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1.
Ultrasonographic examination of the tarsus was performed on four clinically and radiographically normal limbs of adult horses. Particular attention was paid to the articular cartilage surfaces of the trochlear ridges of the talus and the distal intermediate ridge of the tibia. Two separate measurements of articular cartilage thickness were acquired from a longitudinal view at each site. Anatomy was confirmed with post mortem dissection. Ultrasonography was found to be a practical method for imaging the articular cartilage over the trochlear ridges of the talus and distal intermediate ridge of the tibia. The cartilage appeared as a hypoechoic band overlying the hyperechoic subchondral bone. The mean cartilage thickness over the lateral and medial trochlear ridges of the talus and the distal intermediate ridge of the tibia were 0.57 mm, 0.58 mm and 0.7 mm respectively. These measurements may have value for comparison to thickened cartilage and lesions of osteochondrosis and abnormally thinned cartilage of osteoarthritis. Ultrasound examination was not helpful in evaluating the proximal and distal intertarsal and tarsometatarsal joints, the close proximity of the articular surfaces obscured visualization of the articular cartilage.  相似文献   

2.
Cartilage thickness measurement in foals   总被引：1，自引：0，他引：1  
The talus and proximal and distal epiphysis of the humerus, radius, femur, tibia and distal metacarpus of 20 foals aged 0 to 150 days were obtained at necropsy and sawn sagittally into slabs 4 to 8 mm thick. The thickness of the cartilage (articular cartilage and unossified epiphyseal cartilage) was measured in three to five places in each slab, using a sliding calliper. In most epiphyses, the site, or sites, of thickest cartilage was constant in all foals examined. The difference between thickest and thinnest cartilage within one epiphysis was greatest in distal femora and least in distal metacarpi. The sites of most common occurrence of osteochondrosis dissecans in tali and proximal humeri concurred with the site of thickest cartilage in these bones. The most common site of equine osteochondrosis, the middle and distal thirds of the lateral trochlear ridge of femora, is not the location of thickest cartilage in this epiphysis. Haematological epiphyseal osteomyelitis in foals occurs most frequently in the areas where cartilage thickness is greatest in the medial femoral condyle, talus and distal radius.  相似文献   

3.
A circular (5.5 mm diameter) full-thickness cartilage defect was created on the medial ridge of the talus in 12 skeletally mature dogs. In 6 dogs, the articular surface of the lesion was repaired, using an osteochondral graft obtained from the ipsilateral manus. The graft (digit I, first phalanx, distal articular surface and diaphysis) was contoured to obtain a press fit in the drilled talar recipient site. In 6 dogs, the lesion was not treated and healed by fibrous tissue replacement. Functional assessment (lameness, hock range of motion, joint stability, joint crepitus, and mid-femoral muscle circumference) was completed before surgery and at postoperative weeks 2 through 20. Radiographic assessment (periarticular soft tissue width, joint space width, osteophyte formation, and graft incorporation) was completed before surgery and at postoperative weeks 0, 6, 12, and 20. To facilitate histologic assessment, tissues were stained with toluidine blue and H&E. Histologic assessment of the articular surface on the surgically treated talus, ipsilateral tibia, and contralateral talus was completed, using a modification of the Mankin grading system. Subchondral bone was examined to assess graft viability and incorporation. Analysis of the ordinal data was completed, using a Mann-Whitney rank sum test. All dogs were fully weight bearing by postoperative week 7. Dogs without grafts had significantly (P = 0.036) better clinical function at postoperative week 6. Significant difference in functional assessment was not evident at postoperative week 20. Immediate postoperative radiographic assessment revealed significant (P = 0.005) difference between nongrafted and grafted groups. Significant difference was not observed at postoperative week 6, 12, or 20. All grafts appeared radiographically incorporated by postoperative week 12. All grafts restored joint surface congruity, whereas 3 of 6 nongrafted lesions had poor articular congruity. Of 6 grafts, 4 partially retained normal hyaline cartilage, resulting in significantly (P = 0.014) lower Mankin grades. Significant histologic differences between groups were not apparent when the apposing tibia and control talus were examined. Talar reconstruction by use of a phalangeal osteochondral graft is a viable surgical procedure. These data indicate that normal articular and subchondral architecture are more closely approximated by osteochondral reconstruction than by fibrous tissue repair.  相似文献   

