Paraliov Anton Tiberiu, Vicaş Răzvan Marius, Dîrnu Rodica, Guţă Natalia, Radu Lucreţiu, Mogoantă Laurenţiu, Nicolescu Laura Corina
Department of Hygiene, University of Medicine and Pharmacy of Craiova, Romania;
Rom J Morphol Embryol. 2025 Jan-Mar;66(1):217-227. doi: 10.47162/RJME.66.1.20.
Osteoarthritis is a complex, degenerative disease that can affect all the anatomical structures of the synovial joints. Most frequently, the joints of the hand, hip, and knee are affected, especially in the elderly patients. In our study, we evaluated 27 femoral heads, examining the histopathological changes that occurred in the articular cartilage, subchondral bone, and perisynovial soft tissues. At the level of the articular cartilage, there were observed a reduction in thickness, deformation of the articular surface, degradation of the cartilaginous matrix, the occurrence of fissures or fractures in the cartilaginous piece, a reduction in the number of chondrocytes, and changes in their morphology. In the subchondral bone, a rarefaction of the bone trabeculae and a reduction in their thickness were observed, along with an increase in the size of the alveolar cavities. These changes were accompanied by the formation of cystic cavities, non-homogeneous hypertrophy of the subchondral bone plate as a response to the reduction in thickness and change of the articular cartilage structure, or the reduction in the thickness of the subchondral bone plate. The trabecular bone exhibited an atrophic endosteum, absence of bone remodeling processes, cracks or even fractures in the trabecular bone. Likewise, we observed rare ectopic osteogenesis processes, either endochondral or desmal ones, forming osteophytes. The synovium and perisynovial connective tissue contained immune cells, vascular endothelial cells, fibroblasts, adipocytes, and other mesenchymal-derived stromal cells. The immunohistochemical study highlighted the presence of T-lymphocytes, B-lymphocytes, and macrophages, cells capable of synthesizing and releasing matrix metalloproteinases that are involved in the degradation of the articular cartilage. Exploration of cell proliferative capacity using the proliferating cell nuclear antigen (PCNA) showed that, in the articular cartilage, there are few cells (chondrocytes) capable of proliferation, while in the synovium there are numerous young fibroblasts capable of mitotic division.
骨关节炎是一种复杂的退行性疾病，可影响滑膜关节的所有解剖结构。最常见的是手部、髋部和膝部关节受到影响，尤其是老年患者。在我们的研究中，我们评估了27个股骨头，检查了关节软骨、软骨下骨和滑膜周围软组织中发生的组织病理学变化。在关节软骨层面，观察到厚度减小、关节表面变形、软骨基质降解、软骨片出现裂隙或骨折、软骨细胞数量减少以及其形态变化。在软骨下骨中，观察到骨小梁稀疏和厚度减小，同时牙槽腔大小增加。这些变化伴随着囊性腔的形成、软骨下骨板的非均匀性肥大，这是对关节软骨厚度减小和结构变化或软骨下骨板厚度减小的反应。小梁骨表现出萎缩的骨内膜、缺乏骨重塑过程、小梁骨出现裂缝甚至骨折。同样，我们观察到罕见的异位骨生成过程，无论是软骨内成骨还是膜内成骨，形成骨赘。滑膜和滑膜周围结缔组织包含免疫细胞、血管内皮细胞、成纤维细胞、脂肪细胞和其他间充质来源的基质细胞。免疫组织化学研究突出了T淋巴细胞、B淋巴细胞和巨噬细胞的存在，这些细胞能够合成和释放参与关节软骨降解的基质金属蛋白酶。使用增殖细胞核抗原（PCNA）探索细胞增殖能力表明，在关节软骨中，能够增殖的细胞（软骨细胞）很少，而在滑膜中有许多能够进行有丝分裂的年轻成纤维细胞。
