• 1Department of Orthopeadics, 2Department of Pathology, Nanjing First Hospital Affiliated to Nanjing MedicalUniversity, Nanjing Jiangsu, 210006, P. R.China.;
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【Abstract】 Objective To investigate both incidence and mechanism attributing to steroid-associated osteonecrosis
of femoral head(ONFH) using an experimental protocol with a single low-dose l i popolysaccharide (LPS) injection and
subsequently three injections of high-dose methylprednisolone (MPS). Methods Twenty-five New Zealand white rabbits with body weight of (3.0 ± 0.3) kg were divided randomly into 2 groups. In treatment group, 19 rabbits received one intravenous injection of LPS (10 μg/kg); 24 hours later, three injections of 20 mg/kg of MPS were given intramuscularly at an interval of 24 hours. Additional 6 rabbits which received normal sal ine injection at the same time point were used as controls(control group). The blood samples were collected for hematological examinations before and after LPS injection, MRI was performed on bilateral hip six weeks after last MPS injection, meanwhile, bone marrow was aspirated from femoral head region to evaluate stem cell’s activity. Bilateral femoral heads were harvested to make histopathology examination. Results All animals survived throughout the experiment period except one death on the second day after LPS injection. In the histopathological examination
for the femoral head, ONFH+ was observed in 16 rabbits (88.9%), and the lesions were mainly in the metaphysis. In ONFH+ rabbits, micro vessels fibrous thrombosis and extravascular marrow fat cell size increasing were found around necrotic bone; The femoral heads of control group had no changes. MRI accurate ratio was 93.8% (15/16). Compared to basel ine, a significant decrease in ratio of tissue plasminogen activator/plasminogen activator inhibitor 1 and activated partial thromboplatin time, and a significant increase in ratio of low-density l ipoprotein/high-density l ipoprotein were only found in ONFH+ rabbits (P  lt; 0.05). Meanwhile there was a significant decrease in the number of CFU-F (8.50 ± 9.63) compared with the control (70.17 ± 7.78, P  lt; 0.05). Conclusion A single low-dose LPS injection and subsequent three injections of high-dose MPS is effective on building steroid-associated ONFH model, coagulation and l ipometabol ism abnormal ity, activity degeneration of stem cell may be the key factors of ONFH.

Citation: YANG Jianping,WANG Liming,XU Yan,FAN Kewu,WANG Jinsong. AN EXPERIMENTAL OSTEONECROSIS OF FEMORAL HEAD INDUCED BY A COMBINATION OF A SINGLELOW-DOSE LIPOPOLYSACCHARIDE AND METHYLPREDNISONE. Chinese Journal of Reparative and Reconstructive Surgery, 2008, 22(3): 271-275. doi: Copy