Carter D R, Orr T E, Fyhrie D P, Schurman D J
Clin Orthop Relat Res. 1987 Jun(219):237-50.
A new theory is introduced to describe some of the influences of mechanical stresses on chondroosseous biology. It is proposed that degeneration and ossification is a normal process for all cartilage in the appendicular skeleton, which is accelerated by intermittently applied shear stresses (or strain energy), and inhibited or prevented by intermittently applied hydrostatic pressure. These concepts were applied using finite element computer models in an effort to predict the ossification pattern of the prenatal and postnatal femoral anlage. The theoretical calculations successfully predicted the key features of skeletal morphogenesis including the development of the primary ossification site, a tubular diaphysis and marrow cavity, metaphyseal and epiphyseal trabecular bone, the location and geometry of the growth plate, the appearance and location of the secondary ossific nucleus, and the existence and thickness distribution of articular cartilage. The results suggest that degenerative joint disease in immobilized or nonload-bearing mature joints may be a manifestation of the final stage in the ossification of the anlage. In nonfunctional joints, the absence or reduction of intermittent hydrostatic pressure in the articular cartilage permits cartilage degeneration and the progressive advance of the ossification front toward the joint surface until the articular cartilage has been ossified.
一种新理论被引入以描述机械应力对软骨骨生物学的一些影响。有人提出，退变和骨化是附肢骨骼中所有软骨的正常过程，间歇性施加的剪切应力（或应变能）会加速这一过程，而间歇性施加的静水压力则会抑制或阻止这一过程。这些概念通过有限元计算机模型来应用，以预测产前和产后股骨原基的骨化模式。理论计算成功预测了骨骼形态发生的关键特征，包括初级骨化部位、管状骨干和骨髓腔的发育、干骺端和骨骺小梁骨、生长板的位置和几何形状、次级骨化核的出现和位置，以及关节软骨的存在和厚度分布。结果表明，固定或不负重的成熟关节中的退行性关节疾病可能是原基骨化最后阶段的一种表现。在无功能的关节中，关节软骨中间歇性静水压力的缺失或降低会导致软骨退变，骨化前沿逐渐向关节表面推进，直到关节软骨被骨化。
