骨骺软骨中淋巴管的分布及层粘蛋白的表达

目的：观察长骨骨骺软骨中毛细淋巴管及生长板中层粘蛋白（ＬＮ）的分布。方法：取１０、２２、３６周引产胎儿和１１岁儿童截肢标本的胫骨近端骨骺,用ＨＥ染色和ＬＮ免疫组化染色,改良的５′－核苷酸酶染色（Ｖｅｔｅｒ法）等方法观察。结果：软骨管是软骨组织中内衬内皮细胞,外包绕ＬＮ阳性基底膜的管腔状结构,胎儿１０周时尚不存在,２２周和３６周时存在,Ｖｅｔｅｒ染色发现,有的软骨管的内皮细胞呈红色,提示为毛细血管,有的内皮细胞含棕色颗粒,提示为毛细淋巴管。生长板静止带、增殖带及部分肥大带软骨细胞胞浆、胞膜及临近基质,对ＬＮ呈阳性表达。结论：胎儿长骨骨骺软骨中存在毛细淋巴管,与毛细血管一样也是软骨管的组成部分。除生长板静止带外,增殖带及部分肥大带软骨细胞也合成ＬＮ。     

培养软骨对胫骨生长影响的实验研究

目的 :探讨培养软骨植入胫骨干骺端缺损后的组织学改变 ,以及对胫骨生长的影响。方法 :自 3周龄兔关节面分离软骨细胞 ,经离心管培养 2周形成软骨。于 1 6只 1 2周龄新西兰兔右侧胫骨近端生长板下方 1 .5mm处造成边缘性缺损 ,移植培养软骨。左侧胫骨未作手术为正常对照。分别于术后 6、1 2周进行X线摄片和组织学检查。结果 :6周时胫骨近端生长板变窄 ,其下方 6mm处形成薄层软骨或不规则软骨块 ,缺乏生长板柱状细胞排列结构。大量新骨形成和植入区皮质骨增厚。 1 2周时生长板基本闭合 ,干骺端结构正常 ,无软骨。双下肢X线摄片显示双侧胫骨生长无差异 (P >0 .0 5)。结论 :培养软骨植入干骺端可以维持组织性质 ,但不具有生长板结构和生长能力     

骨骺软骨中的管状结构一软骨管

目的：软骨管是发育时期骨骺软骨内的管状主检南组织，对于软骨的生长发育有着重要意义。关于其形成、结构功能等方面，目前尚有分歧，本文就此作了综述。     

良性软骨肿瘤12例报告

良性成软骨细胞瘤与软骨粘液样纤维瘤皆属于良性软骨肿瘤 ,多发生于青少年 ,男多于女。我院从 1978～ 1998年共收治 12例 ,报告如下。1　临床资料与方法1 1　一般资料　良性成软骨细胞瘤 5例中男 3例 ,女 2例 ;年龄 11～ 17岁 ;右肱骨近端 2例 ,右胫骨近端、左股骨近端、左胫骨远端各 1例。软骨粘液样纤维瘤 7例中男 5例 ,女 2例 ;年龄 9～ 36岁 ;左拇指第一指骨近端 1例 ,左胫骨远端 1例 ,多发性 1例 (18块指节同时受累 ) ,右腓骨远端、右股骨远端、左胫骨近端、左第一跖骨基底部各 1例。临床表现 :局部不适、疼痛、肿胀 ,逐渐出现质硬性隆…     

