Summary
Thirty-three femoral heads taken from patients undergoing total hip replacement for osteoarthrosis and rheumatoid arthritis have been examined in undecalcified, plastic-embedded sections, using a quantitative histological method. The characteristic change of trabecular remodelling in the subchondral cancellous bone of the femoral heads was that total osteoid surface in the medial osteoarthritis (medial O.A.) and rheumatoid arthritis (R.A.) was significantly less than in the proximal osteoarthrosis (proximal O.A.) (P<0.01). Resorption surface was slightly greater in R.A. than in proximal O.A. (P<0.05). Bone area in the deep area was not different in each group. In the superficial area it was significantly less in medial O.A. than in proximal O.A. (P<0.05). The average width of trabeculae was slightly less in medial O.A. and R.A. It is suggested that subchondral trabecular remodelling may be a basic pathological process of general importance in the evolution of these diseases.
Zusammenfassung
33 Hüftköpfe, die von Patienten mit Coxarthrose und rheumatoider Arthritis stammen und bei denen eine Totalendoprothese durchgeführt wurde, wurden in unkalzifizierten plastikeingebetteten Schnitten untersucht, wobei eine quantitative histologische Methode zur Anwendung kam.
Die charakteristischen Veränderungen der trabikulären Struktur im subchondralen spongiösen Knochen der Hüftköpfe bestand darin, daß die gesamte Osteoidoberfläche bei den medialen Osteoarthrosen (Mediale O.A.) und rheumatoiden Arthritiden (R.A.) erheblich kleiner war als bei den proximalen Osteoarthrosen (proximale O.A.) (P<0.01). Die resorbierende Oberfläche war geringfügig größer bei den R.A. als bei den proximalen O.A. (P<0.05).
Die Ausdehnung des Knochens in den tiefergelegenen Schichten war in allen Gruppen gleich. In der oberflächlichen Schicht war sie erheblich geringer. Bei den medialen O.A. und R.A. als bei den proximalen O.A. (P<0.05). Die durchschnittliche Breite der Trabikular war bei der medialen O.A. und R.A. geringfügig kleiner. Es besteht die Vermutung, daß subchondraler Umbau der Trabikular ein grundlegender pathologischer Prozeß von allgemeiner Bedeutung in der Entwicklung dieser Krankheitsbilder sein könnte.
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Kusakabe, A. Subchondral cancellous bone in osteoarthrosis and rheumatoid arthritis of the femoral head. Arch orthop Unfall-Chir 88, 185–197 (1977). https://doi.org/10.1007/BF00415099
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DOI: https://doi.org/10.1007/BF00415099