4.
Articular surfaces of the pectoral limb were studied in 50 swine and are described in detail. Synovial fossae were not present at birth but were found commonly on the articular surface of the scapula, distal humerus, proximal radius, distal radius and distal surfaces of the intermediate carpal bone after four to five months of age. When present, they were bilaterally symmetrical and were located at the depth of a concavity of the articular surface. Microscopically, synovial fossae appeared as an invagination of articular cartilage extending into subchondral bone. Evidence of endochondral bone formation was less apparent at the depth of synovial fossae than in areas of weight bearing cartilage.  相似文献   

5.
REASON FOR PERFORMING STUDY: Pathological changes in the blood supply to growth cartilage have been implicated in the pathogenesis of osteochondrosis (OC) in horses, but have not been reported using vascular perfusion techniques. OBJECTIVE: To describe the developmental pattern of cartilage canal vessels in the distal tibial epiphysis and talar growth cartilage of foals. METHODS: Nine foals bred from parents with OC were sacrificed between the ages of 0 and 7 weeks to undergo a barium perfusion procedure. The distal end of the tibia and the entire talus were cleared in methyl salicylate and perfused vessels studied in the intact bones. Slabs with a thickness of 4-5 mm from 3 predilection sites for OC were examined in the stereomicroscope and with light microscopy. RESULTS: Cartilage canals were present for a limited period of growth. Perfused vessels initially entered canals from the perichondrium. Vessels in the proximal portion of canals retained their perichondrial arterial source throughout. With time, the ossification front advanced to incorporate the mid-portion of canals; and anastomoses formed between canal vessels and subchondral vessels. A shift occurred and vessels in the distal terminus of canals came to use subchondral vessels as their arterial source. Twelve histological lesions were found in 7 foals. All contained necrotic vessels surrounded by necrotic growth cartilage and 3 caused macroscopically visible delay in endochondral ossification. Lesions were located where vessels traversed the ossification front to enter the distal terminus of canals. CONCLUSION: Cartilage canal vessels are particularly susceptible to failure at the point where they cross the ossification front, with consequences for the viability of those chondrocytes that depend on them. POTENTIAL RELEVANCE: A better understanding of how lesions of OC arise may improve the ability to identify, monitor, prevent and treat this disorder. Involvement of cartilage canals in the pathogenesis of equine tarsal OC plausibly explains several clinical features of this disease.  相似文献   

6.
The elbows of 13 puppy cadavers were dissected, samples were taken for light and electron microscopy, and the thickness of the articular cartilage of the distal humerus and proximal ulna was measured. Throughout post natal development differences were found in the arrangement of the growth plate and articular chondrocytes. At birth, the articular surface had remnants of a fibrous limiting membrane that was continuous with the perichondrium, a finding not previously recorded in dogs. Orientation of the collagen fibrils within the matrix of the articular cartilage was initially lacking but became established by three weeks. In the humerus cartilage canals were present up to 12 weeks old. The articular cartilage of the humeral condyle varied in thickness across the joint surface, being thicker on the medial than on the lateral side; it was also thicker at the apex of the medial coronoid process. These regions of thick cartilage correspond with the sites where cartilage defects arise in elbow osteochondrosis. No histological evidence was found that the medial cornoid process of the ulna is a separate centre of ossification.  相似文献   

7.
OBJECTIVE: To determine the mRNA expression of bone morphogenetic protein (BMP)-6 and -2 and a BMP antagonist (Noggin) in horses with osteochondrosis. SAMPLE POPULATION: Samples of articular cartilage from affected stifle or shoulder joints of 10 immature horses with naturally acquired osteochondrosis and corresponding joints of 9 clinically normal horses of similar age; additionally, samples of distal femoral growth plate cartilage and distal femoral articular cartilage were obtained from a normal equine fetus. PROCEDURE: Cartilage specimens were snap-frozen in liquid nitrogen, and total RNA was isolated. Adjacent specimens were fixed in 4% paraformaldehyde for histologic examination. Expression of BMP-6, BMP-2, and Noggin mRNA was evaluated by real-time quantitative polymerase chain reaction (PCR) assays. Spatial tissue mRNA expression of BMP-6 was determined by in situ hybridization. RESULTS: Nucleotide sequences were obtained for portions of the BMP-6 propeptide and mature peptide region, as well as the signal and mature peptide region of Noggin. Expression of BMP-6, BMP-2, and Noggin mRNA was found to be similar in cartilage from normal and osteochondrosis-affected horses. Spatial expression of BMP-6 correlated with the middle and deep layers of articular cartilage; no differences were observed in overall expression between cartilage specimens from the 2 groups of horses. No expression of BMP-6 was found in the superficial layer, subchondral bone, or osteochondrosis-affected cleft fibrous tissue. CONCLUSIONS AND CLINICAL RELEVANCE: Although these signaling peptides may play important roles in cartilage differentiation, results did not provide evidence to suggest that they are involved in the disease process of osteochondrosis.  相似文献   

