Observation Of Pathology Shape Structure Osteoarthritis Anthropometric Knee Joint Of Osteochondral

Osteoarthritis (OA) is a degeneration of articular cartilage at the core, involving the bone and including synovium, joint capsule and other structures of the chronic joint inflammation; is a sterile, chronic, sexually assaulted joint, especially weight-bearing joints diseases. Performance for the destruction of articular cartilage, osteophyte formation of articular surface, synovial cell hyperplasia, synovitis and joint space narrowing. Osteoarthritis is the world's most common joint disease, increasing age, a rapid increase in morbidity, and the elderly and disabled joint pain factors.According to the World Health Organization (WHO) statistics, osteoarthritis prevalence rate in women accounted for fourth place in the male prevalence rate in the eighth accounted for the domestic statistical data shows that the number of people suffering from bone and joint of the total population 3%, mostly for knee osteoarthritis, 55-year-old people over there is X-ray manifestations of osteoarthritis of the knee by about 60% of the elderly over 65 years of age the incidence of bone and joint up to 85% over the age of 75 everyone who has at least one joint osteoarthritis changes. Of the total population in the United States 15 percent of arthritis patients, of which 43% for osteoarthritis, amounting to 16 million; year retirement because of osteoarthritis and the number of the total number of retirement accounts for more than 5%, and the number of retirement due to heart disease is similar. According to statistics there are about 190 million worldwide patients with osteoarthritis, but the number is still increasing.The occurrence of osteoarthritis and joint local factors, systemic factors and individual genetic quality are closely related. Articular cartilage and subchondral bone, by direct or indirect pressure and friction injury onset osteoarthritis may be a major predisposing factor. In addition, increased with age, relaxing ligaments around the joints, nervous reflex can be slow and to injuries such as joint instability, resulting in imbalances and the pressure of cartilage damage, which appears to activate chondrocytes, proteinases and inflammatory cytokines secretion such as pathological changes of osteoarthritis. In addition to the role of articular cartilage damage, the induced osteoarthritis another factor is the different causes of the subchondral bone tissue of the abnormal fine structure. Clinical study found that many patients with osteoarthritis of the articular cartilage that occur before the morphological changes of subchondral bone sclerosis, such as X-ray changes. Repeated micro-trauma of the articular cartilage can cause bone tissue under the micro-fractures and articular cartilage caused by the biomechanical and metabolic changes, bone sclerosis and osteophyte formation. However, bone and joint diseases in the pathological calcification of the structure lace depth understanding of the lack of change.To better understand the calcified layer of cartilage of bone joints of the pathological changes, the study selected the most representative of osteoarthritis knee study, through the general observation; pathologically HE staining combined, lycopene red O / Fast Green staining, Mr library Sa staining, toluidine blue stain, Sirius Red staining in a number of ways to carry out histological observation; and ultrastructural analysis of scanning electron microscopy and other methods, from different structural levels of bone cartilage of osteoarthritis of the pathological calcified layer structure in-depth study .Materials and methods1.Specimen Source: selected from the clinical specimens were diagnosed as degenerative knee osteoarthritis based on the site for patients with weight-bearing area of femoral condyle, in which one cases of male, female 20 cases; age: 65.57±7.43 years; height: 155.38±5.32cm ; weight: 59.95±8.99kg; left knee nine cases, 12 cases of right knee.2.Imaging Observation: The patient standing with his legs apart 60°, knee to knee joint, whichever is the mid-point, at x-ray film projector ray films according to the center line, step forward limb flexion 30°, the knee joint for point at the x-ray film projector according to the center line of the lateral film.3. General observation: osteochondral tissue from eight cases, under the stereomicroscope observation platform, 10-fold was observed at all levels osteochondral longitudinal sections of the general form of organization structure, and then photographed with a digital camera.4. Histological observation: the preparation of conventional paraffin sections to carry out. HE