Comparative Study About The Different Pathological Change Between Traumatic Osteonecrosis Of Femoral Head With Glucorticoid-induced Necrosis Offemoral Head

Objective:To discuss the pathological change in avascular osteonecrosis of the femoral head(ONFH) caused by trauma. Using human femoral head as the specimen and comparing the similarities and differences with the femoral head of the animas. To define the pathogenesis action of the disord er fo the fat metabolism in causing osteonecrosis of the femoral head (ONFH). It cold clarify the pathogenesis osteonecrosis of the femoral head (ONFH) and provide new theories basis for prevention and cure the osteonecrosis of the femoral head.Methods:40 casses osteonecrosis of the femoral head(ONFH) 43 femoral heads as studying specimen. Another 10 cases femoral head as normal group. Include 20 cases caused by taking glucocorticoid,20 cases caused by trauma. All specimen were divided into a few groups according it's pathogeny which studied with three methods:1). General pathological histological analyze by HE stainings Observing configuration of the fat cell under microscope and using computer image analysis system to analyze the change of diameter, perimeter and area of the fat cell. To account the ratio of the marrow cell and fat tissue 2). To observe the change of the ultrastructure of the bone cell by transmission electron microscopy(TEM) and observe the lipid tissue in the bone cell3). Fat staining to display the change of the lipid component.Results:In cases caused by glucocorticoid which the ratio of fat tissue and the marrow cell is higher than other groups. The quantity of the fat cell increase, the volume of the fat cell enlarge and lipid was found in bone cell. The quantity of the empty bone lacuna increased. The area of the osteonecrosis not only found at the bearing region but also found in the non-bearing region. Part of the marrow cavity was filled with lipid tissue. Osteonecrosis and fracture of the bone trabecula were increased remarkably. However, the traumatic group and the other group were not found the change that mentioned above.Conclusion:Fat cell in the bone marrow increase in quantity and volume were found in patients with osteonecrosis of femoral head(ONFH) caused by taking hormone. This result is analogous to most animal experiments, but is not closely relevant to total body's lipid metabolism. In traumatic group, there are not increase of fat cell in quantity and volume. Glucocorticoid correlate to lipid metabolism disorder. The bone marrow cavity are filled with lipid tissue, which correlate closely with osteonecrosis caused by taking glucocorticoid Early high pressure in the osteonecrosis of the femoral head and local ischemic in the femoral head correlate closely with taking glucocorticoid. It will help us to ascertain the pathologeny and choice the appropriate method to treat ONFH and provide a new way for the prevention and treatment of ONFH.