8.
Failure of the cartilage canal blood supply to epiphyseal growth cartilage has been implicated in the pathogenesis of articular osteochondrosis in horses and other animal species. In a previous study of the developmental pattern of the blood supply in the tarsus of foals, early lesions of osteochondrosis were consistently found in regions where the cartilage canal vessels traversed the chondro-osseous junction. The developmental pattern of blood vessels has also been described in the distal femoral epiphysis; however, the group of foals examined in that study did not have lesions of osteochondrosis in this location. Therefore, the relationship between the occurrence of early lesions of osteochondrosis and the developmental pattern of the blood supply to epiphyseal growth cartilage in this site in foals has not been examined. Distal femora were collected from 30 fetuses and foals (up to 11 months old) submitted for postmortem examination. Sections from the lateral trochlear ridge and medial femoral condyle of both hind limbs were examined histologically. Sixteen cartilage lesions were found in 7 of the 30 fetuses and foals. All lesions contained evidence of cartilage canal necrosis and ischemic chondronecrosis. The lesions were located in regions where cartilage canal vessels traversed the chondro-osseous junction, as previously observed in the tarsus. The location and morphology of lesions indicated that a subclinical stage of ischemic chondronecrosis existed that preceded and predisposed to the development of osteochondrosis dissecans and subchondral bone cysts.  相似文献   

9.
Lesions of the lateral trochlear ridge (LTR) of the distal femur were investigated in four pony or pony cross horses. The animals were all geldings and were six to 15 months of age. Lesions were bilateral in three ponies and unilateral in one. Femoropatellar joint effusion and lameness were present in two ponies; clinical signs were absent in the others. The proximal LTR was affected in all four animals. The radiographic appearance of the lesions was a subchondral defect containing mineralised bodies. Arthroscopic and postmortem examination findings included an osteochondral flap, a fissured or irregular articular surface and a smooth surface overlying focally thickened cartilage that extended into subchondral bone. Thickened articular cartilage was a histological feature of all the lesions. Among the other histological features, the most common were chondronecrosis, chondrocyte clusters, phenotypically abnormal chondrocytes, horizontal fissures at the osteochondral junction and retained blood vessels. The signalment of the four ponies, their clinical signs and the pathological features of their lesions were consistent with osteochondrosis of the LTR in horses. The use of multiple criteria was considered to be important in making a specific diagnosis.  相似文献   

10.
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11.
Four autogenous osteochondral fragments removed from the lateral trochlear ridge of the talus were arthroscopically placed as loose bodies in a randomly selected middle carpal joint in each of 10 horses. The contralateral middle carpal joint, subjected to a sham procedure, served as control. Postoperative treatment was consistent with that for clinical arthroscopic patients. Lameness evaluation, radiographic examination, carpal circumference measurement, and synovial fluid analysis were performed before and at scheduled intervals after surgery. After a 2-month confinement, horses were subjected to an increasing level of exercise. Horses were euthanatized at intervals through 6 months. Gross and microscopic evaluations were performed on remaining fragments, articular cartilage, and synovial membrane of each middle carpal joint. Increased joint circumference, effusion, lameness, and degenerative joint disease distinguished implanted from control joints over the 6-month period. Implanted joints were characterized by grooved, excoriated cartilage surfaces, and synovium that was thick, erythematous, and irregular. At 4 weeks, implants were found to have adhered to synovium at their subchondral bone surface. The bone within fragments was undergoing necrosis, while cartilage was preserved. At 8 weeks, fragments were radiographically inapparent, grossly evident as pale plaques on the synovial surface, and composed of dense fibrous connective tissue. Synovial membrane specimens from implanted joints had inflammatory change characterized by mononuclear cell infiltration 2 months after implantation. Physical damage was apparent within articular cartilage of implanted joints at 2 months, and was significant (P less than 0.05) at 6 months after surgery. Chondrocyte degenerative change was significant (P less than 0.05) at 6 months after surgery. Focal reduction in safranin-O uptake was observed in cartilage layers adjacent to physical defects. Osteochondral loose bodies of the size implanted in the middle carpal joint of horses in this study were resorbed by the synovium within 2 months. Synovitis and significant articular cartilage damage were associated with the implanted fragments. Regardless of origin, free osteochondral fragments within the middle carpal joint should be removed, and methods to prevent residual postoperative debris should be implemented to reduce potential for articular pathologic change.  相似文献   

