Little Jeffrey P, Bleedorn Jason A, Sutherland Brian J, Sullivan Ruth, Kalscheur Vicki L, Ramaker Megan A, Schaefer Susan L, Hao Zhengling, Muir Peter
Comparative Orthopaedic Research Laboratory, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, United States of America.
Research Animal Resources Center, Comparative Pathology Laboratory, University of Wisconsin-Madison, Madison, Wisconsin, United States of America.
PLoS One. 2014 Jun 3;9(6):e97329. doi: 10.1371/journal.pone.0097329. eCollection 2014.
Cranial cruciate ligament rupture (CR) is a degenerative condition in dogs that typically has a non-contact mechanism. Subsequent contralateral rupture often develops in dogs with unilateral CR. Synovitis severity is an important factor that promotes ligament degradation. Consequently, we wished to evaluate the utility of arthroscopy for assessment of stifle synovitis in dogs with CR. Herein, we report results of a prospective study of 27 dogs with unilateral CR and bilateral radiographic osteoarthritis. Arthroscopic images and synovial biopsies from the lateral and medial joint pouches were obtained bilaterally and graded for synovial hypertrophy, vascularity, and synovitis. Synovial tartrate-resistant acid phosphatase-positive (TRAP+) macrophages, CD3(+) T lymphocytes, Factor VIII+ blood vessels, and synovial intima thickness were quantified histologically and related to arthroscopic observations. Risk of subsequent contralateral CR was examined using survival analysis. We found that arthroscopic scores were increased in the index stifle, compared with the contralateral stifle (p<0.05). Numbers of CD3+ T lymphocytes (SR = 0.50, p<0.05) and TRAP+ cells in joint pouches (SR = 0.59, p<0.01) were correlated between joint pairs. Arthroscopic grading of vascularity and synovitis was correlated with number density of Factor VIII+ vessels (SR>0.34, p<0.05). Arthroscopic grading of villus hypertrophy correlated with numbers of CD3(+) T lymphocytes (SR = 0.34, p<0.05). Synovial intima thickness was correlated with arthroscopic hypertrophy, vascularity, and synovitis (SR>0.31, p<0.05). Strong intra-observer and moderate inter-observer agreement for arthroscopic scoring was found. Dog age and arthroscopic vascularity significantly influenced risk of contralateral CR over time. We conclude that arthroscopic grading of synovitis is a precise tool that correlates with histologic synovitis. Arthroscopy is useful for assessment of stifle synovitis in client-owned dogs, and could be used in longitudinal clinical trials to monitor synovial responses to disease-modifying therapy.
颅交叉韧带断裂（CR）是犬类的一种退行性疾病，通常由非接触机制引起。单侧CR的犬随后常发生对侧韧带断裂。滑膜炎的严重程度是促进韧带退变的一个重要因素。因此，我们希望评估关节镜检查在评估CR犬膝关节滑膜炎中的作用。在此，我们报告了一项对27只单侧CR和双侧影像学骨关节炎犬的前瞻性研究结果。从双侧外侧和内侧关节囊获取关节镜图像和滑膜活检组织，并对滑膜肥大、血管形成和滑膜炎进行分级。对滑膜抗酒石酸酸性磷酸酶阳性（TRAP+）巨噬细胞、CD3（+）T淋巴细胞、VIII因子+血管和滑膜内膜厚度进行组织学定量，并与关节镜观察结果相关联。使用生存分析检查对侧CR的后续风险。我们发现，与对侧膝关节相比，患侧膝关节的关节镜评分增加（p<0.05）。关节囊内CD3+T淋巴细胞数量（SR = 0.50，p<0.05）和TRAP+细胞数量（SR = 0.59，p<0.01）在关节对之间具有相关性。血管形成和滑膜炎的关节镜分级与VIII因子+血管的数量密度相关（SR>0.34，p<0.05）。绒毛肥大的关节镜分级与CD3（+）T淋巴细胞数量相关（SR = 0.34，p<0.05）。滑膜内膜厚度与关节镜下的肥大、血管形成和滑膜炎相关（SR>0.31，p<0.05）。发现关节镜评分的观察者内一致性强，观察者间一致性中等。犬的年龄和关节镜下的血管形成随时间显著影响对侧CR的风险。我们得出结论，滑膜炎的关节镜分级是一种与组织学滑膜炎相关的精确工具。关节镜检查对于评估宠物犬的膝关节滑膜炎很有用，可用于纵向临床试验以监测滑膜对疾病改善治疗的反应。
