Hayashi J
Department of Orthopaedic Surgery, Fujigaoka Hospital, Showa University School of Medicine, Kanagawa, Japan.
Nihon Seikeigeka Gakkai Zasshi. 1995 Nov;69(11):1126-35.
In order to clarify the changes seen in the new acetabular roof produced by Chiari pelvic osteotomy, we performed histological investigations post-operatively, as well as arthrography and arthroscopy before and after the operation. Plain X-rays showed an osseous step between the original surface and the new acetabular roof. Arthrography demonstrated no step between the original acetabular cartilage and the surface of the newly formed acetabular roof. At arthroscopy, the surface of the new acetabular roof could be seen to be covered by a soft white tissue. Histological specimens were taken from the new acetabular roof. Examination revealed that the superficial layer consisted of some oval shaped cells with an extracellular matrix slightly stained by safranin O, but not by anti-human type II collagen antibodies. In the deepest layer, there was cartilage tissue consisting of cartilage-like cells and an extracellular matrix which was stained by safranin O and by anti-type II collagen antibodies. However, the staining intensity of this cartilage tissue was less than that of hyaline cartilage, and the direction of collagen fibers could be clearly seen. These results suggested that the tissue covering the new acetabular roof had no ability to change into hyaline cartilage, despite the superficial layer creating a smooth surface. It was suggested that the bony modification of the new acetabular roof resulted from enchondral ossification of the deepest layer.
为了阐明Chiari骨盆截骨术所形成的新髋臼顶的变化情况，我们在术后进行了组织学研究，并在手术前后进行了关节造影和关节镜检查。X线平片显示原始表面与新髋臼顶之间存在骨质台阶。关节造影显示原始髋臼软骨与新形成的髋臼顶表面之间无台阶。在关节镜检查时，可以看到新髋臼顶表面覆盖着一层柔软的白色组织。从新髋臼顶获取了组织学标本。检查发现，表层由一些椭圆形细胞组成，其细胞外基质经番红O轻度染色，但抗人II型胶原抗体染色阴性。在最深层，有由软骨样细胞和细胞外基质组成的软骨组织，该细胞外基质经番红O和抗II型胶原抗体染色。然而，该软骨组织的染色强度低于透明软骨，且胶原纤维方向清晰可见。这些结果表明，覆盖新髋臼顶的组织尽管表层形成了光滑表面，但没有能力转变为透明软骨。提示新髋臼顶的骨质改变是由最深层的软骨内成骨所致。