骨骺软骨中的管状结构--软骨管

目的软骨管是发育时期骨骺软骨内的管状化疏松间质组织,对于软骨的生长发育有着重要意义。关于其形成、结构及功能等方面,目前尚有分歧,本文就此作一综述。     

关节镜下治疗胫骨近端软骨母细胞瘤

目的总结关节镜下治疗胫骨近端软骨母细胞瘤的疗效。方法 2008年6月-2010年5月采用关节镜下病灶刮除植骨术治疗5例胫骨近端软骨母细胞瘤。男4例,女1例;年龄13～24岁,平均18.5岁。病程6个月～3年,平均21个月。左侧3例,右侧2例。病灶直径为3～6 cm。结果术后病理检查证实为软骨母细胞瘤。术后手术切口均Ⅰ期愈合。5例均获随访,随访时间12个月～2年,平均15个月。X线片及CT示植骨均愈合良好,愈合时间为12～20周,平均16周。膝关节无游离体产生;膝关节无僵直,屈曲活动范围正常,无复发。术后膝关节学会评分系统(KSS)评分为(94±4)分,较术前(76±2)分显著改善(t=9.095,P=0.001)。结论关节镜下病灶刮除植骨术治疗胫骨近端软骨母细胞瘤近期疗效满意。     

培养软骨移植修复兔生长板陈旧性缺损

目的：将培养软骨移植修复生长板陈旧性缺损,防止肢体畸形发生,减轻畸形程度。方法：分离1月龄兔软骨细胞,经离心管内培养形成软骨。在6周兔右侧胫骨上端生长板造成缺损,4周后再次手术切除缺损内组织,植入培养2周软骨。左侧胫骨经相同处理,但无植入物,为自身对照。于4、8、12周行X线照片、组织学、免疫组化检查。结果：移植培养软骨4、8、12周时右侧胫骨畸形增加程度显著低于左侧,生长板缺损区由软骨组织充填,结构完整,Ⅱ型胶原免疫组化染色阳性。左侧胫骨畸形加重,生长板缺损区内骨桥形成,提前闭合。结论：培养软骨移植生长板陈旧性缺损,可以明显减轻肢体畸形程度,但不能纠正已发生畸形。     

胎儿及婴儿股骨近端骺板的组织学结构及发育演变

作者应用胎儿，死后婴儿股骨近端进行大体解剖和切片组织学检查，对骺板各层发育演变进行了描述，根据其组织学特点将骺板分为长短两臂，长臂由颈骺板和转子骺板组成，短臂由头骺板和钩骺板构成。２岁时颈骺板消失；观察了骺板内血管的分布形式。胎儿时间有交通血管存在，来源于骨骺侧，至新生儿期消失，血运屏障建立，骨骺和干骺端形成两个独立的血液循环系统，探讨了软骨周围骨化沟与骺板横径增殖的关系，认为骨化沟参与骺板横径增     

胫骨骨干端延长对胫骨生长板纵向生长的影响

[目的]研究胫骨骨干端截骨延长对胫骨生长板和纵向生长的影响。[方法]建立兔胫骨骨干端截骨和延长的动物模型;拍摄标准胫骨放射照片以测量其长度,胫骨远近端骨骺生长板做成组织切片以测量其厚度。[结果]胫骨中部骨干行单纯截骨后,增加胫骨纵向生长和胫骨远近端骨骺生长板的厚度,胫骨中部骨干行截骨延长后,胫骨纵向生长和胫骨远近端骨骺生长板的厚度没有改变。[结论]胫骨骨干截骨延长术不会妨碍胫骨的纵向生长。     

自体骨关节软骨灭活回植实验观察

目的： 了解经酒精灭活后的骨关节软骨的成活及转归， 进而分析影响关节的保留及康复的理论基础。方法： 采用成年雄性山羊６ 只胫骨近端骨关节灭活回植， 分期宰杀， 从大体标本、 Ｘ 线平片， 光镜、电镜方面进行观察； 并结合２ 例住院患者的 Ｘ 线片综合分析。结果： 骨关节软骨面积的６０ ％ 可以复活， ２０ ％ 由新生纤维软骨代替，２０ ％ 由纤维瘢痕代替。结论： 骨关节软骨灭活回植既可以保全肢体， 又可以保留或复活关节软骨的绝大部。是愈后关节康复训练的物质基础。     

Development of vascularization in the chondroepiphysis of the rabbit.

