Pester J K, Stumpfe S T, Steinert S, Marintschev I, Plettenberg H K, Aurich M, Hofmann G O
Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Jena.
arthrospec GmbH Jena.
Z Orthop Unfall. 2014 Oct;152(5):469-79. doi: 10.1055/s-0034-1382935. Epub 2014 Oct 14.
Non-destructive techniques for the detection and classification of pathological changes of cartilage in the early stages of osteoarthritis are required for arthroscopic and open surgery of joints. Biochemical and histological changes in cartilage with different degrees of destruction were analysed and correlated to changes in the spectroscopic characteristics of cartilage.
PATIENTS, MATERIAL AND METHODS: 24 patients (n = 25 knees) with severely destructed knee joints received total knee replacement. The cartilage of the resected joints was classified according to the ICRS system. Defined cartilage specimens were investigated spectroscopically employing NIRS (near-infrared spectroscopy). In the following the cartilage specimens were harvested to determine the content of proteoglycan (GAG) and hydroxyproline (HP) as an essential part of collagen. Histological evaluation of the Mankin score and Otte score was performed using haematoxylin/eosin and safranin-O staining. Spearman's rank correlation coefficient was used to characterise links between the parameters investigated.
We found significant correlations between spectroscopic, histological and biochemical characteristics. NIRS corresponded to the content of GAG (ρ = 0.58) and HP (ρ = 0.59), as well as to the Mankin (ρ = 0.55) and Otte (ρ = 0.5) scores. Furthermore, the ICRS classification correlated with histological evaluation (Mankin score ρ = 0.725 and Otte score ρ = 0.736), as to be expected.
Characteristic cartilage changes in different degrees of osteoarthritis can be detected and evaluated by the spectroscopic method NIRS as a non-destructive technique. However, the quality of this technical evaluation cannot compete with biochemical and histological analysis.
骨关节炎早期阶段软骨病理变化的检测和分类的非破坏性技术是关节镜和开放手术所必需的。分析了不同程度破坏的软骨中的生化和组织学变化，并将其与软骨光谱特征的变化相关联。
患者、材料与方法：24例（n = 25膝）膝关节严重破坏的患者接受了全膝关节置换术。根据国际软骨修复协会（ICRS）系统对切除关节的软骨进行分类。使用近红外光谱（NIRS）对选定的软骨标本进行光谱研究。随后采集软骨标本以测定蛋白聚糖（GAG）和羟脯氨酸（HP）的含量，后者是胶原蛋白的重要组成部分。使用苏木精/伊红和番红O染色对曼金评分和奥特评分进行组织学评估。采用Spearman等级相关系数来描述所研究参数之间的联系。
我们发现光谱、组织学和生化特征之间存在显著相关性。近红外光谱与蛋白聚糖含量（ρ = 0.58）、羟脯氨酸含量（ρ = 0.59）以及曼金评分（ρ = 0.55）和奥特评分（ρ = 0.5）相关。此外，正如预期的那样，ICRS分类与组织学评估相关（曼金评分ρ = 0.725，奥特评分ρ = 0.736）。
作为一种非破坏性技术，光谱方法近红外光谱可以检测和评估不同程度骨关节炎中软骨的特征性变化。然而，这种技术评估的质量无法与生化和组织学分析相媲美。