12.
Articular cartilage blood vessels in swine osteochondrosis   总被引：1，自引：0，他引：1  
Perfusion studies in swine with early lesions of osteochondrosis demonstrated that lamellar areas of chondrocyte necrosis within reserve zones of growth areas occurred only in regions of nonperfused articular cartilage. Articular cartilage with a similar anatomical location was perfused in some animals. Occasionally, nonperfused articular cartilage showed vascular alterations within cartilage canals without evidence of significant perivascular or lamellar necrosis. By light microscopy, some vessels within or adjacent to nonperfused articular cartilage had normal morphology; however, ultrastructural abnormalities were found in some vessels of all cartilage canals adjacent to necrotic cartilage lamella. Minimal alterations were in the few cartilage canal vessels that appeared normal by light microscopy, and the surrounding chondrocytes showed only minimal alterations. Early cartilage canal alterations were seen in the endothelium of cartilage canal capillaries, and ultrastructural changes in these vessels were similar to those described with experimentally induced, direct vascular injury. Vascular injury was followed by leakage of plasma and cells into the interstitial space of the cartilage canal. Necrosis of the vessel wall and interstitial tissue caused the cartilage canals to appear empty or to be filled with fibrin-like material. Although the vascular changes could be considered as part of the normal process of cartilage maturation and cartilage canal chondrification, observations suggest that in domestic swine the attendant cartilage necrosis and chondrolysis is exuberant. It is suggested that alterations in cartilage canal vessels play a major role in the pathogenesis of articular cartilage lesions that are found in osteochondrosis of swine.  相似文献   

13.
An arthroscopic approach to the palmaroproximal or plantaroproximal pouch of the distal interphalangeal joint was developed in six cadaver limbs and seven limbs of three clinically normal horses. The dorsal aspect of the proximal border and the proximal articular margin of the distal sesamoid (navicular) bone, the palmar aspect of the distal articular margin of the middle phalanx, the collateral sesamoidean ligaments of the distal sesamoid bone, and the joint capsule attachments were readily accessible. Distending the joints with fluid gave access to portions of the articular surface between the distal sesamoid bone and the middle phalanx in all joints, and to a small portion of the distal phalanx in two hind distal interphalangeal joints. Two horses allowed to recover from anesthesia were not lame on days 30 and 37, respectively. Problems encountered initially were difficulty entering the joint, hemarthrosis, and minimal iatrogenic cartilage damage.  相似文献   

14.
Effect of diet on longitudinal bone growth and osteochondrosis in swine   总被引：1，自引：0，他引：1  
Weanling gilts were fed either a 12% or 16% protein diet for 10 weeks. Animals fed the 12% protein diet had reduced body weights and reduced longitudinal bone growth as measured in the distal radial growth plate. There was no difference in the growth plate widths between the two animal groups, but there was a significant reduction in the daily rate of cell production in the proliferative zone of animals fed the 12% protein diet. No effect of diet on the rate of expansion of the epiphysis at the articular-epiphyseal junction of the distal femur or humerus could be detected. All animals in both groups had morphologic cartilage lesions consistent with early changes associated with osteochondrosis (OCD), and there was no difference in the lesion morphology between the dietary groups. Areas of disorderly endochondral ossification in the radial growth plate were associated with perpendicular growth cartilage infractions. Growth plate lesions were characterized by increased widths of the maturing cartilage zone without increased width of the proliferative zone or an increase in the daily rate of cell production. Focal growth plate lesions developed because of a transitory inhibition of cartilage mineralization and resorption. Disorderly foci of endochondral ossification beneath articular cartilage were characterized by an area of chondrocyte necrosis which prevented normal cartilage matrix mineralization. Lamellae of cartilage necrosis were also present within the reserve zone of the articular cartilage. These were associated with abnormalities of the cartilage canal vessels, and chondrocyte necrosis was considered to precede degenerative changes in articular cartilage matrix.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

