Warner J J, Philip J H, Brodsky G L, Thornhill T S
Combined Harvard Orthopaedic Surgery Program, Harvard Medical School, Boston, MA.
Clin Orthop Relat Res. 1987 Dec(225):128-40.
High-dose methylprednisolone was administered to adult rabbits over a five- to nine-week period, according to previously described experimental models of nontraumatic osteonecrosis (NON). Manometric studies were performed using a sensitive computer-directed microvolume flow system. Osteocyte viability within the femoral head was assessed by counting empty osteocyte lacunae in five random high-power fields of hematoxylin- and eosin-stained sections. There was no significant elevation of intramedullary pressure or venous outflow resistance in femoral heads of animals receiving steroids, and a significant random loss of osteocytes was observed in these femoral heads. The clinical relevance of these studies is as follows. NON associated with steroids may not simply be the result of progressive ischemia. Ischemia and elevated intramedullary pressure may be epiphenomena, and a direct cytotoxic effect of steroids on osteocytes may be the earliest event in the development of nontraumatic osteonecrosis. The stress test, as it is currently being used in the clinical setting, may be unreliable.
根据先前描述的非创伤性骨坏死（NON）实验模型，在五至九周的时间内，对成年兔子给予高剂量甲基强的松龙。使用灵敏的计算机控制微量流量系统进行测压研究。通过在苏木精和伊红染色切片的五个随机高倍视野中计数空的骨细胞陷窝来评估股骨头内的骨细胞活力。接受类固醇治疗的动物股骨头内髓内压或静脉流出阻力没有显著升高，并且在这些股骨头中观察到骨细胞明显随机丢失。这些研究的临床意义如下。与类固醇相关的NON可能不仅仅是进行性缺血的结果。缺血和髓内压升高可能是附带现象，类固醇对骨细胞的直接细胞毒性作用可能是非创伤性骨坏死发展过程中的最早事件。目前临床使用的应力测试可能不可靠。
