Journal of the Korean Orthopaedic Association (대한정형외과학회지)

Korean Orthopaedic Association (대한정형외과학회)
권호 표지

Acetabular Degeneration in Osteonecrosis of the Femoral Head

대퇴골두 골괴사에서 비구 연골의 변성

Lee, Soo-Ho;Kwon, Ki-Dae;Lee, Sang-Won;Cho, Su-Hyun;Ahn, Hyung-Sun
이수호;권기대;이상원;조수현;안형선

  • Published : 20040000
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Abstract

Purpose: To determine the degree of acetabular cartilage degeneration and factors that influence acetabular cartilage degeneration in osteonecrosis of the femoral head (ONFH). Materials and Methods: We obtained acetabular cartilage from weight bearing and non-weight bearing portions, including subchondral bone, from 34 hips in 32 patients with ONFH who underwent total hip arthroplasty. Histologic grading by Hematoxylin & Eosin staining and Safranin O staining, and immunohistochemical staining with chondroitin sulfate antibody and type II collagen antibody were performed. Results: Histological grade had no significant correlation with stage, age, weight, or duration or degree of head depression, by the Wilcoxon rank sum test. The weight bearing and the non-weight bearing portions of acetabular cartilage were divided into two groups according to the existence and non-existence of femoral head depression. A significant difference (p=0.01), by Fisher’s exact test, was found between the two weight bearing groups in terms of histologic grade. However no significance (p=0.45) was found between the two non-weight bearing groups. The distribution of type II collagen antibody's stainability score show most values in the normal range, while that of chondroitin sulfate antibody's was mainly in the upper. Conclusion: The degeneration of the weight bearing portion of acetabular cartilage in ONFH is considered to be due to local rather than general changes. When head depression in absent, acetabular cartilage degeneration is less severe than previously reported.

목 적: 대퇴골두 골괴사에서 비구연골의 변성정도와 이에 영향을 미치는 요소들을 알아보고자 하였다. 대상 및 방법: 본원에서 대퇴골두 골괴사로 인공 고관절 치환술을 시행한 환자 32명, 34 고관절을 대상으로 연골하골을 포함한 비구연골을 체중 부하 부위와 비체중 부하 부위에서 채취하여 Hematoxylin & Eosin 염색 및 Safranin O 염색을 시행하여 조직학적 변성 정도를 분류하였고, 부가적으로 chondroitin sulfate 항체와 II형 collagen 항체를 사용하여 면역 조직화학염색을 시행하였다. 결 과: 병기와 나이, 이환기간, 체중, 대퇴골두 함몰의 정도(mm)와 조직학적 분류간의 상관 관계에 대해서 Wilcoxon rank sum test를 시행하였으나 각각 p=0.67, p=0.75, p=0.54, p=0.69, p=0.61로 상관관계가 없었다. 비구연골의 체중 부 하 부위와 비체중 부하 부위를 각각 대퇴골두 함몰이 있는 경우와 없는 경우로 구분하여 조직학적 염색도를 Fisher’s exact test로 시행하여 비교한 결과 체중 부하 부위의 두 집단간에는 유의한 차이가 있었으나(p=0.01), 비체중 부하 부위의 두 집단간에는 유의성이 없었다(p=0.45). 면역화학조직 염색상 II형 collagen 항체의 염색성의 분포는 정상 범위가 제일 많았고, chondroitin 항체의 경우 염색성의 증가가 제일 많았다. 결 론: 대퇴골두 골괴사에서 비구연골의 체중 부하 부위에서의 변성은 전반적인 변화라기 보다는 대퇴골두 함몰에 의한 국소적 변화로 사료되었다. 대퇴골두 함몰이 없는 경우 비구연골의 변성은 과거에 발표된 논문들에서 보고된 것보다 미약하거나, 또는 거의 없는 것으로 보였다.

Keywords

References

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