兔膝关节内骨折后关节面塑形能力的实验研究

目的观察兔膝关节内骨折后不同形式关节面不平整的塑形能力。方法在兔胫骨平台造成关节内骨折,骨折移位0.5、1.0、2.0 mm,形成关节面凹陷或台阶样结构。术后3个月取胫骨平台标本进行组织切片、HE染色,观察不同形式关节面不平整的塑形能力。结果兔胫骨平台凹陷性或台阶性不平整关节面移位0.5 mm时,通过凹侧软骨增生肥厚等塑形,可恢复关节面的平整。关节面移位1.0 mm及2.0 mm时,通过凹侧软骨增生肥厚及来自髓腔的增生修复组织,凹陷性不平整仍可恢复关节面的平整,但台阶性不平整难以通过关节面的重新塑形恢复关节面的平整。结论关节内骨折后形成关节面不平整,凹陷性骨折的再塑形能力可能优于台阶性骨折。

Remodeling of articular incongruities after intra-articular fracture in rabbit knee joints

Objective To observe the remodeling of articular incongruities in different types after intra-articular fracture in rabbit knee joints.Methods Tibial plateau fractures were made in rabbit knee joints.Step-off or depressed articular incongruities were formed by moving fractured bone 0.5 mm,1.0 mm and 2.0 mm.In 3 months after operation,the remodeling of articular incongruities in different types was examined with use of light microscopy（with HE staining）.Results When the offset on articular surface was 0.5 mm,it could be successfully remodeled by cartilage regeneration on the concave side for either step-off or depressed articular incongruity in rabbit tibial plateau.When the offset was more than 1.0 mm,it could probably be successfully remodeled by tissue ingrowth from subchondral bone and proliferation of cartilage on the concave side for depressed incongruity,but it was difficult for step-off incongruity to be successfully remolded.Conclusions For the articular incongruities formed by intra-articular fracture,the remodeling of depressed incongruity is probably superior to that of step-off incongruity.