胫骨扭转畸形诱发髌股关节退变性关节病的实验研究

目的通过实验证实胫骨扭转畸形是否可以诱发髌股关节退变性关节病。方法选取 20只成年犬，分别于胫骨上端截骨固定于内旋 30° (8只 )和外旋 30° (8只 )， 4只截骨后原位固定作为对照。 16、 24周后取髌股关节软骨，经 HE、番红花、甲苯胺蓝染色，观察其病理变化，同时采用电镜观察其超微结构改变。结果胫骨扭转畸形者步态明显改变。髌股关节软骨表面逐渐出现不同程度破溃。软骨基质异染性先强后弱，软骨细胞变性坏死。电镜观察发现基质内Ⅱ型胶原纤维逐渐被Ⅰ型胶原纤维替代；软骨细胞由深至浅出现细胞器的变性和功能障碍，程度随病程加剧。结论胫骨扭转畸形可以诱发髌股关节退变性关节病，在髌股关节退变性关节病防治过程中应予以重视。

Experimental study of canine patellofemoral degenerative arthrosis caused by tibial torsional deformity

Objective To investigate the relationship between patellofemoral degenerative arthrosis and tibial torsional deformity. Methods 20 adult dogs were used in this study. Osteotomy of the upper end of the tibia was performed and wan fixed in 30° internal torsional and 30° external torsional position in each of 8 dogs respectively; 4 animals served as controls. The dogs were sacrificed respectively at 16 and 24 weeks after operation. The patellar cartilage were observed with HE, Safranin O, and Toluidine Blue staining under the light microscopes. The ultrastructure were studied with electron microscope. Results Dogs with tibial torsional deformity changed their gaits obviously. There were superficial or deep ulceration in the cartilage surface. The chondrocytes degenerated gradually from the deeper to the superficial layer demonstrating the degeneration and failure of cytoplasmic organoid. The matrix fibro collagen proliferated and changed from type Ⅱ to type Ⅰ . Conclusion Tibial torsional deformity was an etiological factor which resulted in patellofemoral degenerative arthrosis directly, and worth of further attention.