后交叉韧带断裂对股骨内髁软骨的组织学影响

Effect of PCL rupture on histological features of the medial femoral condyle

[目的]探讨后交叉韧带(posterior cruciate ligament,PCL)断裂对股骨内髁软骨的组织学影响。[方法]48只雄性家兔行后腿单侧PCL切断(实验组)、对侧假手术自身对照(对照组)干预,分别于造模4、8、16、24周随机各处死12只。观察各组股骨内髁大体形态变化,取股骨内髁软骨行HE染色、甲苯胺蓝染色观察股骨内髁软骨的组织学变化并进行Mankin病理评分。[结果]通过大体观察发现,随着时间的推移,实验组股骨内髁软骨逐渐出现色泽改变、表面磨损、开裂、缺损及骨赘形成。通过HE和甲苯胺蓝染色,发现PCL切断后,随着时间的推移逐步出现软骨结构毛糙到解体,软骨细胞增生肥大到细胞减少、基质染色变浅到失染等异常。通过Mankin病理评分,发现PCL切断后4～24周,股骨内髁软骨Mankin评分呈现时间依赖性的增加,各时间点间比较均有显著差异(P<0.05)。[结论]PCL断裂可引起股骨内髁软骨退变的快速进展。

[ Objective] To investigate the effect of posterior cruciate ligament （PCL）rupture on histological features of the medial femoral condyle. [ Method] Following transection of PCL of unilateral knees （experimental group）and sham operation of the contralateral knees （control group）in posterior legs ,48 male rabbits were sacrificed at 4,8,16 and 24 weeks after surgery. Gross pathological obscrvation,hematoxylin-eosin and toluidine blue staining were performed to evaluate the medial femoral condyle cartilage. [ Result] As time passed,cartilage appeared to be yellowish-white,lackluster and its appearance displayed significant cracks and cartilage defects, osteophyte-like structures were observed in the medial femoral condyle after PCL rupture by gross observation. After PCL rupture, the scores for structure ranged from irregular to complete disorganization of the cartilage, scores for cellularity ranged from hypocellularity to large decrease in chondrocytes, scores for stainability ranged from small decrease in color to no stainability over time by HE and toluidine blue staining. There was a significant time-dependent increase of Mankin score in the medial femoral condyle cartilage from 4 to 24 weeks postoperatively （ P 〈 0.05 ）. [ Conclusion] These observations have revealed that PCL rupture resulted in the rapid development of degenerative changes characteristic of osteoarthritis in medial femoral condyle cartilage.