人体下肢长骨负重关节软骨下松质骨显微硬度分布特征的研究

Microhardness distribution of subchondral cancellous bone in weight-bearing joints of the human lower extremity long bones

目的探讨人体下肢长骨负重关节软骨下松质骨显微硬度的分布特征。方法选取3具年龄大于40岁的新鲜冰冻尸体标本,取出所有标本的右侧股骨和胫骨,分别于股骨头、股骨内髁、股骨外髁、胫骨内髁、胫骨外髁、胫骨远端距负重区关节软骨面1 cm处,垂直于下肢机械轴切下3 mm厚松质骨样本。使用维氏显微硬度测量系统测量骨组织显微硬度。比较不同标本、股骨与胫骨以及不同解剖部位软骨下松质骨的显微硬度差异,分析3具标本不同解剖部位软骨下松质骨显微硬度分布规律。结果共制成18个标本,行180次显微硬度测量。3具标本的下肢长骨负重关节软骨下松质骨的总体显微硬度值为20.3~47.3(36.0±5.7)HV,3具标本间差异无统计学意义(F=2.40,P=0.094)。股骨软骨下松质骨显微硬度小于胫骨,分别为(32.5±4.9)HV、(39.4±4.3)HV,差异有统计学意义(t=-10.02,P<0.001)。股骨头软骨下松质骨显微硬度为(32.9±4.6)HV,股骨内髁(35.1±3.9)HV、股骨外髁(29.7±4.7)HV、胫骨内髁(40.8±4.0)HV、胫骨外髁(36.8±4.2)HV、胫骨远端(40.7±3.6)HV,差异有统计学意义(F=33.28,P<0.001),其中股骨外髁显微硬度最低,胫骨内髁显微硬度最高,内髁均高于外髁。3具标本不同解剖部位软骨下骨的显微硬度分布规律相似。结论人体下肢长骨负重关节软骨下松质骨的显微硬度存在较大差异,胫骨软骨下松质骨显微硬度高于股骨,膝关节内侧间室硬度大于外侧间室。

Objective To explore the microhardness distribution of human subchondral cancellous bone in weight-bearing joints of lower extremity long bones.Methods The right femur and tibia were dissected from three fresh frozen Chinese cadavers older than 40 years.Then,3 mm-thick cancellous bone samples were taken from the diaphyseal party on the femoral head,femoral medial condyle,femoral lateral condyle,tibial medial condyle,tibial lateral condyle,and distal tibia perpendicularly to the lower limb mechanical axis and 1 cm below the articular surface.The microhardness of subchondral cancellous bone was measured with a Vickers microhardness measurement system.The microhardness values of subchondral cancellous bone in different specimens,femur and tibia,and different anatomical sites were compared.The microhardness distribution of the subchondral cancellous bone in different anatomical locations of the three donors was analyzed.Results A total of 180 indentations were conducted on 18 specimens.The microhardness of the subchondral cancellous bone in the weight-bearing lower limb long bones of the three donors was 20.3-47.3(36.0±5.7)HV,and no statistically significant difference existed between the three donors(F=2.40,P=0.094).The microhardness of femoral subchondral cancellous bone was smaller than that of the tibia,with(32.5±4.9)HV and(39.4±4.3)HV,respectively,and the difference was statistically significant(t=-10.02,P<0.001).Given the different anatomical sites,the microhardness values were as follows:subchondral cancellous bone of the femoral head(32.9±4.6)HV;femoral medial condyle(35.1±3.9)HV;femoral lateral condyle(29.7±4.7)HV;tibial medial condyle(40.8±4.0)HV;external tibial condyle(36.8±4.2)HV;and distal tibial(40.7±3.6)HV.The difference was statistically significant(F=33.28,P<0.001),of which the microhardness of the external femoral condyle was the lowest,and the microhardness of the internal tibial condyle was the highest.The microhardness of the medial condyle was greater than that of the lateral condyle.The microhardness distributions of the subchondral bone in different anatomical sites of the three specimens were similar.Conclusion A significant difference is observed in the microhardness values of the subchondral bones in lower extremity long bones.The microhardness of subchondral bones in the tibia is higher than that of the femur;the microhardness of the medial compartment of the knee is greater than that of the lateral compartment.