摘要
目的 观察人工关节置换中产生的磨损微粒在动物体内引起的组织学反应 ,并比较不同微粒的差异 ,探讨人工关节松动的原因。方法 成年新西兰兔 32只 ,雌雄不限。按膝关节内注入微粒的不同随机分为 4组 ,每组 8只。甲组 :注入超高分子聚乙烯微粒 ;乙组 :注入钛合金微粒 ;丙组 :注入骨水泥微粒 ;丁组 :对照组注入生理盐水。术后第 2周开始向关节囊内注入各种微粒悬液 ,每次 0 2ml,每隔两周一次直至术后 1 4周 ,在第 1 6周处死动物 ,取股骨远端及关节囊切片 ,HE染色 ,光镜观察。光镜观察关节囊滑膜的组织细胞反应、吞噬磨屑情况。从各组标本中取 0 2 g组织 ,并制成组织匀浆。离心后取上清液 ,放免法测定TNF -α含量。结果 各实验组假体隧道边缘产生一层纤维结缔组织界膜 ,其中含有大量的巨噬细胞和异物巨细胞。而对照组的假体隧道边缘未见明显的组织细胞反应。聚乙烯组、钛合金组、骨水泥组假体隧道边缘的组织细胞含量明显高于对照组 (P <0 0 5) ,而各实验组之间无明显差别。各实验组的关节滑膜细胞增生 ,滑膜下为较多的胶原纤维组织 ,并可见巨噬细胞浸润 ,纤维母细胞和毛细血管增生。而对照组的滑膜基本正常。各实验组组织中的TNF -α含量明显高于对照组(P <0 0 5)。而各实验组之间无明显差异。
Objective To observe the histological response to wear debris in animals in vivo and compare the difference of histological response resulted from various kinds of wear debris.To explore the etiopathology of loosening of prostheses.Methods A plug of titanium alloy was inserted in a cavity that had been drilled in the distal end of the femur in thirty-two adult rabbits.The plug was 15mm long and 4mm in diameter.These rabbits were divided randomly into 4 groups.The wear debris of polyethylene were injected into the knee joint in group A, while titanium alloy in group B and bone cement in group C.The normal saline was injected in group D as control. From the postoperative week 2 (P.O.W 2),one bonus of 0.2ml wear debris was injected into the knee joint per biweek till P.O.W 14 (altogether 7 times). On p.o.w 16, all of the rabbits were killed to obtain the femur and joint capsule for histological examination.The infiltration of histocytes were compared between the 4 groups.The histocytes infiltration into the synovial membranes were examined by light microscopes.From each sample 0.2g tissue was homogenized and centrifuged. After getting the supernatant, the TNF-α was detected by radioimmunology.Results There was a layer of fibrous tissue between the bone and the titanium alloy plug in group A, B and C.Underneath the interface there was a large number of macrophages and foreign-body giant cells.But there was no such changes in group D.The infiltration of histocyte of group A,B and C was higher than that in group D(P<0.05) but there was no difference among Group A,B,C.The synovial cells proliferation were found in group A,B and C.There were lots of collagen fibers under the synovial membranes with infiltration of macrophages and proliferation of microvessels and fiberblasts.But the synovial membranes in group D was almost normal. The content of TNF-α in group A,B and C was higher than that in group D(P<0.05)Conclusion Various kinds of wear debris can cause similar histological responses and promote the release of the inflammatory mediator TNF-α.Further they cause osteolysis around prosthesis which just is one of the reasons of aseptic loosening of prosthesis.
出处
《骨与关节损伤杂志》
2002年第1期33-36,I001,共5页
The Journal of Bone and Joint Injury
