中华关节外科杂志（电子版）
中華關節外科雜誌（電子版）
중화관절외과잡지（전자판）
CHINESE JOURNAL OF JOINT SURGERY(ELECTRONIC VERSION)
2014年
6期
775-778
,共4页
王国良%孙艳%唐兆春%于其龙%王宗江
王國良%孫豔%唐兆春%于其龍%王宗江
왕국량%손염%당조춘%우기룡%왕종강
髌骨软骨软化%生物力学
髕骨軟骨軟化%生物力學
빈골연골연화%생물역학
Chondromalacia patellae%Biomechamics
目的：建立兔髌骨倾斜的模型并观察髌股关节软骨损害的变化，为临床治疗髌股关节疾病提供实验依据。方法新西兰大白兔24只，随机分3组，每组8只，行右膝髌骨内侧支持带松解和外侧支持带紧缩术，术后不固定右膝关节。左膝髌骨为对照组。分别于术后第2周、4周、8周处死取材，分别进行髌骨倾斜角CT测量、髌骨关节面软骨大体观察、软骨组织Mankin评分。结果（1）实验侧髌骨倾斜角明显大于对照侧；（2）术后4周可见关节软骨软化，色泽晦暗，裂隙形成；术后8周关节软骨粗糙，有大的裂隙且色泽晦暗；对照组无软骨退变；（3） HE染色光镜下观察关节软骨，术后4周时，关节软骨轻度变性，可见软骨细胞变扁，表面不规则，术后8周时，软骨明显变性，可见软骨细胞增殖，排列紊乱，基质减少，潮线不完整。根据软骨Mankin评分，术后4、8周时右膝实验组得分明显高于左膝空白对照组，相比较有显著的统计学意义（ P＜0.05）。结论兔髌骨倾斜后4周，髌骨外侧关节面软骨出现软骨软化，随着时间的延长软骨退变进一步加重，为治疗髌股关节软骨疾病提供实验依据。
目的：建立兔髕骨傾斜的模型併觀察髕股關節軟骨損害的變化，為臨床治療髕股關節疾病提供實驗依據。方法新西蘭大白兔24隻，隨機分3組，每組8隻，行右膝髕骨內側支持帶鬆解和外側支持帶緊縮術，術後不固定右膝關節。左膝髕骨為對照組。分彆于術後第2週、4週、8週處死取材，分彆進行髕骨傾斜角CT測量、髕骨關節麵軟骨大體觀察、軟骨組織Mankin評分。結果（1）實驗側髕骨傾斜角明顯大于對照側；（2）術後4週可見關節軟骨軟化，色澤晦暗，裂隙形成；術後8週關節軟骨粗糙，有大的裂隙且色澤晦暗；對照組無軟骨退變；（3） HE染色光鏡下觀察關節軟骨，術後4週時，關節軟骨輕度變性，可見軟骨細胞變扁，錶麵不規則，術後8週時，軟骨明顯變性，可見軟骨細胞增殖，排列紊亂，基質減少，潮線不完整。根據軟骨Mankin評分，術後4、8週時右膝實驗組得分明顯高于左膝空白對照組，相比較有顯著的統計學意義（ P＜0.05）。結論兔髕骨傾斜後4週，髕骨外側關節麵軟骨齣現軟骨軟化，隨著時間的延長軟骨退變進一步加重，為治療髕股關節軟骨疾病提供實驗依據。
목적：건립토빈골경사적모형병관찰빈고관절연골손해적변화，위림상치료빈고관절질병제공실험의거。방법신서란대백토24지，수궤분3조，매조8지，행우슬빈골내측지지대송해화외측지지대긴축술，술후불고정우슬관절。좌슬빈골위대조조。분별우술후제2주、4주、8주처사취재，분별진행빈골경사각CT측량、빈골관절면연골대체관찰、연골조직Mankin평분。결과（1）실험측빈골경사각명현대우대조측；（2）술후4주가견관절연골연화，색택회암，렬극형성；술후8주관절연골조조，유대적렬극차색택회암；대조조무연골퇴변；（3） HE염색광경하관찰관절연골，술후4주시，관절연골경도변성，가견연골세포변편，표면불규칙，술후8주시，연골명현변성，가견연골세포증식，배렬문란，기질감소，조선불완정。근거연골Mankin평분，술후4、8주시우슬실험조득분명현고우좌슬공백대조조，상비교유현저적통계학의의（ P＜0.05）。결론토빈골경사후4주，빈골외측관절면연골출현연골연화，수착시간적연장연골퇴변진일보가중，위치료빈고관절연골질병제공실험의거。
Objective To establish a rabbit model of patellar tilt and observe the change of the patellofemoral cartilage damage , which can provide experimental basis for the clinical treatment of patellofemoral joint diseases .Methods Twenty-four New Zealand rabbits were randomly divided into three groups.The right knee was the experimental side which was operated to make the patella tilted .The left knee was used as the normal control .The animals were sacrificed in the 2nd week, 4th week, and 8th week after the operation .The patellar tilt angle on the CT scanning was measured , gross observation and Mankin scores were also performed . Results ( 1 ) The results revealed that the patellar tilt angle of the experimental side was obviously larger than that of the control side .(2) The joint degeneration, cartilage softening, dull color, and crack formation were observed in the 4th week after the operation.The joint degeneration increased in the 8th week after the operation; while there was no degeneration on the control side of the knee.(3) HE staining results.The degeneration of cartilage began in the 4th week after the operation.The most severe degeneration of the cartilage included chondrocytes proliferation and disorderly arrangement , the matrix reduction , and incomplete tide line .The Mankin score of the experimental side was significantly higher than that of the control side in the 4th and 8th week after the operation (P<0.05). Conclusion The cartilage of the lateral joint surface presented chondromalacia 4 weeks after the rabbit patellar tilt. The cartilage degeneration will aggravate with the time . These findings can provide experimental basis for the treatment of cartilage diseases of patellofemoral joint .
