Analysis Of The Distribution Of Microvessels,osteoblasts And Osteoclasts In Avascular Necrosis Of Femoral Head Based On The Principle Of Treating Disease From The Root

ObjectiveThe purpose of this study was to observe the expression of CD34,CD105,OPG,RANKL,ALP and TRAP in different regions of bone tissue after femoral head necrosis,and to further analyze the correlation between CD34,CD105 and OPG,RANKL.We wanted to reveal the role of microvasculature and osteogenic-osteoclast balance system in the pathogenesis of femoral head necrosis.We hoped to provide some theoretical basis for the pathogenesis of the femoral head necrosis from the microstructure,and provide some theoretical basis for better prevention and treatment of femoral head necrosis at the micro level.MethodsThis study selected femoral head necrosis hospitalized patients with total hip arthroplasty in Guangzhou First Hospital Affiliated Hospital of the orthopedic department from October 2017 to December 2017.Ten specimens of osteonecrosis of the femoral head that meet the inclusion criteria were collected.Each specimen was divided into 4 groups according to the necrosis area,normal area,sclerosus band and granulation tape.Ten specimens in each group were fixed,decalcified,embedded in paraffin and sliced.The expression of CD34,CD105,OPG,RANKL,ALP and TRAP in each group were analyzed by immunohistochemically,ALP and TRAP stainingstaining.The difference of expression of different factors in each group was analyzed by microscope and image analysis software.Results1.The expressions of CD34,CD105,OPG,RANKL,ALP and TRAP in each group were significantly different(P <0.05).Among them,CD34 was the highest expression in normal area and the lowest in necrotic area,which was significantly different from the other three groups(P <0.05).The expression of CD105,RANKL and TRAP was highest in necrotic area and statistically significant compared with the other three groups(P <0.05).The expressions of OPG and ALP were the highest in sclerotic zone and the lowest in necrotic zone,which were significantly different from the other three groups(P <0.05).2.CD34 expression and OPG,RANKL expression no significant correlation;CD105 and OPG has a negative correlation,CD105 and RANKL has a positive correlation.ConclusionThe normal microvessels are mainly distributed in the normal area.The unstable microvessels are mainly distributed in the necrotic area and the granulation area.Osteoclasts and the osteoclasts are in dynamic equilibrium in normal areas.The necrotic area showed active osteoclasts,sclerosus band showed active osteogenesis and granulation tape tended to be active in osteoclast.The unstable microvascular marker CD105 was negatively correlated with osteogenic factor OPG and positively correlated with osteoclastic factor RANKL.It is suggested that unstable microvessels may play a role in the process of necrosis of the femoral head through the osteo-osteoclast balancing system,which may explain the pathogenesis of femoral head necrosis to a certain extent.However,the exact mechanism needs further investigation.