Ahuja S C, Bullough P G
J Bone Joint Surg Am. 1978 Mar;60(2):191-7.
Specimens from thirty-four knees in twenty-eight patients with histologically proved osteonecrosis were reviewed. Twelve knees had the clinical diagnosis of so-called idiopathic osteonecrosis; eight, osteoarthrosis; and fourteen, rheumatoid arthritis. Pathologically, the necrosis was localized in the subchondral region of the medial femoral condyle in 67 per cent of the knees. There were pathological fracture and collapse and fragmentation of the necrotic segment leading to marked deformities in most cases. The response to necrosis consisted of histiocytic resorption of necrotic material and formation of granulation tissue and reactive new bone surrounding it. The response was relatively less prominent in the knees with degenerative joint disease and rheumatoid arthritis.
对28例经组织学证实为骨坏死患者的34个膝关节标本进行了回顾性研究。其中12个膝关节临床诊断为所谓的特发性骨坏死；8个为骨关节炎；14个为类风湿关节炎。病理检查发现，67%的膝关节坏死位于股骨内侧髁软骨下区域。多数病例存在病理骨折以及坏死节段的塌陷和碎裂，导致明显畸形。对坏死的反应包括组织细胞对坏死物质的吸收，以及肉芽组织的形成和其周围反应性新骨的形成。在退行性关节病和类风湿关节炎患者的膝关节中，这种反应相对不明显。
