骨关节炎软骨内骨化病理研究进展

RESEARCH PROGRESS OF PATHOLOGY OF ENDOCHONDRAL OSSIFICATION IN OSTEOARTHRITIS

目的综述骨关节炎(osteoarthritis,OA)软骨内骨化的病理表现和机制研究进展。方法查阅有关OA软骨内骨化、骨-软骨重塑及关节发育的相关文献,并进行分析总结。结果软骨细胞的肥大、凋亡,血管的侵入,潮线的复制,软骨钙化层不断增厚和软骨表层的相对变薄是OA软骨退变的重要特征。关节软骨与生长板在结构上类似,OA的软骨退变是一种类似于生长板的软骨内骨化过程。结论关节软骨失去稳定表征,从静息代谢平衡状态转为临时软骨的高转换状态,继而发生软骨不断钙化和钙化软骨不断骨化重塑,可能是导致OA发生发展的中心环节。

Objective To summarize the research progress of pathological manifestations and mechanism of endochondral ossification in osteoarthritis （OA）. Methods The literature about endochondral ossification, bone- cartilage remodeling in OA, and joints development was reviewed, analyzed, and summarized. Results Chondrocyte hypertrophy and apoptosis, vascular invasion, replication of the tidemark, thickening calcified cartilage, and thinning superficial cartilage are the characteristics of cartilage degeneration in OA. Articular cartilage and growth plate are similar in structure, and cartilage degeneration in OA is similar to a process of endochondral ossification of the growth plate. Conclusion Loss of stability characterization from resting metabolic balance to a high conversion state of temporary cartilage in stimulation of abnormal mechanical stresses and cytokines would subsequently contributed to continual calcification and remodeling of articular cartilage, which may be the key link of the initiation and development of OA.