Comparison of histomorphological changes between osteoarthritis and kaschin-beck disease with knee arthroscope

Ming LING; Zhi YI; Yanhai CHANG; Jianfa LI; Zhenqun LUO

ABSTRACT

BACKGROUND:

The pathological changes of osteoarthritis are similar to that of kaschin-beck disease, but the cause of the latter is still unclear,damage is more serious. From the comparison of pathology changes between them, we hope to find out an effective therapeutic method with the assistance of arthroscope basing on the experiences in osteoarthritis.

OBJECTIVE:

To make comparison of the histomorphological changes between osteoarthritis and kaschin-beck disease with knee arthroscope,which give clues to the diagnosis and selection of operative technique for kaschin-bock disease under arthroscope.

DESIGN:

Case control study.

SETTING:

Department of Orthopaedics, Shaanxi People's Hospital.

PARTICIPANTS:

Thirty-five patients who needed arthroscope surgery due to severer knee osteoarthritis were randomly selected from Department of Orthopaedics, Shaanxi People's Hospital between April 1998 and September 2000; Meanwhile 31 patients with knee joint functional obstacle caused by kaschin-beck disease (epidemic disease area) were randomly selected from Luochuan Hospital of Shaanxi Province in November 2001.

METHODS:

Japanese made OLYMPUS series color television arthroscope and surgery system were used to carry out knee joint operations in all participants. During the operation, video recording, postoperative editing, photographs, comparison and analysis were conducted, in order to find out the pathological changes of the two groups in knee joint synovium, patella, femur, tibia and meniscus with the assistance of arthroscope.

RESULTS:

Totally 66 patients were enrolled in this study and all endamage in Kaschin-beck disease and osteoarthritis Injuries were graded into grade 0, 1, 2 and 3, there were 0,3,5,23 cases and 0,3,16,16cases correspondingly in kaschin-beck disease group and osteoarthritis cartilage damage was presented by big piece of cartilage peeled off, part of them came off leading to bone exposure, the exposed bone surface is uneven; while cartilage damage in osteoarthritis was presented by the wear of cartilage, moreover cartilage island was found remained in the exposed bone with the surface covered with fiber strips and the exposed observed in 24 patients with Kaschin-beck disease, 5 cases with coarse stress point and 19 cases with burr-like damage, amongst which there were 9 cases displayed both medial and lateral meniscus damages; in osteoarthritis group there were 16 cases showed meniscus damages including edge wears in11 cases and breakage in 5 cases.

CONCLUSION:

Cartilage damage in knee articular was obviously severer in Kaschin-beck disease than in osteoarthritis, although kaschin-beck disease is no matter resulting in serious knee joint damage, but its pathology changes are different from osteoarthritis, we should pay more attention to the peculiarity of big piece of cartilage peeling off during operations.