Tribological changes in the articular cartilage of a human femoral head with avascular necrosis
Eun-Min SeoSuman Kumar ShresthaCong-Truyen DuongAshish Ranjan SharmaTae‐Woo KimAyyappan VijayachandraMark S. ThompsonMyung Guk ChoSungchan ParkKwang-Hoon KimSeonghun ParkSang‐Soo Lee
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Abstract:
The present study evaluated the tribological properties of the articular cartilage surface of the human femoral head with postcollapse stage avascular necrosis (AVN) using atomic force microscopy. The cartilage surface in the postcollapse stage AVN of the femoral head was reported to resemble those of disuse conditions, which suggests that the damage could be reversible and offers the possibilities of success of head-sparing surgeries. By comparing the tribological properties of articular cartilage in AVN with that of osteoarthritis, the authors intended to understand the cartilage degeneration mechanism and reversibility of AVN. Human femoral heads with AVN were explanted from the hip replacement surgery of four patients (60–83 years old). Nine cylindrical cartilage samples (diameter, 5 mm and height, 0.5 mm) were sectioned from the weight-bearing areas of the femoral head with AVN, and the cartilage surface was classified according to the Outerbridge Classification System (AVN0, normal; AVN1, softening and swelling; and AVN2, partial thickness defect and fissuring). Tribological properties including surface roughness and frictional coefficients and histochemistry including Safranin O and lubricin staining were compared among the three groups. The mean surface roughness Rq values of AVN cartilage increased significantly with increasing Outerbridge stages: Rq = 137 ± 26 nm in AVN0, Rq = 274 ± 49 nm in AVN1, and Rq = 452 ± 77 nm in AVN2. Significant differences in Rq were observed among different Outerbridge stages in all cases (p < 0.0001). The frictional coefficients (μ) also increased with increasing Outerbridge stages. The frictional coefficient values were μ = 0.115 ± 0.034 in AVN0, μ = 0.143 ± 0.025 in AVN1, and μ = 0.171 ± 0.039 in AVN2. Similarly to the statistical analysis of surface roughness, significant statistical differences were detected between different Outerbridge stages in all cases (p < 0.05). Both surface roughness and frictional coefficient of cartilage, which were linearly correlated, increased with increasing Outerbridge stages in postcollapse AVN. The underlying mechanism of these results can be related to proteoglycan loss within the articular cartilage that is also observed in osteoarthritis. With regard to the tribological properties, the cartilage degeneration mechanism in AVN was similar to that of osteoarthritis without reversibility.Keywords:
Avascular Necrosis
Articular surface
Objective To establish an immature rabbit model of avascular necrosis of the femoral head in-duced by exercise. Methods Ten male, immature New Zealand white rabbits were subjected to large range, in- tense passive movement and concentric impingement on their right hips for 4 weeks. The left hips were used as self-controls. Then X-ray and magnetic resonance imaging, gross anatomical observation and histological examination were used to evaluate avascular necrosis of the femoral head. Result After 4 weeks, avascular necrosis of the femoral head was successfully replicated. Increased bone density, decreased osteoepiphysis height and indistinct bone trabec-ula were found in X-rays of the right hips. In MRI images obvious joint hydrops could be detected in all right hips, and schistic low signal areas in the femoral head could be seen in TIWI and T2WI images. Thin bone trabeculae of low density, with irregular and broken structures, were also found in H-E sections. Conclusion An immature rab-bit model of avascular necrosis of femoral head can be successfully induced through large range, intense, passive movement and concentric impingement.
Key words:
Avascular necrosis of the femoral head; Immature rabbits; Exercise
Avascular Necrosis
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Objective To study the value of radionuclide bone imaging for patients with avascular necrosis of the femoral head.Method 30 patients with avascular necrosis of the femoral head were studied by the radionuclide bone imaging after injection of 99m Tc MDP.Result 47 femoral head of avascular necrosis showed the types of “defect”,“concentrate” and “doughunt”in plane imaging and the“defect” and “doughunt” in tomography.Of 13 normal femoral head,3 femoral head showed the “defect”.Conclusion Radionuclide bone imaging was the diagnostic method for early assessment of the avascular necrosis of the femoral head. [
Avascular Necrosis
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Objective To evaluate the value of X-ray and CT imaging in the diagnosis of avascular necrosis of femoral head.Methods X-ray and CT findings of the femoral head were studied in 67 patients retrospectively which were compared with ability to demonstrate the early ANFH.Results 26 patiets with Ⅰ～Ⅱ ANFH were detected by X-ray imaging, the diagnostic accuracy rate was 38.8 %.While 46 patiets with Ⅰ～Ⅱ ANFH were detected by CT imaging, the diagnostic accuracy rate was 68.6 %.Conclusion It is difficult to detect the early avascular necrosis of femoral head. CT technique is an effective and reliable method in diagnosing early avascular necrosis of femoral head, and superior to X-ray examination.
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Objective To evaluate the diagnosis value of MRI i n avascular necrosis of femoral head(ANFH).Method 60 cases of avasc ular necrosis of femoral head were studied with MRI,compared the findings with c linical symptoms.Results MRI could specifically reflect the each stage imaging findings of avascular necrosis of femoral head.Double-line sign the characteristic expression of MRI in early avascular necrosis of femoral head.Conclusion MRI could exactly display early ANFH and reflect the exact range.It is very valuable in early treatment and prognosis.
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Objective To improve the recognition of avascular necrosis of the femoral head.Methods X-ray fingings of the adults avascular necrosis of femoral head in 10 cases were analyzed retrospectively.Results Avascular necrosis of the femoral head was 10 cases,3 cases of stage I,2 cases of stage Ⅱ,4 cases of stage Ⅲ,1 cases of stage Ⅳ.In followed up period,all cases were checked up by X-ray film,it was seen that the femoral head deformate and joint hyperplasing sclerosis.Conclusion X-ray plain film is the important role in detecting avascular necrosis of the femral head and can clearly demonstrates the anatomic and pathologic details of the femoral head ,such as the size 、location、extent、density、sclerosis and necrosis.so X-ray plain film is of valuable in diagnosis of avascular necrosis of the femoral head.
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Objective: to discuss early diagnosis of avascular necrosis of femoral head.Methods:To estimate the diagnosis value of avascular necrosis of femoral head by comparing the X-ray、CT and ECT Films.Result:The diagnosis sensitivity of X-ray,CT、and ECT are respectively 18.8%,43.8% and 87.5%,the diagnosis accuracy of X-ray,CT and ECT are respectivly 45.8%,68.5% and 91.7%.Conclusion:ECT examination is a satisfactory diagnostic method for early avascular necrosis of femoral head.
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To observe the expression of VEGF in rabbits of hormonal avascular necrosis of femoral head(ANFH) and probe its pathogenesis.The results showed that there was expression of VEGF in normal group,and overexpression in hormonal ANFH,but its expression was weaker with time-lapse.It indicated that hormone could inhibit the expression of VEGF,hinder the rebuild of blood vessel,and then aggravate avascular necrosis of femoral head.
Avascular Necrosis
Pathogenesis
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