15.
The effect of intra-articular polysulfated glycosaminoglycan (PSG) on repair of chemical and physical articular cartilage injuries was evaluated in 8 horses. In each horse, a partial- and a full-thickness articular cartilage defect was made on the distal articular surface of the radial carpal bone. In the contralateral middle carpal joint, a chemical articular cartilage injury was induced by injecting 50 mg of Na monoiodoacetate (MIA). Four of the 8 horses were not treated (controls), and 4 horses were treated by intra-articular injection of 250 mg of PSG into both middle carpal joints once a week for 5 treatments starting 1 week after cartilage injury. Horses were maintained for 8 weeks. There was less joint circumference enlargement in PSG-treated horses in MIA-injected and physical defect carpi, compared with that in controls. In MIA-injected joints, there was less articular cartilage fibrillation and erosion, less chondrocyte death, and greater safranin-O staining for glycosaminoglycans in PSG-treated horses. Evaluation of joints in which physical defects were made revealed no differences between control and PSG-injected joints. None of the partial-thickness defects had healed. Full-thickness defects were repaired with fibrous tissue (which was more vascular and cellular in PSG-injected joints) and occasionally small amounts of fibrocartilage. Seemingly, PSG had chondroprotective properties in a model of chemically induced articular cartilage damage, whereas PSG had no obvious effect in a physical articular cartilage-defect model.  相似文献   

16.
OBJECTIVE: To examine articular cartilage of the distal interphalangeal (DIP) joint and distal sesamoidean impar ligament (DSIL) as well as the deep digital flexor tendon (DDFT) for adaptive responses to contact stress. SAMPLE POPULATION: Specimens from 21 horses. PROCEDURE: Pressure-sensitive film was inserted between articular surfaces of the DIP joint. The digit was subjected to a load. Finite element models (FEM) were developed from the data. The navicular bone, distal phalanx, and distal attachments of the DSIL and DDFT were examined histologically. RESULTS: Analysis of pressure-sensitive film revealed significant increases in contact area and contact load at dorsiflexion in the joints between the distal phalanx and navicular bone and between the middle phalanx and navicular bone. The FEM results revealed compressive and shear stresses. Histologic evaluation revealed loss of proteoglycans in articular cartilage from older horses (7 to 27 years old). Tidemark advancement (up to 14 tidemarks) was observed in articular cartilage between the distal phalanx and navicular bone in older clinically normal horses. In 2 horses with navicular syndrome, more tidemarks were evident. Clinically normal horses had a progressive increase in proteoglycans in the DSIL and DDFT. CONCLUSIONS AND CLINICAL RELEVANCE: Load on the navicular bone and associated joints was highest during dorsiflexion. This increased load may be responsible for microscopic changes of tidemark advancement and proteoglycan depletion in the articular cartilage and of proteoglycan production in the DSIL and DDFT Such microscopic changes may represent adaptive responses to stresses that may progress and contribute to lameness.  相似文献   

17.
Adult articular cartilage is divided by the tidemark into a deep calcified layer and a more superficial uncalcified layer. Histologic examination of articular cartilage from the knee joint of golden Syrian hamsters 123 days of age or older revealed defects at the tidemark in the tibia. Defects ranged from small separations of the calcified and uncalcified layers along the tidemark to progressively larger defects apparently formed by dissolution. These larger defects appeared as cavities in the noncalcified cartilage, had smooth rather than rough edges, frequently contained coalesced debris, and often resulted in a bulge in the articular surface. Occasionally, these large defects broke through the articular surface. Defects were not observed in tibial cartilage of younger (<90 days old) hamsters or in femoral cartilage from hamsters of any age. Exercise neither protected against nor increased the severity of the defects. Collagen cross-linking by pyridinoline was examined as a function of age and increased from 1,090 to 3,062 micromoles of pyridinoline/mole of hydroxyproline over the period of 1-9 months of age but was not correlated with defect formation. With increasing age, these focal tidemark defects could lead to osteoarthrosis-like cartilage lesions.  相似文献   