Although numerous studies have addressed the presence of cartilage canals within developing epiphyses, the chronology of their appearance and their vascular contribution to the developing chondroepiphysis remain to be studied. We have selected a model, similar to the developing human skeletal system, in which extensive cartilage canal development precedes the subsequent secondary ossification process. In the rabbit proximal tibia, both chondroepiphyseal and vascular (cartilage canals) development were quantified from the first evidence of vessels until the formation of the secondary center of ossification. The volume of hyaline cartilage increased 25 times after intraepiphyseal vessels were initially observed. The blood supply, measured in cartilage canal volume, increased 400-fold over the same period. Three distinct cartilage canal morphologies were identifiable before the formation of the secondary center of ossification: (a) an early phase, in which the canals appeared as infoldings derived from the perichondrium; (b) a reactive phase, occurring simultaneously with chondrocyte hypertrophy and characterized by a very large increase in mesenchymal cells within the cartilage canal; and (c) a vascular phase, coincident with mineralization of the matrix, in which the familiar, unitary canal morphology was replaced by that of a vascular plexus. While matrix mineralization and the formation of bone seem dependent on critical cellular events, notably chondrocyte hypertrophy, the role that the vascular supply plays in developing sufficient biological inertia for the ossifying transition must not be underestimated.     

Determination of in-vivo articular cartilage contact areas of human talocrural joint under weightbearing conditions

OBJECTIVE: The knowledge of in-vivo cartilage contact biomechanics is important to the understanding of the pathogenesis of joint diseases such as osteoarthritis. This study investigated the in-vivo contact areas of human talocrural joint under weightbearing conditions that simulated the stance phase of walking using a combined magnetic resonance (MR) and dual-orthogonal fluoroscopic imaging technique. DESIGN: Nine healthy ankles of living subjects were recruited for this study. The in-vivo talocrural joint positions were recorded using the dual-orthogonal fluoroscopic images at three ankle positions that simulated those occurring during the stance phase of walking: heel strike, mid-stance, and toe off. Three-dimensional (3D) models of the talocrural joints were created from MR images and used to reproduce the in-vivo ankle positions recorded on the fluoroscopic images. The talocrural cartilage contact area was defined as the overlap area of the distal tibial and the proximal talar cartilage surfaces. The method was validated using an in-vitro experimental setup to evaluate its accuracy in determination of cartilage contact area. RESULTS: The validation study demonstrated that the articular cartilage contact area of the talocrural joint determined using the imaging technique was approximately 4% lower than that of the experimental measurement. In the nine living ankles, the average cartilage coverage area was 964.9+/-156.1 mm(2) on the distal tibia and 1304.8+/-208.4 mm(2) on the proximal talus. The average talocrural cartilage contact areas were 272.7+/-61.1 mm(2) at heel strike, 416.8+/-51.7 mm(2) at mid-stance, and 335.7+/-64.5 mm(2) at toe off. The contact area at mid-stance was significantly larger than those at heel strike and toe off, while the contact area at toe off was significantly larger than that at heel strike. CONCLUSION: The combined dual fluoroscopic and MR imaging technique was shown to be capable of determining in-vivo talocrural cartilage contact areas. During the simulated stance phase of walking, the contact areas were less than 44% and 31% of the cartilage coverage areas of the distal tibia and the proximal talus, respectively. These data may be useful for understanding in-vivo biomechanical function of the cartilage as well as the etiology of osteoarthritis.     

Experimental ischemia of porcine growth cartilage produces lesions of osteochondrosis.

