Non-traumatic osteonecrosis of the femoral head (ONFH) is believed to be avascular necrosis. Certainly, a disruption of a supplying artery induces necrosis in the supplying artery-dominant region. However, when an abnormality such as cell apoptosis, or another reason, is developed in the supplying artery-dominant region, it induces a disruption of the supplying artery. Therefore, to prove that ONFH is avascular necrosis, it is necessary to demonstrate the disruption of the supplying artery prior to histological osteonecrosis development. Here we investigate histologically, using a rat model, whether disruption of the supplying artery occurs before the initial development of ONFH following corticosteroid treatment. Rats were given imiquimod and methylprednisolone, and were sacrificed 1, 2, 3, 7 or 14 days after the last injection. At the sacrifice, the rat was perfused with 20 ml black Indian ink through the left ventricle. ONFH was observed in the Imiquimod + Methylprednisolone group at 7 and 14 days. The osteonecrotic area was not stained with perfused black Indian ink. However, the lateral portion of the femoral head near the superior retinacular artery was stained with the ink. In conclusion, the present study shows that the superior retinacular artery did not occlude before the initial development of ONFH histologically in rats.
References
[1]
Chang, C.C., Greenspan, A. and Gershwin, M.E. (1993) Osteonecrosis: Current Perspectives on Pathogenesis and Treatment. Seminars in Arthritis and Rheumatism, 23, 47-69. http://dx.doi.org/10.1016/S0049-0172(05)80026-5
[2]
Mont, M.A., Cherian, J.J., Sierra, R.J., Jones, L.C. and Lieberman, J.R. (2015) Nontraumatic Osteonecrosis of the Femoral Head: Where Do We Stand Today? A Ten-Year Update. The Journal of Bone & Joint Surgery American, 97, 1604-1627. http://dx.doi.org/10.2106/JBJS.O.00071
[3]
Atsumi, T. and Kuroki, Y. (1992) Role of Impairment of Blood Supply of the Femoral Head in the Pathogenesis of Idiopathic Osteonecrosis. Clinical Orthopaedics and Related Research, 277, 22-30.
[4]
Janke, L.J., Liu, C., Vogel, P., Kawedia, J., Boyd, K.L., Funk, A.J. and Relling, M.V. (2013) Primary Epiphyseal Arteriopathy in a Mouse Model of Steroid-Induced Osteonecrosis. The American Journal of Pathology, 183, 19-25. http://dx.doi.org/10.1016/j.ajpath.2013.03.004
[5]
Okazaki, S., Nagoya, S., Matsumoto, H., Mizuo, K., Sasaki, M., Watanabe, S. and Inoue, H. (2015) Development of Non-Traumatic Osteonecrosis of the Femoral Head Requires Toll-Like Receptor 7 and 9 Stimulations and Is Boosted by Repression on Nuclear Factor Kappa B in Rats. Laboratory Investigation, 95, 92-99. http://dx.doi.org/10.1038/labinvest.2014.134
[6]
Yamamoto, T., Hirano, K., Tsutsui, H., Sugioka, Y. and Sueishi, K. (1995) Corticosteroid Enhances the Experimental Induction of Osteonecrosis in Rabbits with Shwartzman Reaction. Clinical Orthopaedics and Related Research, 316, 235-243. http://dx.doi.org/10.1097/00003086-199507000-00033
[7]
Okazaki, S., Nishitani, Y., Nagoya, S., Kaya, M., Yamashita, T. and Matsumoto, H. (2009) Femoral Head Osteonecrosis Can Be Caused by Disruption of the Systemic Immune Response via the Toll-Like Receptor 4 Signalling Pathway. Rheumatology, 48, 227-232. http://dx.doi.org/10.1093/rheumatology/ken462
[8]
Okazaki, S., Nagoya, S., Tateda, K., Katada, R., Mizuo, K., Watanabe, S. and Matsumoto, H. (2013) Experimental Rat Model for Alcohol-Induced Osteonecrosis of the Femoral Head. International Journal of Experimental Pathology, 94, 312-319. http://dx.doi.org/10.1111/iep.12035
[9]
Sugioka, Y. (1978) Transtrochanteric Anterior Rotational Osteotomy of the Femoral Head in the Treatment of Osteonecrosis Affecting the Hip: A New Osteotomy Operation. Clinical Orthopaedics and Related Research, 130, 191-201. http://dx.doi.org/10.1097/00003086-197801000-00019
[10]
Trueta, J. and Harrison, M.H. (1953) The Normal Vascular Anatomy of the Femoral Head in Adult Man. The Journal of Bone and Joint Surgery. British Volume, 35-B, 442-461.
[11]
Theron, J. (1977) Superselective Angiography of the Hip. Technique, Normal Features, and Early Results in Idiopathic Necrosis of the Femoral Head. Radiology, 124, 649-657. http://dx.doi.org/10.1148/124.3.649