external fixators were fixed at the left ankle joints of 18 experimental dogs,and the fixators were stretched with a speed of 1 mm /d to create a varus deformity. After three weeks,the ankle varus was 15 degree;when the degree was confirmed by X-ray film,the same traction was retained for 3 weeks. Then the traction decreased at the same speed of 1 mm /d to correct the deformity for 3 weeks. At the 3rd,7th and 9th weeks,articular cartilages were separated from medial foot of the experimental and normal side to do morphology observation after HE stain,which were group A,group B,group C and group D respectively separately. The gray scale values were obtained using Image-Pro Plus 6.0 software and compared among the 4 groups using SPSS 13.0. The microstructure of cartilage was observed through transmission electron microscopy.

Results: ① The Mankin scores: there was significant difference between group A and group B(P=0.043<0.05); and significant difference between group B and group C(P=0.038<0.05). ② The values of gray scale: there was significant difference between group A and group B(P=0.047<0.05); significant difference between group B and group C(P=0.045<0.05);significant difference between group A and group D(P=0.039<0.05);no significant difference between group C and group D(P=1.23>0.05).

Conclusion: Using Ilizarov technique,when the pressure between the cartilage surface of the ankle joint increases,the necrosis of articular cartilage occurred;and when the stress between the articular cartilage surface decreases,the damaged articular cartilage can be restored.
KEY WORDS  Ankle joint  Cartilage,articular  Bone regeneration  Pathology
 
引用本文,请按以下格式著录参考文献:
中文格式:韩大为,李良华,王清玉,卢圣友.Ilizarov技术对关节软骨病理改变的实验观察[J].中国骨伤,2009,22(12):923~926
英文格式:HAN Da-wei,LI Liang-hua,WANG Qing-yu,LU Sheng-you.Effects of Ilizarov technique on the histopathological changes of articular cartilage[J].zhongguo gu shang / China J Orthop Trauma ,2009,22(12):923~926
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