University of Nottingham, Division of Orthopaedic & Accident Surgery, School of Clinical Sciences, Queen's Medical Centre Campus, Nottingham NG7 2UH, UK.
Osteoarthritis Cartilage. 2011 Mar;19(3):324-31. doi: 10.1016/j.joca.2010.12.005. Epub 2010 Dec 21.
To determine the reliability, reproducibility, variability and validity of the Osteoarthritis Cartilage Histopathology (OACH) assessment system and Mankin Histological-Histochemical Grading System (HHGS) when applied to the characterisation of the osteoarthritic human knee.
Osteoarthritic knees of 10 patients undergoing unilateral knee arthroplasty were assessed, and assigned Kellgren-Lawrence and Line Drawing Atlas (LDA) radiology scores. The tibial plateaux were scored using the Modified Collins (MC) and Société Française d'Arthroscopie (SFA). Three observers twice scored both the OACH and HHGS across a single complete medial and lateral tibial plateau transect taken to include the region with the most severe osteoarthritis (OA) lesion. Intra- and inter-observer reliability, reproducibility, variability and validity were assessed, and the correlation between the two histopathology scoring systems was calculated.
Both histopathology scoring systems were determined to be reliable and reproducible exhibiting similar variability, when applied to characterise OA specimens sampled from a well defined patient group with knee OA. A strong correlation between the mean OACH and mean HHGS scores was identified (Spearman's ρ 0.980, P<0.0001).
Both scoring systems implemented provide useful measures in the characterisation of knee osteoarthritis. It is of note that an additional parameter within the OACH score over the HHGS defines the extent of the disease, where the HHGS is a grade attributed to the most representative level of the biological aggression within the OA lesions. This study has confirmed the OACH system's utility in human knee OA and is supported by a significant correlation with the established HHGS.
确定骨关节炎软骨组织病理学（OACH）评估系统和 Mankin 组织化学分级系统（HHGS）在评估人类膝关节骨关节炎特征时的可靠性、可重复性、变异性和有效性。
对 10 例接受单侧膝关节置换术的骨关节炎膝关节进行评估，并分配 Kellgren-Lawrence 和直线绘图图谱（LDA）放射学评分。使用改良柯林斯（MC）和法国关节镜学会（SFA）对胫骨平台进行评分。三位观察者两次对 OACH 和 HHGS 进行评分，横跨单个完整的内侧和外侧胫骨平台进行，包括最严重的骨关节炎（OA）病变区域。评估了内部和观察者之间的可靠性、可重复性、变异性和有效性，并计算了两种组织病理学评分系统之间的相关性。
当应用于从具有膝关节 OA 的明确患者群体中采样的 OA 标本时，两种组织病理学评分系统均被确定为可靠且可重复的，具有相似的变异性。OACH 和 HHGS 平均评分之间存在很强的相关性（Spearman's ρ 0.980，P<0.0001）。
两种评分系统均可为膝关节骨关节炎的特征提供有用的衡量标准。值得注意的是，OACH 评分中的一个附加参数超过了 HHGS，定义了疾病的程度，其中 HHGS 是赋予 OA 病变中最具代表性的生物学侵袭水平的等级。本研究证实了 OACH 系统在人类膝关节 OA 中的实用性，并得到了与既定 HHGS 显著相关性的支持。
