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Ilizarov技术对关节软骨病理改变的实验观察
引用本文: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
作者姓名:韩大为  李良华  王清玉  卢圣友
作者单位:福建中医学院附属人民医院骨科,福建,福州,350004
基金项目:自然科学基金高校专项 
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1mm/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(1mm/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ImagePro Plus6.0取得图像灰度值,用SPSS13.0进行统计学处理。使用透射电镜观察软骨的显微结构。结果:①Mankin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
收稿时间:2009-10-13

Effects of Ilizarov technique on the histopathological changes of articular cartilage
HAN Da-wei,LI Liang-hu,WANG Qing-yu and LU Sheng-you. Effects of Ilizarov technique on the histopathological changes of articular cartilage[J]. China journal of orthopaedics and traumatology, 2009, 22(12): 923-926
Authors:HAN Da-wei  LI Liang-hu  WANG Qing-yu  LU Sheng-you
Affiliation:Department of Orthopaedics,the People's Hospital Affiliated to Fujian College of TCM,Fuzhou 350004,Fujian,China;Department of Orthopaedics,the People's Hospital Affiliated to Fujian College of TCM,Fuzhou 350005,Fujian,China;Department of Orthopaedics,the People's Hospital Affiliated to Fujian College of TCM,Fuzhou 350006,Fujian,China;Department of Orthopaedics,the People's Hospital Affiliated to Fujian College of TCM,Fuzhou 350007,Fujian,China
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.
Keywords:Ankle joint   Cartilage,articular   Bone regeneration   Pathology
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