Chronic changes in rabbit retro-patellar cartilage and subchondral bone after blunt impact loading of the patellofemoral joint.

Animal models of acute joint injury are useful for study of changes in joint tissues that may eventually lead to degradative disease. Our laboratory has developed a joint trauma model using a single blunt impact to the patellofemoral joint of rabbits and documented softening of retro-patellar cartilage and thickening of its underlying bone out to 12 months post-trauma. In the present study, we examined changes in these joint tissues out to 36 months post-impact. Forty-nine Flemish giant rabbits were impacted on the right patellofemoral joint and sacrificed at one of six times: 0, 4.5, 7.5, 12, 24, and 36 months post-impact. A 30% reduction in the compressive modulus of traumatized retro-patellar cartilage occurred at 4.5 months versus the contralateral, non-impacted limb and remained at this reduced level out to 36 months. The fluid permeability of traumatized cartilage also increased over time from baseline and versus the non-impacted limb. Tissue thickness increased slightly at 4.5 months and then decreased over time to a 45% difference from baseline at 36 months post-trauma. While impacted cartilage revealed a significantly greater length of surface fissuring than contralateral, non-impacted cartilage, no time-dependent changes were evident in this study. Moreover, the number and depth of these impact surface lesions did not change as a function of time. Finally, the histological analyses indicated that the thickness of underlying subchondral bone increased over time from baseline and versus that in the non-impacted limb. This long-term study suggested an association between a decrease in the characteristic time constant of traumatized cartilage and thickening of the underlying subchondral bone. Any potential cause and effect relationship, however, must be investigated in future studies.     

Synovial membrane and cartilage changes in experimental osteoarthrosis

The Hulth instability model was performed on 25 rabbit knee joints. Electron-microscopic, light-microscopic, and histomorphometric data demonstrated consistent chondrocyte alterations and cartilage destruction. The comparison between operated, sham, and control knees shows that surgical intervention without surgically induced instability is followed by changes in the synovial membrane and cartilage. The cartilage destruction is preceded by a synovial reaction, suggesting that the inflammatory response has an important role in the onset of cartilage damage in this model. The damage was more severe in the experimental knees, suggesting that mechanical instability is also a factor in cartilage destruction.     

Isometric and isokinetic quadriceps strength in gonarthrosis; Inter-relations between quadriceps strength,walking ability,radiology, subchondral bone density and pain

Summary Patients with osteoarthrosis suffer from disability and pain. We measured isokinetic and isometric peak torque in 20 women with gonarthrosis (GA) and in 26 healthy controls. Relationships between muscle strength, walking and stair climbing time, pain level and pain disability scores as assessed by the patients using an extensive questionnaire, radiological changes and subchondral sclerosis expressed as bone mineral density (BMD, g/cm²) of the proximal tibia were studied.Precision errors of the torque measurements in both GA patients and controls were approximately 6%. In the GA patients, isokinetic and isometric quadriceps strength was reduced by 40 and 15% (p<0.01) respectively, and walking and stair climbing time was increased by 30% (p<0.005). Isokinetic strength was a better predictor of pain level and pain disability scores than isometric strength and radiological stage. Walking time and stair climbing time were not associated with quadriceps strength, pain level, pain disability scores or radiological changes. Subchondral BMD was not predictive of pain.The study suggests that quadriceps strength assessed by isokinetic dynamometry in GA is a reliable measurement. Isokinetic strength was pronouncedly reduced compared to isometric strength and was a more important predictor of pain and pain disability than isometric strength. These findings should be taken into consideration when planning exercise studies and programmes in GA.     

中药熏蒸配合矿泉浴治疗膝关节骨关节炎病的临床观察

目的 观察采用中药熏蒸配合矿采浴治疗膝关节骨关节炎病的疗效。方法 采用中药熏蒸配合矿泉浴治疗膝关节骨关节炎病56例，与单纯矿泉浴及骨友灵擦剂治疗膝关节骨关节病53例对照，用功能恢复评价疗效。结果 中药熏蒸配合矿泉浴总有效率96％。对照组总有效率81％，治疗组疗效明显优于对照组（P〈0．01）。结论 中药熏蒸配合矿采浴是治疗膝关节骨关节炎病的一种理想的方法。     