Osteochondrosis is a disorder of growth cartilage in which a focal failure of blood supply has been proposed as an important initiating factor. In the present study we investigated the effect on epiphyseal growth cartilage of experimentally interrupting the blood supply to a limited area of the distal femur of growing pigs. In 12 pigs, a thin full-thickness cartilage slab was removed from the abaxial margin of the medial condyle, thereby transecting a limited number of cartilage canals. The pigs were culled 1, 2, 3, 7, 14, 21 and 29 days post-surgery. The condylar cartilage was studied histologically, immunohistologically and by use of the TUNEL method. The transection induced cellular death of cartilage canal elements followed by cellular death of chondrocytes within the deep layers of the resting zone of the epiphyseal growth cartilage. However, in the superficial layers of the resting zone, chondrocytes appeared to proliferate into and subsequently chondrify some of the necrotic cartilage canals. The dying and dead cells were TUNEL-positive, but active caspase 3-negative. The loss of vascular supply induced increased VEGF-immunostaining in chondrocytes surrounding the affected area. We conclude that transection of cartilage canals produces chondronecrosis in the deep resting zone of the epiphyseal growth cartilage similar to that observed in spontaneously occurring osteochondrosis.     

Characterisation of the guinea pig model of osteoarthritis by in vivo three-dimensional magnetic resonance imaging

OBJECTIVE: To characterise longitudinal changes in joint integrity and cartilage volume in vivo in the guinea pig spontaneous osteoarthritis (OA) model by magnetic resonance imaging (MRI). METHODS: Guinea pigs knee were imaged in vivo by high-resolution three-dimensional (3D) MRI between the ages of 3 and 12 months. Image analysis was performed to assess qualitative knee joint changes between 3 and 12 months (n=16) and quantitative volumetric changes of the medial tibial cartilage between 9 and 12 months (n=7). After imaging, animals were killed and knees were assessed macroscopically and histologically. RESULTS: From 3 to 6 months qualitative observation by MRI and histopathology indicated localised cartilage swelling on the medial tibial plateau. At 6 months, bone cysts had developed in the epiphysis. At 9 months, we observed by MRI and histopathology, fragmentation of the medial tibial cartilage in areas not protected by the meniscus. Cartilage degeneration had intensified at 12 months with evidence of widespread loss of cartilage throughout the tibial plateau. Segmentation of the MR cartilage images showed a 36% loss of volume between 9 and 12 months. CONCLUSIONS: We have achieved 3D image acquisition and segmentation of knee cartilage in a guinea pig model of chronic OA, which permits measurements previously only possible in man. High resolution and short acquisition time allowed qualitative longitudinal characterisation of the entire knee joint and enabled us to quantify for the first time longitudinal tibial cartilage volume loss associated with disease progression.     

Focal changes in blood supply during normal epiphyseal growth are central in the pathogenesis of osteochondrosis in pigs

Cartilage canals are temporary vessel-containing structures within the growth cartilage. The canals gradually regress with age in a process designated chondrification, where the content of the canals is replaced by cartilage. The process of chondrification is considered physiological; however, premature regression has been associated with the formation of lesions of osteochondrosis. The purpose of the present study was to gain further insight into the nature of and relationship between chondrification of cartilage canals and the initial steps in the pathogenesis of osteochondrosis with respect to morphology, presence of factors influencing the processes, and mode of cellular death. The articular–epiphyseal cartilage complexes of the distal femur of 48 pigs were studied, combining a technique of perfusion and tissue clearing with histological and immunohistological methods.

The results provided strong evidence that the process of chondrification occurs at the terminations of the cartilage canals and is characterized by disintegration of the endothelial cells and transformation of perivascular cells into matrix-producing chondrocytes. Lesions of osteochondrosis, however, are characterized by necrosis of the portion of the affected cartilage canal distal to a point of interruption, with subsequent necrosis of adjacent resting zone growth cartilage. This interruption of the cartilage canal blood supply occurs at the junction between cartilage and bone where anastomoses are formed between cartilage canal vessels and vessels from the bone marrow. It is possible that microfractures occurring secondary to minor trauma at a vulnerable time in the development of the cartilage may be the initial event in pathogenesis of osteochondrosis.     

