Hurtig M B, Fretz P B, Doige C E, Schnurr D L
Department of Clinical Studies, Ontario Veterinary College, University of Guelph.
Can J Vet Res. 1988 Jan;52(1):137-46.
The mechanisms and completeness of equine articular cartilage repair were studied in ten horses over a nine month period. Large (15 mm square) and small (5 mm square) full-thickness lesions were made in weight bearing and nonweight bearing areas of the radiocarpal, middle carpal and femoropatellar joints. The horses were euthanized in groups of two 1, 2.5, 4, 5 and 9 months later. Gross pathology, microradiography, and histopathology were used to evaluate qualitative aspects of articular repair. Computer assisted microdensitometry of safranin-O stained cartilage sections was used to quantitate cartilage matrix proteoglycan levels. Structural repair had occurred in most small defects at the end of nine months by a combination of matrix flow and extrinsic repair mechanisms. Elaboration of matrix proteoglycans was not complete at this time. Statistically better healing occurred in small weight bearing lesions, compared to large or nonweight bearing lesions. Synovial and perichondrial pannus interfered with healing of osteochondral defects that were adjacent to the cranial rim of the third carpal bone. Clinical and experimental experience suggests that these lesions are unlikely to heal, whereas similar lesions in the radiocarpal and femoropatellar joints had satisfactory outcomes. Observations made in this study support the use of early postoperative ambulation, passive flexion of operated joints, and recuperative periods of up to a year for large cartilage defects.
在九个月的时间里，对十匹马的马关节软骨修复机制及完整性进行了研究。在桡腕关节、腕中间关节和股髌关节的负重区和非负重区制造了大的（15平方毫米）和小的（5平方毫米）全层损伤。这些马在1、2.5、4、5和9个月后分两组实施安乐死。采用大体病理学、显微放射摄影术和组织病理学来评估关节修复的定性方面。对番红O染色的软骨切片进行计算机辅助显微密度测定，以定量软骨基质蛋白聚糖水平。在九个月结束时，大多数小缺损通过基质流动和外部修复机制的结合实现了结构修复。此时基质蛋白聚糖的形成尚未完成。与大的或非负重性损伤相比，小的负重性损伤在统计学上愈合更好。滑膜和软骨膜血管翳干扰了与第三腕骨颅侧边缘相邻的骨软骨缺损的愈合。临床和实验经验表明，这些损伤不太可能愈合，而桡腕关节和股髌关节的类似损伤有令人满意的结果。本研究中的观察结果支持对大的软骨缺损采用术后早期活动、手术关节被动屈曲以及长达一年的恢复期。
