Scanning electron microscopy study of articular cartilage in the evolution of hip arthritis

The authors report the results of scanning electron microscopy examination of samples of articular surface taken from 15 arthritic femoral heads removed during hip replacement. The specimens were collected from areas of the femoral head where different degrees of degenerative changes were identified, and processed with the normal techniques for scanning electron microscopy. A definition was made of the mechanisms leading to articular cartilage wear, the most obvious sign of cartilage degeneration. The earlier stages were characterized by the appearance of clefts in the surface layer, which merged and formed scales that flaked off, giving rise to superficial abrasions. The evolution of the degenerative process led to a deepening of the clefts, reaching the intermediate and deep layers and creating further scales of cartilage tissue, oblique or perpendicular to the surface. The elimination of these formations causes more or less marked wear that can extend down to the subchondral bone (ulcers and ground surfaces). As well as information on the condition of the articular surfaces, scanning electron microscopy may also provide details on the morphology and structure of the chondrocytes and the fibrillar network in the sagittal sections, showing the regressive phenomena associated with arthritis.