Myers S L, Flusser D, Brandt K D, Heck D A
Rheumatology Division, Indiana University School of Medicine, Indianapolis 46202-5103.
J Rheumatol. 1992 Aug;19(8):1247-51.
It has been suggested that incorporation of shards of fibrillated cartilage into the synovium is a cause of synovitis in osteoarthritis (OA). We examined the prevalence with which fragments of cartilage are seen in synovium, and their association with synovitis, in patients with endstage OA and early OA of the knee. Samples of synovium were obtained from 12 patients with endstage OA who were undergoing knee joint replacement and 30 with only mild/moderate radiographic changes of OA who exhibited articular cartilage changes of OA at arthroscopy. The presence of cartilage shards was sought in synovium from the medial and lateral tibiofemoral compartments and the suprapatellar pouch of each patient. Comparable volumes of the synovial lining from patients with endstage and early OA were examined, and tissue mononuclear cell infiltration was graded as an indicator of synovitis. Cartilage shards were seen in synovium from 7 of 12 patients with endstage OA, all of whom had synovitis. No topographic relationship was found between shards and mononuclear cell infiltration. In contrast, cartilage fragments were not seen in synovium from any of the 30 patients with early OA, although 9 of them had full thickness cartilage ulcers and 17 had evidence of synovitis.
有人提出，原纤维软骨碎片并入滑膜是骨关节炎（OA）滑膜炎的一个病因。我们检查了终末期OA和早期膝关节OA患者滑膜中软骨碎片的出现率及其与滑膜炎的关系。滑膜样本取自12例接受膝关节置换术的终末期OA患者以及30例仅具有轻度/中度OA影像学改变且在关节镜检查时表现出OA关节软骨改变的患者。在每位患者的胫股关节内外侧间室及髌上囊的滑膜中寻找软骨碎片。对终末期和早期OA患者的等量滑膜衬里进行检查，并将组织单核细胞浸润分级作为滑膜炎的指标。12例终末期OA患者中有7例的滑膜中可见软骨碎片，所有这些患者均患有滑膜炎。未发现碎片与单核细胞浸润之间存在地形学关系。相比之下，30例早期OA患者的滑膜中均未见到软骨碎片，尽管其中9例有全层软骨溃疡，17例有滑膜炎证据。
