骨性关节炎软骨下骨力学性能变化的实验研究  

Experimental study on biomechanical changes of subchondral bone in osteoarthritis

作　　者：董启榕[1] 陈向阳[1] 

机构地区：[1]苏州大学附属第二医院骨科,215004

出　　处：《中华创伤杂志》2007年第5期386-389,共4页Chinese Journal of Trauma

基　　金：卫生部科学研究基金资助项目（WKJ2004-2-009）

摘　　要：目的观察膝关节不稳早期软骨下骨力学性能的改变及二磷酸盐的干预作用。方法新西兰大白兔50只随机分为对照组（10只）、模型组（20只）、二磷酸盐组（20只），制作Hulth兔膝关节不稳模型。二磷酸盐组予1mg／kg帕米磷酸二钠静脉注射，每月1次；术后2，10周，模型组和二磷酸盐组各取10个膝关节，对照组取5个膝关节，观察股骨内髁关节软骨表面形态及HE染色，进行Mankin评分；对胫骨内髁进行软骨下骨生物力学性能测定，观察载荷和压缩模量。结果模型组的Mankin评分在术后2周和10周时升高非常明显（P〈0．01），二磷酸盐组只在10周时升高（P〈0．05）。术后2周生物力学测定，与对照组相比，模型组载荷下降22．7％（P〈0．01），二磷酸盐组下降3．1％（P〉0．05）；模型组压缩模量下降21．07％（P〈0．01），而二磷酸盐组下降8．0％（P〉0．05）。在10周时，模型组载荷和压缩模量较2周时显著升高，但仍较对照组降低，模型组载荷下降14．5％（P〈0．05），二磷酸盐组下降4．41％（P〉0．05），模型组压缩模量下降11．8％（P〈0．05），二磷酸盐组下降1．1％（P〉0．05）。结论兔膝关节不稳早期软骨下骨经历了一个硬度和强度由低到高的过程，关节软骨的退变与其有高度相关性。应用二磷酸盐可明显提高软骨下骨的压缩强度和压缩模量，对关节软骨有较好的保护作用。Objective To observe the biomechanical changes of subchondral bone of the rabbit with instable knee joint at early stage and the intervention effect of diphosphonate. Methods A total of 50 white New Zealand rabbits were divided randomly into three groups, ie, control group （n = 10 ）, model group （n = 20） and diphosphonate group （n = 20）. Hulth model of instable knee joint was made on the right knee joint. The rabbits in the diphosphonate group were injected intravenously with Pamidronate Disodium at 1 mg/kg once per month after surgery. At weeks 2 and 10 after surgery, 10 rabbit knee joints from model group, 10 from diphosphonate group and 5 from control group were used for observing the gross morphology of the articular cartilage of medial femur condyles, HE staining and Mankin scoring. The subchondral bone of main loading area of the medial tibia plateau in the right knee was harvested to detect its loading strength and compressive module. Results Mankin score of model group increased significantly at weeks 2 and 10 （ P 〈0.01 ） after operation, while in diphosphonate group it only increased significantly at week 10 （P 〈 0.05 ） Compared with those in control group at week 2, loading strength in model group and diphosphonate group decreased by 22.7% （ P 〈 0.01 ） and 3.08% （ P 〉 0.05 ） respectively, compressive module in model group and diphosphonate group decreased by 21.1% （ P 〈 0.05 ） and 7.96% （ P 〉 0.05 ） respectively. Loading strength and compressive module at 10th week were increased more significantly than those at second week after operation in model group. Compared with control group, loading strength decreased by 14.5% in model group （ P 〈 0.05 ） and 4.4% in diphosphonate group （ P 〉 0.05 ）. Compressive module was decreased by 11.8% in model group （ P 〈 0.05 ） and 1.14% in diphosphonate group （ P 〉 0.05 ）. Conclusions At the early stage of the instable knee, tensile strength and stiffness of the subchondral bone increase gradually,

关 键 词：骨关节炎 膝 软骨 关节 生物力学 

分 类 号：R686[医药卫生—骨科学]