CAJ | 학술논문

目的探讨兔股骨头表面置换术对股骨头组织学的影响及临床意义. 方法取60只新西兰大白兔,左侧行股骨头表面置换术,作为手术侧；右侧采用相同手术路径暴露髋关节,随即缝合切口,作为对照侧.分别于术后3、6、9及12周分批处死动物,每批15只.通过大体标本、HE染色、动脉墨汁灌注、扫描电镜4种方法从组织学角度分析股骨头表面置换术对正常股骨头的影响. 结果手术侧与对照侧3周时骨陷窝空虚率平均分别为8.00％±0.26％、7.96％±0.32％,6周时平均分别为8.11％±0.15％、7.82％±0.29％,9周时平均分别为8.27％±0.26％、8.04％±0.24％,12周时平均分别为8.33％±0.27％、8.00％±0.27％,两侧比较差异均无统计学意义(P＞0.05).股骨头表面置换术后股骨头骨质仅在骨-水泥界面有小范围的骨细胞坏死、肉芽组织增生纤维化及骨吸收；骨-假体界面也有轻度小范围骨细胞坏死和内芽组织增生纤维化,但无骨吸收表现；在远离骨水泥和假体的股骨头中心部位既无骨坏死表现,也无骨吸收表现,组织表现与正常未手术骨质相同. 结论股骨头表面置换术不会引起正常股骨头坏死,股骨头坏死与此术式及假体本身无因果关系.
목적 탐토토고골두표면치환술대고골두조직학적영향급림상의의. 방법 취60지신서란대백토,좌측행고골두표면치환술,작위수술측；우측채용상동수술로경폭로관관절,수즉봉합절구,작위대조측.분별우술후3、6、9급12주분비처사동물,매비15지.통과대체표본、HE염색、동맥묵즙관주、소묘전경4충방법종조직학각도분석고골두표면치환술대정상고골두적영향. 결과 수술측여대조측3주시골함와공허솔평균분별위8.00％±0.26％、7.96％±0.32％,6주시평균분별위8.11％±0.15％、7.82％±0.29％,9주시평균분별위8.27％±0.26％、8.04％±0.24％,12주시평균분별위8.33％±0.27％、8.00％±0.27％,량측비교차이균무통계학의의(P＞0.05).고골두표면치환술후고골두골질부재골-수니계면유소범위적골세포배사、육아조직증생섬유화급골흡수；골-가체계면야유경도소범위골세포배사화내아조직증생섬유화,단무골흡수표현；재원리골수니화가체적고골두중심부위기무골배사표현,야무골흡수표현,조직표현여정상미수술골질상동. 결론 고골두표면치환술불회인기정상고골두배사,고골두배사여차술식급가체본신무인과관계.
Objective To explore the effect of rabbit femoral head resurfacing on the histology of the femoral head and its clinical significance. Methods The femoral head resuffacing was performed at the left side (the surgery side) in 60 New Zealand white rabbits while at the tight side of the rabbits (the control side) the same operative approach was adopted to only expose the hip joint before the incisions were sutured.The animals were sacrificed 3,6,9 and 12 weeks postoperation,with 15 rabbits in each batch.Gross observation,HE staining under light microscopy,arterial ink perfusion and scanning electron microscopy were conducted to observe the histological effects of femoral head resurfacing on the normal femoral head.Results The lacunae empty rates for the surgery side and the control side were respectively 8.00％ ±0.26％ versus 7.96％ ±0.32％ at 3 weeks,8.11％ ±0.15％ versus 7.82％ ±0.29％ at 6 weeks,8.27％ ±0.26％ versus 8.04％ ±0.24％ at 9 weeks,8.33％ ±0.27％ versus8.00％ ±0.27％ at 12 weeks,with no significant differences between the 2 sides at all the time points ( P ＞ 0.05).After operation,bone necrosis,fibrous tissue and bone resorption were seen in a small region at the bone-cement interface. At the bone-implant interface,bone neerosis and fibrous tissue were also found in a small region,but no bone resorption was observed.In regiona far from the coment and implant,neither bone necrosis nor bone resorption waa found,and the histology was.the same as in the healthy bone. Conclusion Femoral head resurfacing may not cause osteonecrosis of a nonml femoral head,and necrosis of femoral head may not be associated with the resurfacing surgery or the prosthesis.