膝关节软骨人体标本解剖与磁共振成像的比较研究

目的 探讨膝关节尸体标本解剖与磁共振成像(MRI)三维序列-扰相梯度回波序列(3D-FS-SPGR)测量关节软骨厚度的差异,并分析软骨组织主要成分在关节软骨不同位置的差异.方法选用国人青壮年中等身材、无明显关节病变的成年男性尸体膝关节标本2具,首先进行3D-FS-SPGR序列矢状位扫描.复冻后按解剖部位进行矢状位解剖,分别对股骨及胫骨内、外髁负重区前、后面及髌骨面软骨厚度进行测量.关节软骨石蜡切片进行维多利亚蓝-丽春红复合染色并观察.结果 软骨尸体标本解剖与3D-FS-SPGR序列测得的膝关节软骨厚度:股骨外侧髁前负重面平均分别为2.25、2.25 mm,股骨外侧髁后负重面平均分别为2.70、2.75 mm,胫骨外侧髁前负重面平均分别为2.00、2.10 mm;胫骨外侧髁后负重而平均分别为2.35、2.25 mm,股骨内侧髁前负重面平均分别为2.20、2.20 mm,股骨内侧髁后负重面平均分别为2.15、2.30 mm,胫骨内侧髁前负重面半均分别为2.20、2.45mm,胫骨内侧髁后负重面平均分别为2.70、2.95 mm,髌骨面软骨平均分别为3.08、3.15 mm.软骨组织学染色显示:关节软骨表层胶原纤维含量相对较多,软骨细胞及其周围基质相对较少;在关节软骨深层,胶原纤维含量相对较少,而软骨及软骨周围基质相对较多.结论 3D-FS-SPGR序列能够相对真实地反映关节软骨的形态及厚度.胶原纤维主要集中在软骨表层,其分布与软骨的功能相一致.

Abstract：

Objective To compare corpse sampling and MR imaging with 3D-FS-SPGR sequences in measurement of the articular cartilage thickness and to investigate knee cartilage topography. Methods Two fresh specimens of the knee joint were obtained from 2 normal young adult male corpses of medium stature. MR1 scanning was carried on the 2 specimens in sagittal 3D-FS-SPGR MR sequences. After defrosted,the knee specimens were dissected longitudinally, and the cartilage thicknesses were measured at different locations of the knee joint. Paraffin sections of the knee cartilage were observed following compound staining with victoria blue and ponceau red. Results The average cartilage thicknesses measured by dissection and MR imaging sequence were respectively: 2. 25 mm and 2. 25 mm at the anterior weight-loading surface of the femoral lateral condyle, 2. 70 mm and 2. 75 mm at the posterior weight-loading surface of the femoral lateral condyle, 2. 00 mm and 2. 10 mm at the anterior weight-loading surface of the tibial lateral condyle,2. 35 mm and 2. 25 mm at the posterior weight-loading surface of the tibial lateral condyle, 2. 20 mm and 2. 20mm at the anterior weight-loading surface of the femoral medial condyle, 2. 15 mm and 2. 30 mm al the posterior weight-loading surface of the femoral medial condyle, 2. 20 mm and 2.45 mm at the anterior weight-loading surface of the tibial medial condyle, 2. 70 mm and 2. 95 mm at the posterior weight-loading surface of the tibial medial condyle and 3. 08 mm and 3. 15 mm at patella cartilage surface. Collagen fibers were rich at the periphery of the articular cartilage with sparse chondrocytes and matrixes, while the opposite was observed at the center of the articular cartilage. Conclusions MR imaging with 3D-FS-SPGR sequences can display the actual knee cartilage topography. Collagen fibers mainly concentrate at the periphery of the articular cartilage, which accounts for the function of the articular cartilage.     

