摘要
目的探讨髋关节骨性关节炎负重部位关节囊的变化与 Chiari骨盆截骨术的术后临床效果的关系。方法根据 Bombelli的影像学分类方法，将 66例髋关节骨性关节炎患者分为增生型、正常型和萎缩型三组。在髋关节骨性关节炎的全髋关节置换术中，切取负重部位关节囊行 HE、 Van- Gieson和 Safranin O染色，观察和比较这三种类型的负重部位关节囊的组织病理学改变。结果负重部位关节囊纤维软骨化生，增生型组阳性率 (63.6％ )多于正常型组 (32.1％ )和萎缩型组 (25.0％ )。萎缩型组纤维性滑膜炎或滑膜纤维化阳性率 (81.3％ )多于增生型组 (50.0％ )。髋关节骨性关节炎负重部位关节囊肉芽组织浸润较少见，而胶原纤维的透明样变性和炎性细胞浸润较多见。结论髋关节骨性关节炎负重部位关节囊的变化与 Chiari骨盆截骨术的术后临床效果相关。增生型、萎缩型和正常型三者比较，增生型髋关节骨性关节炎是 Chiari骨盆截骨术的最佳适应证。
Objective To explore the capsular changes at the weight- bearing area of hip with osteoarthritis and its correlation to postoperative clinical results of Chiari pelvic osteotomy. Methods According to the Bombelli radiological classification, the 66 hips with osteoarthritis were classified into three groups: hypertrophic, normotrophic and atrophic. Specimens of the capsule at weight- bearing area were obtained during total hip replacement for osteoarthritis, and stained with HE, Van- Gieson and Safranin O. Histopathological changes of the capsules were observed and compared among the three groups. Results The hypertrophic group showed a high incidence of metaplastic cartilage (63.3％ ). Normotrophic group(32.1％ )and atrophic group(25.0％ ) showed a low incidence of metaplastic cartilage. The atrophic group had a higher incidence of fibrous synovitis or fibrosis(81.3％ ) than hypertrophic. Among the three group, the frequency of infiltration granulation tissues was low, the frequency of both infiltration of inflammatory cells and degeneration of collagen fiber was high. Conclusion Associating with clinical research, these findings suggest that the capsular changes at weight- bearing area are responsible for postoperative clinical results of Chiari pelvic osteotomy. Compared with normotrophic and atrophic type, the hypertrophic type has the best adaptation of Chiari pelvic osteotomy.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2001年第3期167-171,共5页
Chinese Journal of Orthopaedics
