髋臼周围损伤对髋关节发育影响的实验研究

Effect of Periacetabular Injury on Hip Development

目的 :探讨髋臼软骨及周围骨膜损伤对髋关节发育的影响。方法 :4～ 5周龄白兔 2 0只 ,切除其右侧髋关节部分髋臼软骨 (A组 )及臼缘上方骨膜 (B组 ) ,左侧作为对照。用X线、形态学及组织学方法观察髋关节发育状况。结果 :右侧全部出现髋关节发育不良 ,半脱位发生率 :A组 80 % ,B组 40 %。对照侧发育正常。结论 :髋臼软骨及臼缘上方骨膜破坏可导致髋关节发育不良和半脱位。

Objective:To study the effect of acetabular cartilage or periacetabular periosteum injury on hip development.Methods Twenty rabbits aged 4～5 weeks were randomly divided into to 2 groups,each group contains 10 rabbits.The experimental model was produced by partial excision of acetabular cartilage or supra-acetabular periosteum on the right hip of each rabbit.The opposite unoperated hip served as control.Radiographs of both hips were performed on the second postoperative day and 3,6,9,12 weeks after surgery to evaluate the development and stability of hips.All rabbits were killed at 12 weeks.The gross and microscopic histologic changes of the hip joint were subsequently assessed.Results:Series radiography and morphologic observation showed all the operated hips appeared hip dysplasia.In Group A,the joint gap was indistinct and the femoral head became flat and their density increased,8 animals(80%)manifested subluxation.In Group B,the operated ilium was small and twisted.The acetabular roof was sloping and 4 hips(40%) appeared subluxation but no dislocation occurred.The control hips in both groups remained normal.Histopathological analysis correlated strongly with the radiographic findings.Conclusions:The subsequence of acetabular cartilage damage includes acetabular maldevelopment and roughness on acetabular roof,which may result in hip dysplasia and subluxation and ostarthritis;Damage to supra-acetabular iliac periosteum could induce iliac deformity and poor development of superior-lateral acetabular border,subsequent hip dysplasia and instability.