Observation Of Femur Osteochondral Pathology Shape Structure In Osteoarthritis Knee Joint

ObjectivesThrough Observation of femoral condyle pathological morphology in the kneeosteoarthritis patients，analyzing the characteristics of the pathological changes of distalfemoral cartilage layer，explore biomechanical influence on its change, order to provide atheoretical basis for clinical diagnosis and treatment and prevention for knee osteoarthritis.Materials and Methods1experimental materialThis experiment materials is the distal femoral cut bone grafts in voluntarycontributions from Taishan medical school affiliated hospital between November2011andOctober2012patients by total knee replacement.31cases of patients were diagnosed withprimary knee osteoarthritis,with different degree of knee varus, exclusion of rheumatoidarthritis and knee joint diseases caused by trauma, infection, tumor.2Experimental methodsDO standard X-ray inspection with knee joint in patients with lower limb lengthbefore the operation. Observe the cut bone first, including colour and lustre of the cartilage,presence with cartilage ulcer, osteophyte formation condition, etc. Make10mm*2mm*15mm size bone specimens including full-thickness cartilage and subchondral fromweight-bearing area in femoral condyle.Put in10%formaldehyde solution24h, decalcified2weeks, dehydration,then make into paraffin block. Serial section and thickness about5microns. HE staining,observe the change of pathologica morphology with full-thicknesscartilage and subchondral bone. Measuring thickness of ACC,TAC and NC. Putthemeasured results in defferent group according to the internal and external sideof femoralcondyle and BMI. BMI>=25as obese, BMI <25as non-obese group.3statistical methodsAnalysis by SPSS18.0statistical software. Take measurements mean+/-standarddeviation, said compared with t test between diffrent group;Using Pearson correlation analysis test correlation,Inspection level of α=0.05.Results1Gross obserbationThere are hyperplasia osteophyte formated on femur condyle, mainly distributed inthe edge of condyle, osteophyte on the medial condyl are more than the lateral condyle.cartilage degeneration is more serious on the medial condyl. its colour and lustre is dim,the color is grayish yellow, rough surface, visible softening oven, cartilage surface cracks,ulcer, subchondral bone exposed, flexibility is poor. lateral condyle is relatively normal tothe medial condyl, the surface is smooth, colour and lustre is good, also it has ulcerformation but shallow than the medial condyl, rare cracks, no cartilage full-thicknessdefects.2histology observationthe thickness of cartilage is irregular attenuation and cartilage is ibrosis, arrangementof cartilage cells are disordered, cell count decreased, cartilaginous sclera continuity isinterrupt. visible crack limitation and superficial or deep, the subchondral bone isoutleakage, cartilage coloboma, the thickness of ACC is thickening, the thickness canreach nearly880microns; Tidemark forward, copy, enlargement, and even double tiemarkstructure.3quantitative observationThe thickness of NC or TAC in medial femoral condyle is much less than the lateralfemoral condyle,it was significant on statistics(p<0.05); The thickness of ACC in medialfemoral condyle is more than the lateral femoral condyle, it was significant onstatistics(p<0.05); The ratio of ACC/TAC in medial femoral condyle is more than thelateral femoral condyle,it was significant on statistics(p<0.05);The thickness of condyles offemur NC in obesity group is less than the non-obesity group, it was significant onstatistics(p<0.05).Conclusion1It has specific pathological changes on cartilage layer of condyles of femur in Kneeosteoarthritis patients.2The thickness of the NC and TAC in femoral distal medial condyle are less than inthe lateral condyle; The thickness of the ACC and The ratio of ACC/TAC are greater thanin the lateral condyle with patients with knee varus. It was negative correlation between thethickness of the NC in femoral distal medial condyle and Knee varus Angle. It was positivecorrelation between the ratio of ACC/TAC and Knee varus Angle. 3The thickness of the NC in femoral distal condyle with obese patients issignificantly smaller than the non-obese patients, It was negative correlation between thethickness of the NC and BMI.