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目的通过动物模型,探讨发育性髋发育不良髋臼的病理变化。方法21只新西兰兔,左膝关节伸直位管型石膏固定制作出髋臼发育不良或半脱位模型,有侧作为对照。按照石膏固定和模型出现的时间将实验动物分为A(4周)、B(6周)、C(8周)三组。测量X线片Sharp角及臼头指数,观察髋臼软骨的组织学变化,比较组间及组内各项指标是否存在显著性差异。结果A组出现髋臼发育不良6例,全脱位型1例;B组出现髋臼发育不良6例,全脱位型2例;C组6例全部为髋臼发育不良。结果比较显示。实验侧Sharp角均比对照侧增大(P<0.01),A、B组实验侧臼头指数均比对照侧减小,差异有统计性意义(P<0.05),但C组间无差异。随着固定时间的延长,各组间实验侧的Sharp角相比差异无统计学意义(P>0.05)。组织学观察显示髋发育不良的髋臼软骨厚度明显变薄,软骨细胞排列紊乱,且有局灶性软骨细胞聚集或者退化的改变。而全脱位型的髋臼软骨则表现为厚度显著增加。结论发育性髋发育不良表现为一个渐进性的病理过程。体位因素影响髋臼的发育和病理改变,但这种影响具有个体差异,且可能仅作用于髋关节发育的某个阶段。
Objective To investigate the pathological changes of acetabular dysplasia in developing hip by animal model. Methods Twenty-one New Zealand rabbits with left knee joint orthopedic cast plaster were fixed to produce acetabular dysplasia or subluxation model, with the side as a control. The animals were divided into three groups: A (4 weeks), B (6 weeks) and C (8 weeks) according to the time when gypsum was fixed and the model appeared. Sharp angle and acetabular index of X-ray film were measured to observe the histological changes of acetabular cartilage, and to compare the indexes between groups and groups whether there is a significant difference. Results There were 6 cases of acetabular dysplasia and 1 case of total dislocation in group A, 6 cases of acetabular dysplasia in group B and 2 cases of total dislocation in group B, and 6 cases of acetabular dysplasia in group C. The results show that comparison. The Sharp angle of the experimental side was higher than that of the control side (P <0.01). The acetabular index of the experimental side in the A and B groups was lower than that of the control side (P <0.05), but there was no difference between the C groups. With the extension of the fixed time, there was no significant difference in the Sharp angle between experimental groups (P> 0.05). Histological observation showed that the thickness of acetabular cartilage of hip dysplasia was significantly thinner, cartilage cells were disordered, and focal chondrocytes were aggregated or degenerated. The dislocation of the acetabular cartilage showed a significant increase in thickness. Conclusion Developmental hip dysplasia is a progressive pathological process. Postural factors affect the development and pathological changes of the acetabulum but this effect has individual differences and may only act at a certain stage of hip development.