Primitive Study On The Pathological Changes And Expression Of VEGF And BMP-2of The Femoral Head Necrosis In Different Etiology

Objective: To investigate the pathological changes and expression ofvascular endothelial growth factor(VEGF) and bone morphogeneticprotein-2(BMP-2) and its significance of the femoral head necrosis in differentetiology. To explore the pathogenesis of osteonecrosis of the femoralhead(ONFH). Provide a theoretical basis for clinical personalized treatment.Methods: Collect the specimens of femoral heads of ONFH as theexperimental group and the specimens of femoral heads of fresh femoral neckfracture as control group, overall specimens were collected from total articularreplacement arthroplasty in Liuzhou Worker’s Hospital from2011October to2013October. According to etiology, overall specimens were divided into fourgroups: steroid-induced necrosis of the femoral head(SANFH) group,alcohol-induced necrosis of the femoral head(AOFH) group,idiopathic ischemic necrosis of the femoral head group and fresh femoral neck fracture as control group. Observe their pathological change by using opticalmicroscope and detect the expression of VEGF and BMP-2in femoral headthrough making use of hematoxylin-eosin(HE) staining andimmunohistochemistry technique. Used SPSS17.0software in statisticalanalysis, inspection level α=0.05.Results: Pathological changes of the femoral head necrosis in differentetiology were very similar. the pathologic changes of femoral head specimens inthe optical microscope can be divided into four zones，as follows：the cartilagearea，the area of necrotic，the proliferation and repair area, the relatively normalarea. Compared with control group, Surface of the articular cartilage is shededand fragmented, Chondrocytes are irregularly arranged，cartilage matrix areinequalities. the area of necrotic can see a lot of empty lacunaes, trabecula bonebecome sparse， bone marrow cells become slight, and fat cells becomehypertrophy．the proliferation and repair are a large number of dense connectivetissue can be seen. The relatively normal area is similar to the control group.Relatively，the structure of trabecular bone is complete. Immunohistologicalstudy showed that the area percent of staining andthe mean optical density of VEGF and BMP-2in each experimental groupdecreased obviously as compared with control group. Result shows statisticalsignificance(P<0.05). The expression of VEGF in three experimental groups,There was no significance difference between the SANFH group, AOFH groupand the idiopathic ischemic necrosis of the femoral head group(P>0.05). The expression of BMP-2in three experimental groups, the area percent of stainingand the mean optical density of the AOFH group obviously higher than theSANFH group and the idiopathic ischemic necrosis of the femoral headgroup(P<0.05). There was no significance difference between the SANFH groupand the idiopathic ischemic necrosis of the femoral head group(P>0.05).However, the idiopathic ischemic necrosis of the femoral head group had ahigher count than the SANFH group. Through relevant analysis between VEGFand BMP-2, the expression of VEGF and BMP-2were postitivecorrelation(P<0.05).Conclusion:1、Osteonecrosis of the femoral heads with different etiology have similarhistological changes were observed by light microscopy. The microcirculationdysfunction Within the femoral head and the disturbed lipid metabolism mayplay an important role in the mechanism of the ONFH.2、Immunohistological study showed that the expression of VEGF andBMP-2in femoral head necrosis in different etiology were restrainedsignificantly. That may be an important reason that affect its rehabilitation andspeed up the illness progresses.3、There is something different in the expression of VEGF and BMP-2infemoral head necrosis in different etiology. It may be of benefit to the reparativeprocess of the femoral head necrosis if the expression of VEGF and BMP-2willincrease in the femoral head.