Murphy E, FitzGerald O, Saxne T, Bresnihan B
Department of Rheumatology, St Vincent's University Hospital, Dublin, Ireland.
Ann Rheum Dis. 2002 Nov;61(11):981-5. doi: 10.1136/ard.61.11.981.
Chondromalacia patellae is a potentially disabling disorder characterised by features of patellar cartilage degradation.
To evaluate markers of cartilage and bone turnover in patients with chondromalacia patellae.
18 patients with chondromalacia patellae were studied. Serum cartilage oligomeric matrix protein (s-COMP) and bone sialoprotein (s-BSP) levels were measured by enzyme linked immunosorbent assay (ELISA) and compared with those of age and sex matched healthy control subjects. Periarticular bone mineral density (BMD) of both knee joints was assessed by dual energy x ray absorptiometry (DXA).
s-COMP levels were significantly raised in all patients with chondromalacia patellae compared with healthy control subjects (p=0.0001). s-BSP levels did not differ significantly between the groups (p=0.41). BMD of the patella was significantly reduced in patients with chondromalacia patellae compared with the control subjects (p=0.016). In patients with bilateral chondromalacia patellae, BMD of the patella was lower in the more symptomatic knee joint (p=0.005). Changes in periarticular BMD were localised to the patella and were not present in femoral regions. Neither s-COMP (p=0.18) nor s-BSP (p=0.40) levels correlated with patellar BMD.
Increased s-COMP levels, reflecting cartilage degradation, and reduced BMD localised to the patella may represent clinically useful markers in the diagnosis and monitoring of patients with chondromalacia patellae. Measures of cartilage degradation did not correlate with loss of patellar bone density, suggesting dissociated pathophysiological mechanisms.
髌骨软化症是一种潜在的致残性疾病，其特征为髌软骨退变。
评估髌骨软化症患者软骨和骨转换标志物。
对18例髌骨软化症患者进行研究。采用酶联免疫吸附测定（ELISA）法测定血清软骨寡聚基质蛋白（s-COMP）和骨唾液酸蛋白（s-BSP）水平，并与年龄和性别匹配的健康对照者进行比较。采用双能X线吸收法（DXA）评估双侧膝关节周围骨密度（BMD）。
与健康对照者相比，所有髌骨软化症患者的s-COMP水平均显著升高（p=0.0001）。两组间s-BSP水平无显著差异（p=0.41）。与对照者相比，髌骨软化症患者的髌骨骨密度显著降低（p=0.016）。在双侧髌骨软化症患者中，症状较重膝关节的髌骨骨密度较低（p=0.005）。关节周围骨密度变化局限于髌骨，股骨区域未见异常。s-COMP（p=0.18）和s-BSP（p=0.40）水平均与髌骨骨密度无关。
反映软骨退变的s-COMP水平升高以及局限于髌骨的骨密度降低可能是髌骨软化症患者诊断和监测的临床有用标志物。软骨退变指标与髌骨骨密度丢失无关，提示存在不同的病理生理机制。
