Song Y, Greve J M, Carter D R, Giori N J
Bone and Joint Center, VA Palo Alto Healthcare System, Palo Alto, CA, United States.
Osteoarthritis Cartilage. 2008 Dec;16(12):1545-54. doi: 10.1016/j.joca.2008.04.011. Epub 2008 Jun 2.
Meniscectomy-induced osteoarthritis may be mechanically based. We asked how meniscectomy alters time-dependent deformation of physiologically loaded articular cartilage. We hypothesized that meniscectomy alters nominal strain in tibial articular cartilage, and that meniscectomy affects cartilage thickness recovery following cessation of loading.
A cyclic load simulating normal gait was applied to four sheep knees. A custom device was used to obtain MR images of cartilage at 4.7T during cyclic loading. Articular cartilage thickness and nominal strain were measured every 2.5 min during 1h of cyclic loading, and during 2.5h after cessation of loading.
Following meniscectomy the loaded joints rapidly developed high strain centrally and minimal strain peripherally. Maximum nominal strains after 1h of loading were about 55% in the intact knees and 72% in the meniscectomized knees. Nominal strains in the peripheral tibial cartilage were significantly reduced in the meniscectomized knees. Strain recovery was markedly prolonged in the meniscectomized knees.
With meniscectomy, tibial articular cartilage in the central load bearing region remains chronically deformed and dehydrated, even after cessation of loading. Post-meniscectomy osteoarthritis may be initiated in this region by direct damage to the cartilage matrix, or by altering the hydration of the tissue. In peripheral regions, reduced loading and strain may facilitate subchondral vascular invasion, and endochondral ossification. This is consistent with the central fibrillation and peripheral osteophyte formation seen in post-meniscectomy osteoarthritis.
半月板切除术诱发的骨关节炎可能基于机械因素。我们探究了半月板切除术如何改变生理负荷下关节软骨的时间依赖性变形。我们假设半月板切除术会改变胫骨关节软骨的名义应变,并且半月板切除术会影响负荷停止后软骨厚度的恢复。
对四只绵羊的膝关节施加模拟正常步态的循环负荷。使用定制设备在4.7T下于循环负荷期间获取软骨的磁共振图像。在循环负荷1小时期间以及负荷停止后的2.5小时内,每隔2.5分钟测量关节软骨厚度和名义应变。
半月板切除术后,负荷的关节中央迅速出现高应变,周边应变最小。负荷1小时后的最大名义应变在完整膝关节中约为55%,在半月板切除的膝关节中为72%。半月板切除的膝关节中胫骨周边软骨的名义应变显著降低。半月板切除的膝关节中应变恢复明显延长。
半月板切除术后,即使负荷停止,中央承重区域的胫骨关节软骨仍长期处于变形和脱水状态。半月板切除术后骨关节炎可能通过对软骨基质的直接损伤或改变组织水合作用在该区域引发。在周边区域,负荷和应变的降低可能促进软骨下血管侵入和软骨内成骨。这与半月板切除术后骨关节炎中所见的中央纤维化和周边骨赘形成一致。