Bravo C, Kawamura H, Yamaguchi T, Hotokebuchi T, Sugioka Y
Department of Orthopaedic Surgery, Faculty of Medicine, Kyushu University, Fukuoka.
Fukuoka Igaku Zasshi. 1996 Jun;87(6):133-41.
Skeletal immature rabbits were used to study the pathogenesis of Osteochondritis Dissecans (OCD). Both histological studies and a radiographical examination were utilized after sagittal and coronal surgical chondral fractures were made in the femoral condyles cartilage. Serial microangiographies were performed in rabbits between 0 and 84 days after the chondral fractures were made. Analyses of the histology and microradiography findings suggest in either a coronal or sagittal direction, that avascular lesions like an experimental OCD occur as a sequence of chondral injury. A fracture in a wide pedicle of a stable cartilaginous flap with abundant cartilage canals heals in the usual way. However, a fracture in an unstable fragment with a small isthmus devoid of cartilage canals and of nutritious vessels, probably doesn't heal completely and a fragment closely resembling OCD is instead formed. An experimental OCD depends on the slender hinge of the flap and on the lack of stability in a rabbit's non-ossified epiphyseal cartilage. The damage to the cartilage canals and the rupture of vessels in the canals by a chondral fracture and the disturbance in the revascularization in the healing process by abnormal mechanical forces are thus most likely considered to be the main factor for OCD production.
采用骨骼未成熟的兔子来研究剥脱性骨软骨炎(OCD)的发病机制。在股骨髁软骨上制作矢状面和冠状面手术软骨骨折后,进行组织学研究和影像学检查。在软骨骨折后的0至84天内对兔子进行连续微血管造影。组织学和微放射学结果分析表明,在冠状面或矢状面方向上,像实验性OCD这样的无血管病变是软骨损伤的一系列结果。具有丰富软骨管的稳定软骨瓣宽蒂骨折以通常方式愈合。然而,具有小峡部且无软骨管和营养血管的不稳定碎片骨折可能无法完全愈合,反而形成了一个与OCD非常相似的碎片。实验性OCD取决于瓣的细长铰链以及兔子未骨化骨骺软骨的稳定性不足。因此,软骨骨折对软骨管的损伤以及管内血管的破裂,以及异常机械力对愈合过程中血管再生的干扰,最有可能被认为是产生OCD的主要因素。