Expression Of Matrix Metalloproteinase-13in Synovium Of Early Osteonecrosis Of Femoral Head

Background: Osteonecrosis of fermoral head is a common orthopaedic disease. Thepathogenesis of osteonecrosis of fermoral head is varied. But the common pathogeny isbone tissue ischemia necrosis which cause the collapse and deformation of the femoralhead and eventually developed into osteoarthritis. Previous research has focused on thechange of the bone tissue and cartilage of the femoral head after the onset ofosteonecrosis of femoral head. But in recent years with the development oficonography inspection techniques, it had been found that synovial membrane reactionhad appeared before the collapse of the femoral head in many patients withosteonecrosis of femoral head in clinical work. The synovial membrane reactioninclude mang kinds of inflammatory change such as joint synovial fluid increase,synovial hyperplasia, synovial erosion of cartilage and so on. In the process ofdegenerative osteoarthritis, synovial membrane reaction is often secondary to thedetriment of cartilage and bone tissue. Therefore, synovial pathological process inosteonecrosis of femoral head may different with degenerative osteoarthritis. Its role inosteonecrosis of femoral head is still need further research. Matrixmetalloproteinases-13is a key medium in the process of osteoarthritis. The expressionof matrix metalloproteinases-13is very low in the normal synovial tissue. Physical andchemical stimulation activates the gene of matrix metalloproteinases-13in synovialcells of the osteoarthritis patients and causes the transcription and translation of matrixmetalloproteinases-13. And the early mechanism of cartilage destruction is started. Objective: In order to further understand the synovial pathological changes inosteonecrosis of fermoral head and for providing objective evidence of synovialtreatment of early osteonecrosis of fermoral head, this study mainly researchs themorphology change of synovial membrane and the expression of matrixmetalloproteinases-13protein and mRNA in synovial membrane of both osteonecrosisof fermoral head patients and osteoarthritis patients.Methods: The cases are collected from patients visited and operated at No.1Dept oforthopaedics in the First Affiliated Hospital of Anhui Medical University in the periodof September2011to June2013. Those causes includes30osteonecrosis of fermoralhead patients,30hip osteoarthritis patients, and30transcervical fracture patients. Thehip joint synovial tissues were dissected during operation. After embedded in paraffinsection, investigate expression of matrix metalloproteinases-13protein andmorphological change of synovium by immunohistochemical technology. Extractmatrix metalloproteinases-13mRNA from synovial tissue and reverse transcript cDNAsynthesis. Investigate expression of matrix metalloproteinases-13mRNA of synoviumby RT-PCR technology. Compare the expression between different patients.Result: Immunohistochemistry results showed statistically significant difference inexpression of matrix metalloproteinases-13protein in osteonecrosis of fermoral headpatients and osteoarthritis patients between transcervical fracture patients (P＜0.05).No statiscially significant difference between osteonecrosis of fermoral head patientsand osteoarthritis patients (P＞0.05). RT-PCR results showed statistically significantdifference in expression of matrix metalloproteinases-13mRNA in osteonecrosis offermoral head patients between osteoarthritis patients (P＜0.05).Conclusion: High expression of matrix metalloproteinases-13protein in osteonecrosisof fermoral head patients and osteoarthritis patients show they may have the same synovial pathological mechanism. It show that both patients may have the samesynovial pathological mechanism and cause the detriment of the articular cartilage ofthe femoral head. But higher expression of matrix metalloproteinases-13mRNA inosteonecrosis of fermoral head patients than osteoarthritis patients show the severity ofabnormality synovium is different. The severity of abnormality synovium may hascorrelation with the process of osteonecrosis of fermoral head. But this study cannotprove matrix metalloproteinases-13has the correlation whith the process ofosteonecrosis of fermoral head.