Newton B, Crawford C J, Powers D L, Allen B L
Department of Bioengineering, Clemson University, South Carolina.
J Invest Surg. 1994 Sep-Oct;7(5):417-30. doi: 10.3109/08941939409016508.
Legg-Calvé-Perthes disease (LCPD) results from avascular necrosis of the capital femoral epiphysis in growing children. This disease often yields a significant deformity of the proximal femur, which may result in osteoarthritis. Its cause is unknown, although extensive radiographic, clinical, and histologic evaluations have been performed. Attempts at developing an animal model for LCPD have been unsuccessful. Previous models have been based predominantly on determining the vascular etiology of the disease. There is a need for an animal model that mimics the growth pattern of the proximal femur seen in LCPD. Such a model would allow for the development and testing of new treatments. Thus far, no treatment strategy has been completely successful. A study involving graphic analysis of radiographs found that arrested anterolateral physeal growth with continued or accelerated perichondrial ring and posteromedial epiphyseal growth would account for the most severe morphologic changes observed in the femoral heads of patients with LCPD. A surgical procedure was performed to ablate the capital femoral physis in goat kids in an attempt to mimic the changes noted in this study. The procedure was evaluated with radiographs, gross specimens, and histopathologic slides. Graphic analysis of the radiographs revealed changes in the shape of the operated femoral head compared with the unoperated femoral head. While bone, fibrous, and fibrocartilaginous bridges were histologically observed across the physis, the resultant deformities did not mimic the changes identified in the graphic analysis study, perhaps because of inconsistencies in the surgical ablative techniques, which will require further modification. This study provides the basis for further research to develop a successful model.
Legg-Calvé-Perthes病（LCPD）是由于儿童生长过程中股骨头骨骺缺血性坏死所致。这种疾病常导致股骨近端严重畸形，进而可能引发骨关节炎。尽管已经进行了广泛的影像学、临床和组织学评估，但其病因仍不明。此前尝试建立LCPD动物模型均未成功。以往的模型主要基于确定该疾病的血管病因。需要一种能模拟LCPD中股骨近端生长模式的动物模型。这样的模型将有助于开发和测试新的治疗方法。迄今为止，尚无治疗策略完全成功。一项涉及X线片图像分析的研究发现，外侧骨骺生长停滞，同时软骨膜环持续或加速生长以及后内侧骨骺生长，可解释LCPD患者股骨头观察到的最严重形态学变化。为了模拟该研究中提到的变化，对幼山羊进行了手术切除股骨头骨骺。通过X线片、大体标本和组织病理学切片对该手术进行评估。X线片的图像分析显示，与未手术的股骨头相比，手术侧股骨头形状发生了变化。虽然在组织学上观察到骨桥、纤维桥和纤维软骨桥跨越骨骺，但所产生的畸形并未模拟图像分析研究中确定的变化，这可能是由于手术切除技术不一致所致，这需要进一步改进。本研究为进一步开发成功模型的研究提供了基础。