18.
The uptake and distribution of intramuscularly (IM) administered tritium-labeled polysulfated glycosaminoglycan (3H-PSGAG) in serum, synovial fluid, and articular cartilage of eight horses was quantitated, and hyaluronic acid (HA) concentration of the middle carpal joint was evaluated in a pharmacokinetic study. A full-thickness articular cartilage defect, created on the distal articular surface of the left radial carpal bone of each horse served as an osteochondral defect model. 3H-PSGAG (500 mg) was injected IM, between 14 and 35 days after creation of the defects. Scintillation analysis of serum and synovial fluid, collected from both middle carpal joints at specific predetermined times up to 96 hours post-injection, revealed mean 3H-PSGAG concentrations peaked at 2 hours post-injection. 3H-PSGAG was detected in cartilage and subchondral bone 96 hours post-injection in samples from all eight horses. There were no statistically significant differences in 3H-PSGAG concentration of synovial fluid or cartilage between cartilage defect and control (right middle carpal) joints.

HA assay of synovial fluid revealed concentrations significantly increased at 24, 48, and 96 hours post-injection in both joints. The concentration nearly doubled 48 hours post-injection. However, no statistically significant differences were found between synovial concentrations of HA in cartilage defect and control joints.

3H-PSGAG administered IM to horses, was distributed in the blood, synovial fluid, and articular cartilage. HA concentrations in synovial fluid increased after IM administration of polysulfated glycosaminoglycan.  相似文献   


19.
Using biodegradable pins, sternal cartilage autografts were fixed into osteochondral defects of the distal radial carpal bone in ten 2 to 3-year-old horses. The defects measured 1 cm2 at the surface and were 4 mm deep. Control osteochondral defects of contralateral carpi were not grafted. After confinement for 7 weeks, horses were walked 1 hour daily on a walker for an additional 9 weeks. Horses were euthanatized at 16 weeks. Half of the repair tissue was processed for histologic and histochemical (H&E and safranin-O fast green) examinations. The other half was used for the following biochemical analyses: type-I and type-II collagen contents, total glycosaminoglycan content, and galactosamine-to-glucosamine ratio. On histologic examination, the repair tissue in the grafted defects consisted of hyaline-like cartilage. Repair tissue in the nongrafted defects consisted of fibrocartilaginous tissue, with fibrous tissue in surface layers. On biochemical analysis, repair tissue of grafted defects was composed predominantly of type-II collagen; repair tissue of non-grafted defects was composed of type-I collagen. Total glycosaminoglycan content of repair tissue of grafted defects was similar to that of normal articular cartilage. Total glycosaminoglycan content of nongrafted defects was 62% of that of normal articular cartilage (P less than 0.05). Repair tissue of all defects was characterized by galactosamine-to-glucosamine ratio significantly (P less than 0.05) higher than that of normal articular cartilage. These results at 16 weeks after grafting indicate that sternal cartilage may potentially constitute a suitable substitute for articular cartilage in large osteochondral defects of horses.  相似文献   

20.
This article describes the ultrasonographic (US) appearance of bony abnormalities on the dorsal aspect of the third metacarpal/metatarsal bone of the equine fetlock in cadavers with radiographic signs of osteoarthrosis. After US, computed tomography was undertaken to better characterise the lesions. Twelve fetlock joints were collected and all had more than one bone abnormality on US. Normal subchondral bone appeared on US as a well-defined and regular hyperechoic line with distal acoustic shadowing. Bone abnormalities detected on US included (1) gaps in the proximal subchondral bone filled with material of heterogeneous echogenicity, (2) bone fragments represented as small straight smoothly delineated hyperechoic lines with distal shadowing located superficial to the surface of the adjacent bone, (3) proximal new bone formation visible as mild to severe cortical protrusions, (4) marginal osteophytoses seen as an elevation of the hyperechoic surface of the subchondral bone at the edges of the joint surfaces, (5) indentations in subchondral bone seen as a concave deviation of the hyperechoic line without interruption, (6) focal or diffuse irregularities of the subchondral bone seen as disruptions of the normal smooth bony contours, and (7) focal hyperechoic spikes originating from the subchondral plate and invading the articular cartilage. These findings are discussed.  相似文献   

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