强的松龙治疗颞下颌关节骨关节病的实验研究

目的：评价强的松龙关节上腔注射对山羊颞下颌关节骨关节病的治疗效果。方法：将12只山羊的双侧颞下颌关节上腔一次性注射胶原酶诱导骨关节病变,随机分为对照组和治疗组,每组6只,处死后对标本进行X线、组织学和扫描电镜观察,对治疗组疗效进行评价。结果：在光镜和扫描电镜下观察,对照组髁状突、关节盘、关节凹表现为骨关节病变化,治疗组表现出较对照组更严重的病理变化。结论：强的松龙关节上腔封闭能加重骨关节病的程度。     

骨质疏松症与退行性骨关节病相关性实验研究——模型鼠血清碱性磷酸酶与酸性磷酸酶含量测定

目的观察各组模型动物体内碱性磷酸酶（ＡＬＰ）与酸性磷酸酶（ＴＲＡＰ）水平变化,探讨骨质疏松症与退行性骨关节病的相互关系。方法７０只初生雌性大白鼠分为４组（正常对照组Ａ、去卵巢组Ｂ、双后肢组Ｃ、去卵巢双后肢组Ｄ）。造模后,于生长的不同阶段取血,用生物试剂盒测定。结果ＡＬＰ水平在各时间段Ｂ、Ｃ、Ｄ组均显著高于Ａ组,Ｂ、Ｃ组均显著低于Ｄ组;ＴＲＡＰ水平在各时间段Ｂ组均显著高于Ａ、Ｃ、Ｄ组,Ｃ组低于Ａ组。结论负重加大可刺激成骨细胞活性,抑制破骨细胞活性,促进骨形成;雌激素减少可同时增强成骨细胞与破骨细胞活性,只是破骨作用的增强要高于成骨的增强,最终表现为骨丢失。     

颞下颌关节骨关节病的临床诊断

目的:探讨颞下颌关节骨关节病的临床症状、体征、影像学特点与临床诊断的相关关系。方法:选取40例OA患者,其中男性6例,女性34例,平均年龄34.8岁。纳入标准为患者有明显的临床症状,进行过临床检查、X线检查及关节造影检查,并排除有全身系统性疾病的患者。由专业医生进行Fricton颞下颌关节功能紊乱指数评分;X线检查由放射科专业医生阅片,再对其进行影像学分期,所有40例OA被分为4期。结果:经过综合评定,40例OA中,Ⅰ期9例;Ⅱ期9例;Ⅲ期11例;Ⅳ期11例。Fricton功能障碍指数评分,Ⅰ期0.38;Ⅱ期0.35;Ⅲ期0.28;Ⅳ期0.26,经统计学处理,其中第Ⅳ期与第Ⅰ期之间有有统计学意义(P(0.05);疼痛指数评分,Ⅰ期6.23;Ⅱ期5.93;Ⅲ期4.73;Ⅳ期3.05,经统计学处理,其中第Ⅳ期与第Ⅰ期之间有有统计学意义(P(0.05)。结论:骨关节病患者的临床症状、体征与其影像学分期有一定的相关性。     

血清IL-6水平与骨性关节炎的临床相关性观察

目的对比正常人群,探讨血清白细胞介素石在骨性关节炎发病中的病理作用,评价其在临床反应膝骨关节炎早期病理改变的可行性。方法入选57例膝骨关节炎患者以X线诊断分成早、中、晚三期。同期入选正常对照者33例,采用双抗体夹心ABC-ELISA法测定人选者血清白细胞介素-6水平,评价其意义。结果膝骨关节炎患者血清白细胞介素-6水平（29．83±13．65）明显高于正常对照者（5．43±6．27）（P〈0．01）;膝骨关节炎患者早期亚组（10．43±9．03）pg／ml、膝骨关节炎患者中期亚组（38．24±15．35）pg／ml的血清白细胞介素击水平随着病程程度增加而升高（P〈0．05）,膝骨关节炎患者晚期亚组（21．82±10．17pg／ml）较中期有所下降。结论骨性关节炎人群血清白介素石水平明显增高;该物质的该病中期达到高峰,晚期下降,血清白介素石水平可能参与软骨的病理代谢,可作为临床诊断早期骨性关节炎及临床分型的血清学指标。