stains. Annona Red O / Fast Green staining, von Cusa staining, toluidine blue stain, Sirius Red staining.5. Ultrastructural observation: fresh femur specimens from eight cases, preparation of bone cartilage tissue, conventional fixation, dehydration, spray gold treatment, the use of scanning electron microscopy of articular cartilage surface and the vertical section of the ultrastructure of bone cartilage.6. Statistical analysis: SPSS 11.0 statistical software applications for statistical analysis, measurement data, said the use of x±s.Results1. Case data: a total of 21 cases of selected patients with osteoarthritis of the knee replacement removed specimens, of which one cases of male, female 20 cases; left knee nine cases, 12 cases of right knee. Average age: 65.57±7.43 years; the average height: 155.38±5.32cm; average weight: 59.95±8.99kg; average duration: 13.04±9.66 years.2. Imaging observation: joint swelling joint effusion organizations; joint space narrowing, severe cases, joint space disappeared; articular surface density increased peripheral lip-like changes can be seen; subchondral cortical sclerosis, have broken trabeculae; appear cortical bone Under the cystic changes, osteophyte formation and intra-articular loose bodies and so on.3. General observation: the cartilage surface defects, uneven, thinning of the cartilage layer, bone cartilage Profile shows clear three-tier structure, tide-line fracture, gap widened, thickened calcified cartilage layer.4. Histological observation: The main pathological changes: (1) copy the tidemark, drift; (2) layer thickening with calcification of vascular ingrowth; (3) non-calcified and calcified cartilage layer of typeⅠcollagen protein fiber-like change; (4) gap widened tidemark; (5) the deep and calcified cartilage defect.5. Ultrastructural observation: osteoarthritis cartilage surface is not flat, there are obvious scale or bran-like changes in the ridge and around the fracture there is an obvious and large and small, superficial ulcers, ulcers have thickness ranging from small holes, and protruding rough, we can see the cartilage cells and collagen fibers exposed.6. Statistical analysis of results showed that all specimens of both tidemark replication, drift, from a normal to Article 4-16; calcified layer of maximum thickness from 300um to 900um. Other pathological changes in blood vessels into the pathology of 12 cases of the right, accounting for 57% of the total number of cases; occurred right calcified layer of eight cases of defects, accounting for 38.1 percent of total number of cases; tidemark widened gap of five cases, the total number of cases of 23.8%; calcified layer of fibrosis occurred in three cases, the total number of 14.3 percent pathology.ConclusionsIn this study, the most representative selection of primary OA of the knee joint for the study, through the general observation; pathologically HE staining combined, lycopene red O / Fast Green staining, von Cusa staining, toluidine blue stain, Sirius Red staining methods such as histological observation; ultrastructural scanning electron microscope analysis, bone on bone arthritis calcified cartilage layer Pathomorphological observation results show that:1. Primary OA of the three-tier structure of vertical section of bone cartilage showed a clear fracture line surges, gaps widened, thickened calcified cartilage layer.2 The main histopathological changes include: (1) copy the three-tier structure of tidemark, drift; (2) layer thickening with calcification of vascular ingrowth; (3) non-calcified and calcified cartilage layer fiber-like change; (4)tidemark gap widened; (5) the deep and calcified cartilage defect.3. Ultrastructure osteoarthritis significantly scale or bran-like changes in the ridge and around the fracture there is an obvious and large and small, superficial ulcers, ulcers have thickness ranging from small holes, and protruding rough, shows that exposure of cartilage cells and collagen fibers.4. 0A primary calcification seen increased thickness, with an average of 895±24μm, and the normal (256±12μm) significant difference (p <0.01); tidemark of copy, the copy number of approximately normal (a) 10±6-fold; Other pathological changes in blood vessels into the pathology of 12 cases of the right, accounting for 57% of the total number of cases; occurred right calcified layer of eight cases of defects, accounting for 38.1 percent of total number of cases; tidemark widened gap of five cases, the total number of cases of 23.8%; calcified layer of fibrosis occurred in three cases, the total number of 14.3 percent pathology.5. Primary OA bone calcified cartilage layer of the early pathological changes in an in-depth study needed.