Faculty of Health Sciences, University of Western Ontario, London, ON N6G 1H1, Canada,; Bone and Joint Institute, University of Western Ontario, London Health Sciences Centre-University Hospital, London, ON N6A 5B5, Canada.
Bone and Joint Institute, University of Western Ontario, London Health Sciences Centre-University Hospital, London, ON N6A 5B5, Canada; Physiology & Pharmacology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Osteoarthritis Cartilage. 2024 Nov;32(11):1503-1512. doi: 10.1016/j.joca.2024.06.015. Epub 2024 Jul 4.
To identify the presence and distribution of histopathological features of synovial inflammation and tissue damage, and to test their associations with ultrasound (US) imaging measures of synovitis and patient-reported measures of pain in knee osteoarthritis (OA).
In the cross-sectional study of 122 patients undergoing surgery for painful late-stage (Kellgren-Lawrence Grade 3 or 4) knee OA, we compared US measures of synovitis (n = 118) and pain (Knee Injury and Osteoarthritis Outcome Score) to histopathological measures of inflammation vs. synovial tissue damage in synovial tissue biopsies. Associations of histopathological features with US measures of inflammation or pain were assessed using linear or logistic regression while controlling for covariates.
Histopathological features of inflammation were associated with higher odds of moderate/severe US synovitis (odds ratio [OR] = 1.34 [95%CI 1.04, 1.74), whereas features of synovial tissue damage were associated with lower odds of moderate/severe US synovitis (OR = 0.77 [95%CI 0.57, 1.03]). Worse histopathological scores for synovial tissue damage were associated with more pain (-1.47 [95%CI -2.88, -0.05]), even while adjusting for synovial inflammation (-1.61 [95%CI -3.12, -0.10]).
Synovial tissue damage is associated with pain in late-stage knee OA, independent from inflammation and radiographic damage. These novel findings suggest that preventing synovial tissue damage may be an important goal of disease-modifying OA therapy.
确定滑膜炎症和组织损伤的组织病理学特征的存在和分布，并检验它们与膝关节骨关节炎（OA）的超声（US）滑膜炎影像学指标和患者报告的疼痛指标的相关性。
在对 122 例因晚期（Kellgren-Lawrence 分级 3 或 4 级）膝关节 OA 而接受手术治疗的患者进行的横断面研究中，我们比较了滑膜炎症的 US 指标（n=118）和疼痛（膝关节损伤和骨关节炎结果评分）与滑膜组织活检中滑膜炎症与滑膜组织损伤的组织病理学指标。使用线性或逻辑回归评估组织病理学特征与 US 炎症或疼痛指标的相关性，同时控制协变量。
炎症的组织病理学特征与中度/重度 US 滑膜炎的更高几率相关（优势比 [OR] = 1.34 [95%CI 1.04, 1.74），而滑膜组织损伤的特征与中度/重度 US 滑膜炎的更低几率相关（OR = 0.77 [95%CI 0.57, 1.03））。滑膜组织损伤的组织病理学评分更差与疼痛更严重相关（-1.47 [95%CI -2.88, -0.05）），即使在调整滑膜炎症后也是如此（-1.61 [95%CI -3.12, -0.10））。
晚期膝关节 OA 中滑膜组织损伤与疼痛相关，与炎症和放射学损伤无关。这些新发现表明，预防滑膜组织损伤可能是改变 OA 疾病进程的治疗的一个重要目标。
