Pathology Appearance And Expression Of VEGF For Human Nontraumatic Osteonecrosis Of Femoral Head

Objective:To observe the pathology performance of human nontraumatic osteonecrosis of femoral head(NONFH).To detect the change of the expression of vascular endothelial growth factor(VEGF)of the femoral head in the nontraumatic osteonecrosis of femoral head and to explore its significance.Method:Collect 9 samples of femoral heads of NONFH as the experimental group and 9 samples of femoral heads of fresh femoral neck fracture as control group,overall examples were collected from total articular replacement arthroplasty.The samples are splitted in coronal plane, parallel to the coronal plane saw the bone coming 5mm thick.Make them into microtome section after the process of immobility, decalcification and paraffin-embedded.Observe their pathological change by using optical microscope and detect the expression of VEGF in femoral head through making use of immunohistochemistry.Results:In experimental group,the pathologic changes of femoral head specimens in the optical microscope can be divided into four zones,as follows:the cartilage area,the area of subchondral necrotic,the repair area, the relatively normal spongy bone area.(1)The cartilage area:Surface of the articular cartilage is sheded and fragmented.Chondrocytes are irregularly arranged.Cartilage matrix is uneven.Cartilage and subchondral trabecular bone are fractured or non-continuous.(2)The area of subchondral necrotic:Hematopoietic tissue reduces and even necrosis.Fat cells of bone marrow cavity proliferate and become hypertrophy.Trabecular become sparse,slight and cataclastic.There are more empty lacunaes and fragments of trabecular bone which are surrounded by loose connective tissue,osteoclasts can be seen around the fragments of trabecular bone.(3)The repair area:Around the necrotic area,there are inflammatory granulation tissue growth. In the area a large number of dense connective tissue can be seen. Around the old trabecular bone,there are more osteoblasts and the resulting new bone.(4)The relatively normal spongy bone area:Relativeiy,the structure of trabecular bone is complete.Hemopoietic tissue and adipocyte in bone marrow cavity are normal. The average gray value of the experimental groupis higher than the control group. Namely,compared with the control g roup,expression of VEGF in the experimental group is significantly weakened.Result shows statistical significance (P<0.01).Conclusion:In experimental group,the pathologic changes of femoral head can be divided into four zones, as follows:the cartilage area,the area of subchondral necrotic,the repair area, the relatively normal spongy bone area. There is not obvious repair responded between the cartilage area and the area of subchondral necrotic.The expression of VEGF in the experimental group is lower than the control group. If increases the expression of VEGF in the necrosis femoral head, will possibly promote the blood vessel regeneration and the new bone formation, then promote bone tissue own repairing.