Takahashi S, Sugimoto M, Kotoura Y, Oka M, Sasai K, Abe M, Yamamuro T
Department of Orthopedic Surgery, Faculty of Medicine, Kyoto University, Japan.
Clin Orthop Relat Res. 1992 Feb(275):300-5.
In experimental intraoperative irradiation, 18 adult rabbits received a single, 50-Gy dose of x-radiation at a unilateral knee joint, and subsequent changes in the articular cartilage were examined over a 15-month period by histology, scanning electron microscopy, and autoradiography. Although the subchondral bone showed histologically typical findings of osteonecrosis three to nine months postirradiation, the articular cartilage revealed no obvious degenerative changes during the entire study period. Scanning electron microscopy revealed normal collagen architecture in the irradiated cartilage for as long as 15 months postirradiation. Autoradiography demonstrated active RNA synthesis by the irradiated chondrocytes during the same period. These results indicate that articular cartilage tissue tolerates intraoperative radiotherapy without sustaining serious degenerative changes, unless possible collapse or contracture disturbs its biomechanical integrity. The survival of articular cartilage can be advantageous for this type of limb-salvage surgery in the treatment of malignant bone tumors around a synovial joint.
在实验性术中放疗中,18只成年兔单侧膝关节接受单次50 Gy的X线辐射,随后在15个月的时间里,通过组织学、扫描电子显微镜和放射自显影检查关节软骨的后续变化。尽管照射后3至9个月,软骨下骨在组织学上显示出典型的骨坏死表现,但在整个研究期间,关节软骨未显示出明显的退行性变化。扫描电子显微镜显示,照射后长达15个月,照射软骨中的胶原结构正常。放射自显影显示,同期照射的软骨细胞有活跃的RNA合成。这些结果表明,关节软骨组织能够耐受术中放疗而不发生严重的退行性变化,除非可能的塌陷或挛缩扰乱其生物力学完整性。关节软骨的存活对于这种治疗滑膜关节周围恶性骨肿瘤的保肢手术可能是有利的。