Stanitski D F, Rossman K, Torosian M
Department of Orthopaedic Surgery, Children's Hospital of Michigan, Detroit, USA.
J Pediatr Orthop. 1996 Mar-Apr;16(2):151-4. doi: 10.1097/00004694-199603000-00003.
Loss of joint motion is a common complication of limb lengthening despite newer methods of incremental bone elongation. A pilot canine study has demonstrated that 30% femoral lengthening causes reproducible knee cartilage injury manifest by frank loss of cartilage substance or fibrillation. This study was undertaken to examine the potential of knee joint protection by apparatus extension to the tibia. Four dogs underwent application of a modified Ilizarov apparatus to the femur and tibia with coaxial hinges at the knee. After osteotomy, 30% lengthening was undertaken at 0.75 mm daily in three increments. At the completion of lengthening, experimental and contralateral knee joints were harvested, assessed grossly, decalcified, sagittally sectioned, and stained with safranin-O. All control joints were normal histologically. All experimental joints demonstrated a decrease in proteoglycan staining without evidence of fibrillation or necrosis. These findings suggest a protective effect of the tibial apparatus by avoiding joint compression.
尽管有了更新的渐进性骨延长方法，但关节活动丧失仍是肢体延长的常见并发症。一项犬类初步研究表明，股骨延长30%会导致可重复性的膝关节软骨损伤，表现为软骨实质明显丧失或出现原纤维形成。本研究旨在探讨通过胫骨延长装置来保护膝关节的可能性。对四只犬的股骨和胫骨应用改良的伊利扎洛夫装置，膝关节处有同轴铰链。截骨术后，以每天0.75毫米的速度分三次进行30%的延长。延长完成后，取出实验侧和对侧膝关节，进行大体评估、脱钙、矢状面切片，并用番红O染色。所有对照关节组织学检查均正常。所有实验关节均显示蛋白聚糖染色减少，但无原纤维形成或坏死迹象。这些发现表明胫骨装置通过避免关节受压具有保护作用。
