Rein Susanne, Hanisch Uwe, Schaller Hans-Eberhard, Zwipp Hans, Rammelt Stefan, Weindel Stefan
Susanne Rein, Department of Plastic and Hand Surgery, Burn Unit, Trauma Center Bergmannstrost, 06112 Halle (Saale), Germany.
World J Orthop. 2016 Jul 18;7(7):418-25. doi: 10.5312/wjo.v7.i7.418.
To analyse bone remodeling in regard to the age of scaphoid non-unions (SNU) with immunohistochemistry.
Thirty-six patients with symptomatic SNU underwent surgery with resection of the pseudarthrosis. The resected material was evaluated histologically after staining with hematoxylin-eosin (HE), tartrate resistant acid phosphatase (TRAP), CD 68, osteocalcin (OC) and osteopontin (OP). Histological examination was performed in a blinded fashion.
The number of multinuclear osteoclasts in the TRAP-staining correlated with the age of the SNU and was significantly higher in younger SNU (P = 0.034; r = 0.75). A higher number of OP-immunoreactive osteoblasts significantly correlated with a higher number of OC-immunoreactive osteoblasts (P = 0.001; r = 0.55). Furthermore, a greater number of OP-immunoreactive osteoblasts correlated significantly with a higher number of OP-immunoreactive multinuclear osteoclasts (P = 0.008; r = 0.43). SNU older than 6 mo showed a significant decrease of the number of fibroblasts (P = 0.04). Smoking and the age of the patients had no influence on bone remodeling in SNU.
Multinuclear osteoclasts showed a significant decrease in relation to the age of SNU. However, most of the immunhistochemical findings of bone remodeling do not correlate with the age of the SNU. This indicates a permanent imbalance of bone formation and resorption as indicated by a concurrent increase in both osteoblast and osteoclast numbers. A clear histological differentiation into phases of bone remodeling in SNU is not possible.
采用免疫组织化学方法分析舟骨不愈合（SNU）的年龄与骨重塑的关系。
36例有症状的SNU患者接受了假关节切除手术。切除的组织在用苏木精-伊红（HE）、抗酒石酸酸性磷酸酶（TRAP）、CD 68、骨钙素（OC）和骨桥蛋白（OP）染色后进行组织学评估。组织学检查采用盲法进行。
TRAP染色中多核破骨细胞的数量与SNU的年龄相关，在较年轻的SNU中显著更高（P = 0.034；r = 0.75）。OP免疫反应性成骨细胞数量较多与OC免疫反应性成骨细胞数量较多显著相关（P = 0.001；r = 0.55）。此外，OP免疫反应性成骨细胞数量较多与OP免疫反应性多核破骨细胞数量较多显著相关（P = 0.008；r = 0.43）。6个月以上的SNU显示成纤维细胞数量显著减少（P = 0.04）。吸烟和患者年龄对SNU的骨重塑没有影响。
多核破骨细胞数量与SNU的年龄呈显著下降关系。然而，骨重塑的大多数免疫组织化学结果与SNU的年龄无关。这表明成骨细胞和破骨细胞数量同时增加所显示的骨形成和吸收的永久性失衡。SNU中骨重塑阶段的明确组织学分化是不可能的。
