Email this article Morphofunctional remodeling of bone tissue during periprotheric fractures in the femoral component
- Authors: Batpenov N.D.1, Rakhimov S.K.1,2, Stepanov A.A.1, Orasbaev D.A.1, Manekenova K.B.2, Smailova G.K.3
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Affiliations:
- Scientific Research Institute of Traumatology and Orthopedics
- Non-commercial joint-stock company “Astana medical university”, Nur-Sultan
- Non-commercial joint-stock company “Astana medical university”
- Issue: Vol 27, No 2 (2020)
- Pages: 24-29
- Section: Original study articles
- URL: https://journals.rcsi.science/0869-8678/article/view/34202
- DOI: https://doi.org/10.17816/vto202027224-29
- ID: 34202
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Abstract
Periprosthetic fractures in the area of the femoral component after hip replacement are one of the reasons for performing revision surgery. The treatment is always associated with many complications and therefore does not lose its relevance. The aim of our research was a pathomorphological study of bone tissue repair and reactive changes in the soft tissues around the periprosthetic fracture after arthroplasty. The research results will predict the long-term outcome and stability of the revision endoprosthesis.
Materials and methods. The materials for pathomorphological studies were biopsy, (11 — periprosthetic fractures in the zone of the femoral component, 5 — from the hip joint), fragments of bone tissue from the zone of the periprosthetic fracture, femoral canal, altered connective tissue obtained by repeated interventions in the area of periprosthetic fracture, and revision endoprosthetics. Pathomorphological studies of biopsy specimens of bone fragments and soft tissues were carried out after conventional histological processing with the production of histological sections, 5–7 μm thick, followed by staining with hematoxylin and eosin and according to Van Gieson.
Results. Morphological signs of structural disorganization of bone tissue in the fracture zone were revealed after fragments of bone and soft tissues were removed from the fracture zone; various options for repair of bone tissue were investigated, as well as reactive changes up to ischemia from the surrounding soft tissues were observed. Signs of damage to the tubules, lacunae and trabeculae, and with them the intraosseous branches of the supplying artery were noticed. Bone tissue repair in the area of periprosthetic fractures was carried out in various ways: due to activation of osteoblasts, through endesmal osteogenesis (from preexisting fibrous structures), endochondral osteogenesis (from provisional corns), as well as mixed osteogenesis from complexes of bone–cartilaginous tissue. Slowing of osteogenesis was the reason for the formation of appositional gluing lines in bone trabeculae, which are considered as a morphological sign of delayed osteogenesis. The absence of multinucleated osteoclasts in the bone tissues we studied is apparently due to the fact that pathological osteolysis with signs of ischemia does not develop in the fracture zone.
Conclusion. The results of our histopathological studies indicate that by the time of revision endoprosthetics in the area of femoral fractures, morphological signs of a slowdown in reparative osteogenesis develop with the pathological functional remodeling of bone tissue and microischemia in the bone and, of course, in the surrounding soft tissues.
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##article.viewOnOriginalSite##About the authors
Nurlan D. Batpenov
Scientific Research Institute of Traumatology and Orthopedics
Author for correspondence.
Email: niitokz@mail.ru
ORCID iD: 0000-0001-5607-3397
Doctor of Medical Science, Professor, Corresponding member of Academy of Medicine Science, Director
Kazakhstan, Nur-SultanSerik K. Rakhimov
Scientific Research Institute of Traumatology and Orthopedics; Non-commercial joint-stock company “Astana medical university”,Nur-Sultan
Email: rakhimovsk@mail.ru
Doctor of Medical Science, Professor, Chief Scientific Researcher; Curator of Polytrauma Department, Professor of the Department of traumatology and orthopedics
Kazakhstan, Nur-SultanAlexei A. Stepanov
Scientific Research Institute of Traumatology and Orthopedics
Email: jsars@mail.ru
Head of the Department of traumatology No. 2
Kazakhstan, Nur-SultanDidar A. Orasbaev
Scientific Research Institute of Traumatology and Orthopedics
Email: zh.aitykova@mail.ru
resident of the traumatology department No. 2 (polytrauma)
Kazakhstan, Nur-SultanKenzhegul B. Manekenova
Non-commercial joint-stock company “Astana medical university”,Nur-Sultan
Email: rakhimovsk@mail.ru
Doctor of Medical Science, Professor, Head of the Department of Pathologic Anatomy
Kazakhstan, Nur-SultanGulzira K. Smailova
Non-commercial joint-stock company “Astana medical university”
Email: rakhimovsk@mail.ru
Candidate of Medical Science, Assistant of the Department of Pathologic Anatomy
Kazakhstan, Nur-SultanReferences
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