组织工程化软骨修复兔骺板损伤的实验研究

目的　探讨组织工程化软骨细胞 生物载体复合物修复兔骺板损伤的可行性。方法于 8周龄兔胫骨上端骺板缺损模型中 ,A、B、C三组分别植入组织工程化软骨、单纯外消旋聚乳酸(PDLLA)、空白对照 ,术后 4、8、16周时对双下肢行X线摄片、组织学检查。结果　 4、8、16周时双侧胫骨长度、胫骨角之差A组与B、C组相比 ,短缩与成角畸形轻 ,差异有统计学意义 (P <0 .0 1) ,组织学显示缺损区呈薄层骺软骨细胞样结构 ;B、C两组间差异无统计学意义 (P >0 .0 5 )。结论　骨髓间充质干细胞 (MSCs)可定向诱导分化为软骨细胞 ;组织工程化软骨细胞植入可减轻骺板损伤后肢体短缩与成角畸形。     

Topical administration of the nitric oxide donor glyceryl trinitrate modifies the structural and biomechanical properties of ovine articular cartilage

Objective: To examine the effect of topical administration of glyceryl trinitrate (GTN), an exogenous nitric oxide (NO) donor, on the structural and biomechanical properties of uncalcified articular cartilage (UCC) in aged ewes.Design: Twelve ewes were used for this study. Six of these were treated with 2% GTN ointment (0.7 mg/kg) twice per week (GTN), and the remaining six were used as normal controls (NOC). After sacrifice at 26 weeks, dynamic biomechanical indentation testing and thickness determination (by needle penetration) were performed on tibial plateau articular cartilage at 18 locations. Using histological sections prepared from the lateral and medial femoral condyles (LFC, MFC) and tibial plateau (LTP, MTP), the thickness of UCC, cartilage proteoglycan content (intensity of toluidine blue staining; LFC, MFC only), and collagen birefringence (LTP, MTP, LFC only) were quantified by computer-assisted image analysis.Results: Phase lag of tibial plateau cartilage was reduced in GTN sheep relative to NOC (mean of all testing locations 11.0±1.9° vs 12.1±2.3°; P=0.0001). GTN treatment also globally reduced UCC thickness across the joint (ANOVA for all measured zones, P<0.0001). UCC thinning was most pronounced in the MFC (P=0.025) and LTP (P=0.0002). Proteoglycan content was reduced in the MFC(P=0.019), while collagen birefringence was increased in superficial cartilage zones of the LTP.Conclusions: NO donation via topical administration of GTN to normal ewes reduced the thickness and phase lag of femoro-tibial articular cartilage, suggesting a disturbance in chondrocyte metabolism. Regional alterations of collagen organisation and proteoglycan content were consistent with this interpretation.     

胫骨上干骺端缓慢牵伸延长对兔膝关节软骨形态的影响

目的 探讨关节软骨是否适应肢体延长时的缓慢牵伸应力刺激。方法 32只成年新西兰兔随机分为延长组（A组）和延迟观察组（B组），各组又按延长幅度不同分为10％、20％及40％三个亚组（即A10、A20、A40、B10、B20、B40六组，每组5只），另2只为正常对照。采用胫骨上干骺端1mm／d速度缓慢牵伸延长。通过X线确定延长幅度及膝关节影像学变化，用光镜及电镜观察胫骨平台关节软骨组织及细胞形态变化，用扫描电镜观察软骨表面结构变化。结果 （1）各组术前、延长前、延长终止及取材时膝关节软骨未见明显影像学异常。（2）A40及B40组部分内侧胫骨平台软骨外观苍白、光泽差，其余各组无异常。（3）A40组细胞排列紊乱，可见散在的退变细胞及部分同源软骨细胞群；B20组及B40组细胞数量增多且胞体增大，有较多同源软骨细胞群，无退变细胞。（4）A40组部分细胞有轻度的粗面内质网扩张及线粒体肿胀，但细胞周晕正常；部分细胞粗面内质网丰富、胞周基质小泡丰富。B组表现与A组基本相似。（5）A10组软骨表面偶见形态不规则表面突起；A20组网状纤维稍紊乱；A40组出现条束状不规则粗大纤维束，偶见表面细小裂隙。与A40组比较，B40组软骨表面粗大纤维明显减少，未见表面裂隙。结论 低幅度延长时关节软骨能有效适应缓慢牵伸刺激，但大幅度延长时关节软骨会出现不同程度的形态结构异常。