Document Detail


Articular cartilage degeneration in post-collapse osteonecrosis of the femoral head. Radiographic staging, macroscopic grading, and histologic changes.
MedLine Citation:
PMID:  15930536     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Osteonecrosis of the femoral head is a debilitating condition characterized by progressive degeneration of bone that eventually leads to collapse of the femoral head in the majority of patients. Femoral head-sparing procedures have been more successful in pre-collapse stages of osteonecrosis than in post-collapse stages, although some patients with early post-collapse disease have had no additional progression of the disorder. Nevertheless, the effects of collapse on the articular cartilage are not well understood, and radiographic staging of femoral head collapse does not address the condition of the articular cartilage. METHODS: In the current study, we investigated the relationship between the mechanical properties of post-collapse articular cartilage and the histologic findings and macroscopic grades of the articular cartilage from hips with stage-IV osteonecrosis, those with stage-V osteonecrosis, and those without osteonecrosis. RESULTS: The cartilage from both stage-IV and stage-V hips showed significant degeneration compared with the normal control cartilage, but there was no significant difference between the two stages. There was significant variability in the histologic and mechanical properties of these samples that correlated strongly with the gross appearance of the cartilage surface but not with the lesion size. CONCLUSIONS: These results suggest that articular cartilage that appears macroscopically normal may remain mechanically functional even in patients with large osteonecrotic lesions or a late radiographic stage of the disease.
Authors:
Robert A Magnussen; Farshid Guilak; Thomas P Vail
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Journal of bone and joint surgery. American volume     Volume:  87     ISSN:  0021-9355     ISO Abbreviation:  J Bone Joint Surg Am     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-06-02     Completed Date:  2005-07-29     Revised Date:  2010-10-25    
Medline Journal Info:
Nlm Unique ID:  0014030     Medline TA:  J Bone Joint Surg Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1272-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Orthopaedics, Vanderbilt University, 137 Medical Center South, Nashville, TN 37232, USA.
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MeSH Terms
Descriptor/Qualifier:
Biomechanics
Cartilage, Articular / pathology*,  physiopathology
Femur Head / pathology*,  radiography
Femur Head Necrosis / pathology*,  physiopathology,  radiography
Humans
Orthopedic Procedures
Grant Support
ID/Acronym/Agency:
AG15768/AG/NIA NIH HHS; AR48182/AR/NIAMS NIH HHS; AR50245/AR/NIAMS NIH HHS; T35 GM8679/GM/NIGMS NIH HHS

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