Department of biomedical engineering, Lerner research institute, Cleveland clinic, 9500 Euclid avenue, OH 44195 Cleveland, USA.
Department of biomedical engineering, Lerner research institute, Cleveland clinic, 9500 Euclid avenue, OH 44195 Cleveland, USA; Department of orthopedic surgery, Cleveland clinic, OH 44195 Cleveland, USA; Instituto Universitario del Hospital Italiano de Buenos Aires, Potosí 4234, C1199ACL Caba, Argentina.
Curr Res Transl Med. 2017 Nov;65(4):133-139. doi: 10.1016/j.retram.2017.09.002. Epub 2017 Nov 11.
The two main objectives of the study include (1) Test the hypothesis that the lateral femoral condyle (LFC) in patients with primary OA and varus knees undergoing total knee arthroplasty (TKA) can be used as a model to better characterize varying histological features of human OA, (2) Correlate characteristic OA features using the established histopathological scoring systems (HHGS and OARSI) to understand potential histopathological patterns of OA initiation.
Two osteochondral specimens (4×4×8mm) were collected from fifty patient's LFC at the time of TKA (total 100 specimens), who presented preserved lateral knee compartment with joint space width>2mm. Three independent readers graded the sections on three different occasions using HHGS and OARSI systems. The correlation between individual parameters of the two scoring systems and their inter- and intra-reader variability, reliability and reproducibility were estimated.
All samples in this cohort showed abnormal histopathological features. Total histopathological scores of the LFC ranged from HHGS median=4.6 (range=0 to 11), and OARSI median=5.2 (range=0 to 19.5). The four individual sub-items of HHGS scoring system (structure, cells, safraninO staining, tidemark) were weakly correlated, with the correlation between structure and cellularity being the strongest (r=0.40). Both the scoring systems had similar repeatability and reproducibility coefficients of<21%.
OA changes in the LFC are not confined to any one region, and maybe seen in different regions of cartilage, tidemark, subchondral bone, and/or the marrow space vascularity. These variations may point to the possibility of several potential patterns of initiation in OA.
本研究的两个主要目的包括：(1)检验这样一个假设，即患有原发性 OA 和膝内翻的 TKA 患者的外侧股骨髁（LFC）可以作为一个模型，更好地描述人类 OA 的不同组织学特征，(2)使用既定的组织病理学评分系统（HHGS 和 OARSI）来分析特征性 OA 特征，以了解 OA 起始的潜在组织病理学模式。
在 TKA 时从五十名患者的 LFC 收集了两个骨软骨标本（4×4×8mm）（共 100 个标本），这些患者的外侧膝关节间隙保留完好，关节间隙宽度>2mm。三名独立的读者使用 HHGS 和 OARSI 系统在三个不同的时间点对切片进行分级。评估了两种评分系统的个体参数之间的相关性，以及它们的内部和内部读者的变异性、可靠性和可重复性。
该队列中的所有样本均显示出异常的组织病理学特征。LFC 的总组织病理学评分范围为 HHGS 中位数=4.6（范围=0 至 11），OARSI 中位数=5.2（范围=0 至 19.5）。HHGS 评分系统的四个个体分项（结构、细胞、番红 O 染色、骺线）呈弱相关，结构与细胞相关性最强（r=0.40）。两种评分系统的重复性和再现性系数均<21%。
LFC 的 OA 变化不限于任何一个区域，可能出现在软骨、骺线、软骨下骨和/或骨髓空间血管的不同区域。这些变化可能表明 OA 起始存在几种潜在模式的可能性。
