Histological features of articular cartilage and bone marrow reparative potential under conditions of coxarthritis in patients with radiographic signs of epiphyseal dysplasia

Abstract

Coxarthritis in patients with radiographic signs of epiphyseal dysplasia causes disturbances of social adaptation of this patients group at a young age and ensure the relevance of studying the problem of optimizing the orthopaedic treatment of this patients category. Objective. To define the tactics of orthopaedic treatment in such patient category based on study of morphological features of articular cartilage and osteogenic activity of bone marrow stem stromal cells. Materials and Methods. We have clinically examined 68 adult patients having coxarthritis in the presence of radiological signs of epiphyseal dysplasia. In 52 cases we performed total hip and knee arthroplasty that allowed to obtain articular cartilage fragments for histological study and epiphysis bone fragments for study of reparative potential of the bone tissue. Results. In patients having coxarthritis that evolves on the ground of epiphyseal dysplasia by histological and cultural studies we have obtained the data as for deep microstructural disorders in joint cartilage matrix organization as a result of modification of collagen mesh in patients having epiphyseal dysplasia. We have identified the fact of significantly increased bone marrow stem cells proliferative potential at significantly decreased quantity of colony forming fibroblast units in spongious volume unit in epiphysis zone in this patients group which indicates a threat of decompensation of reparatory bone potential risk. Conclusions. Pathological factors of increasingly progressing course of osteoarthrosis in the presence of radiological signs of epiphyseal dysplasia are deep microstructural disorders of joint cartilage matrix organization as a result of modification of collagen mesh and consequent changes of epiphysis of the lower limbs form. There is no possibility of prevention and etiological therapy of coxarthritis evolving from epiphyseal dysplasia, meanwhile there is a threat of decompensation of reparatory bone tissue potential in epiphysis zone in this patient category. Therefore, in patients with coxarthritis and radiographic signs of epiphyseal dysplasia, resistant to the course of conservative treatment, it is advisable do not delay use the method of joint arthroplasty.