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首页> 外文期刊>Osteoarthritis and cartilage >Spontaneous osteonecrosis of the knee: biochemical markers of bone turnover and pathohistology.
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Spontaneous osteonecrosis of the knee: biochemical markers of bone turnover and pathohistology.

机译:膝部自发性骨坏死:骨转换和病理组织学的生化标志物。

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OBJECTIVE: The aim of this study was to evaluate bone metabolism in patients with spontaneous osteonecrosis (ON) of the medial femoral condyle. METHOD: In 22 consecutive patients, undergoing total knee arthroplasty, biochemical markers of bone metabolism were measured in aspirates from cancellous bone and in samples obtained simultaneously from peripheral blood. Specimens of the medial femoral condyle were available for histologic examination and the lesion size, assessed on radiographs, was compared with the results from bone turnover measurements. Twenty patients with osteoarthritis (OA) of the knee served as a control. Bone-specific alkaline phosphatase (bone ALP), osteocalcin (OC), procollagen type I N-terminal propeptide (PINP), and C-terminal cross-linking telopeptide (ICTP) were studied. RESULTS: Mean serum levels of analytes were not different in patients with ON and OA. The serum concentrations averaged 16.2 vs 13.3 ng/mL (OC), 10.2 vs 12.1 ng/mL (bone ALP), 4.6 vs 4.1 ng/mL (ICTP), and 33.2 vs 40.4 ng/mL (PINP) in patients with ON and OA, respectively. In samples obtained from cancellous bone, mean concentrations of all markers were elevated significantly when compared to serum levels. The mean marker concentrations in samples obtained from cancellous bone were 33.8 vs 43.3 ng/mL (OC), 34.6 vs 37.3 ng/mL (bone ALP), 64.8 vs 36.1 ng/mL (ICTP, P=0.02), and 208.0 vs 176.2 ng/mL (PINP) in patients with ON and OA, respectively. The lesion size was at mean 440.5+/-275.8mm(2) in knees with ON and did not correlate with either serum or bone concentrations of all markers tested (P>0.1). CONCLUSION: The marked elevation of markers in samples obtained from cancellous bone pointed at increased turnover in both diseases when compared to healthy individuals. In line with histologic findings of necrosis of subchondral bone, focal degradation of collagen type I was more pronounced in knees with ON. Mean serum concentrations of all markers, however, were not different from healthy individuals and thus did not provide any useful clue in the diagnosis spontaneous ON.
机译:目的:本研究旨在评估股骨内侧dy自发性骨坏死(ON)患者的骨代谢。方法:在连续进行全膝关节置换术的22例患者中,从松质骨的抽吸物中以及从外周血同时获得的样本中测量了骨代谢的生化标志物。股骨内侧dy的标本可用于组织学检查,并在X光片上评估病灶大小,并将其与骨周转测量结果进行比较。二十例膝关节骨关节炎(OA)患者作为对照。研究了骨特异性碱性磷酸酶(bone ALP),骨钙蛋白(OC),胶原蛋白I型N末端前肽(PINP)和C末端交联端肽(ICTP)。结果:ON和OA患者的平均血清分析物水平没有差异。 ON和ON患者的血清平均浓度分别为16.2 vs 13.3 ng / mL(OC),10.2 vs 12.1 ng / mL(骨ALP),4.6 vs 4.1 ng / mL(ICTP)和33.2 vs 40.4 ng / mL(PINP) OA,分别。从松质骨获得的样品中,与血清水平相比,所有标志物的平均浓度均显着升高。从松质骨中获得的样品中平均标志物浓度分别为33.8 vs 43.3 ng / mL(OC),34.6 vs 37.3 ng / mL(骨ALP),64.8 vs 36.1 ng / mL(ICTP,P = 0.02),208.0 vs 176.2 ng / mL(PINP)分别用于ON和OA患者。膝关节开通时,病变大小平均为440.5 +/- 275.8mm(2),与所有测试标记物的血清或骨浓度均无关(P> 0.1)。结论:与健康个体相比,从松质骨获得的样品中标志物的显着升高表明两种疾病的周转率均增加。与软骨下骨坏死的组织学结果一致,ON的膝盖中I型胶原的局灶性降解更为明显。但是,所有标志物的平均血清浓度与健康个体没有差异,因此在诊断自发性ON时没有提供任何有用的线索。

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