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The fate of the articular cartilage in intracapsular fracture of the femoral neck (articular cartilage in femoral neck fracture)

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Archiv für orthopädische und Unfall-Chirurgie, mit besonderer Berücksichtigung der Frakturenlehre und der orthopädisch-chirurgischen Technik Aims and scope Submit manuscript

Summary

The fate of the articular cartilage of the hip joint with intracapsular neck fracture was studied by histological, histochemical and autoradiographic techniques and by using a polarized microscope and a scanning electron microscope.

Cartilage specimens from 93 femoral heads and 7 acetabula were obtained from fractured hips 2 days to 4 1/3 years postfracture and from control hips with various disorders.

The cartilage degeneration appeared 2 weeks after fracture and advanced steadily with time. The matrix was covered, invaded and ultimately replaced by the fibrous tissue. Chondrocyte viability, though it was lost from the surface, was recognized in the deep matrix even in the oldest fracture examined.

It is concluded that the humoral factor directly caused by the injury as well as the biomechanical impairment, i.e. a loss of physical stress, may play an essential role in the pathogenesis of the degeneration. The possibility of regeneration was discussed.

Zusammenfassung

Um den Verlauf der Knorpeldegeneration im Hüftgelenk mit intrakapsulärer Schenkelhalsfraktur klarzumachen, wurden morphologische und autoradiographische Untersuchungen durchgeführt.

2 Wochen nach einer Fraktur fanden sich schon Zeichen von kartilagener Degeneration, und sie entwickelten sich mit der Zeit. Die Matrix war bedeckt, infiltriert, und sie wurde durch fibröse Gebilde ersetzt. Die Chondrocyten überlebten nicht mehr in der Oberfläche, jedoch bleiben sie, sogar an älteren Frakturen, lebhaft in der Tiefe der Matrix.

Wir sind der Ansicht, daß nicht nur humorale Faktoren, die direkt durch Unfall ausgelöst wurden, sondern auch biomechanische Läsionen, d. h. Auslösen des physikalischen Streß, eine große Rolle spielen können. Die Möglichkeit der Regeneration wurde diskutiert.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Faculty of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyoku, 606, Kyoto, Japan

    Hayato Hirotani & Tetsuo Ito

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  1. Hayato Hirotani
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  2. Tetsuo Ito
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Hirotani, H., Ito, T. The fate of the articular cartilage in intracapsular fracture of the femoral neck (articular cartilage in femoral neck fracture). Arch orthop Unfall-Chir 86, 195–209 (1976). https://doi.org/10.1007/BF00415331

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  • DOI: https://doi.org/10.1007/BF00415331

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