[What is the effect of para-articular fractures on hyaline joint cartilage? Experimental electron optic studies of the rabbit on post-traumatic subchondral vascularization disorders].
Joint fractures can interrupt the arterial and venous blood supply to the hyaline cartilage. Previous studies revealed effects of venous engorgement and hypertension in the cartilage. In this study the influence of interruption of the blood supply on the development of osteoarthritis was analysed. In a prospective, experimental study in 40 rabbits all vessels in the patella were ligated and the cartilage was investigated after 2, 6, 12, and 24 weeks by transmission electron microscopy. After 2 weeks no degenerative signs were determined. After 6 weeks there were distinct signs of cartilage injury. The degeneration of the hyaline cartilage increased with time. The endpoint of injury was the destruction of the cartilage and necrosis of the chondrocytes, determined after an ischaemic period of 24 weeks. The stages of cartilage degeneration in our trial correspond to the changes that are well known to occur in osteoarthritis. In conclusion, interruption of the blood supply of the patella results in degenerative changes to the joint cartilage. This effects is related to the duration of ischaemia. On the basis of results we recommend early and watertight repositioning of fractured joints not only for biomechanical reasons but also to avoid irrevocable effects of interrupted blood supply on hyaline joint cartilage.
Simank
H G
HG
Chirurgische Universitätsklinik Mannheim.
Graf
J
J
Fromm
B
B
Niethard
F U
FU
D000818:Animals; D002358:Cartilage, Articular / Q000098:blood supply* / Q000473:pathology; D050723:Fractures, Bone / Q000473:pathology*; D007511:Ischemia / Q000473:pathology*; D007596:Joints / Q000293:injuries*; D008854:Microscopy, Electron; D010003:Osteoarthritis / Q000473:pathology*; D010329:Patella / Q000473:pathology; D011817:Rabbits
Welche Wirkung haben gelenknahe Frakturen auf den hyalinen Gelenkknorpel? Experimentelle elektronenoptische Untersuchungen am Kaninchen zur posttraumatischen subchondralen Vaskularisationsstörung.