Correlation between synovitis detected on enhanced-magnetic resonance imaging and a histological analysis with a patient-oriented outcome measure for Japanese patients with end-stage knee osteoarthritis receiving joint replacement surgery

Abstract

Osteoarthritis (OA) is a disease that primarily results in the degeneration and destruction of the articular cartilage. However, synovitis that occurs secondarily by this primary phenomenon is crucial for both the structural and symptomatic progression of the disease. The Japanese Knee Osteoarthritis Measure (JKOM) was created as an outcome measure for Japanese patients with knee OA. This study was conducted to determine whether synovitis in knee OA correlates with the current disability of patients with knee OA who required total knee arthroplasty (TKA). Thirty-four Japanese patients with end-stage knee OA who required TKA were included in this study. The visual analog scale (VAS, 0-100) for pain and the JKOM score, as well as the Western Ontario and McMaster Universities Arthritis Index (WOMAC), were examined before the operation. Synovial samples were taken at the time of the operation. A histological analysis and gadolinium-enhanced magnetic resonance imaging (Gd-MRI) were conducted to evaluate synovitis. Correlations between the synovitis score evaluated by histological analysis and Gd-MRI with either the pain VAS score or the JKOM score were examined using Spearman's rank correlation coefficient. Neither the synovitis scores evaluated by the histological analysis nor those by a Gd-MRI correlated with the pain VAS score (n = 34, r = 0.25, p = 0.18 and r = 0.08, p = 0.75, respectively) and WOMAC (n = 14, r = 0.35, p = 0.22 and r = 0.45, p = 0.16, respectively) of the patients. However, they significantly correlated with the JKOM score of the patients (n = 34, r = 0.55, p = 0.001 and r = 0.71, p = 0.001, respectively). The severity of synovitis in OA was closely correlated with the current functional impairment and disability of the patients receiving TKA with end-stage knee OA.

Synovial perlecan is required for osteophyte formation in knee osteoarthritis

“…In synovitis, the synovial membrane produces proteases and cytokines, which enhance cartilage degradation. In addition, while synovitis occurs throughout the affected joint in rheumatic arthritis, synovitis occurs locally and more mildly in OA (Ayral et al, 2005; Goldring and Goldring, 2007; Liu et al, 2010; Ning et al, 2011). …”

Effects of N-acetyl glucosamine and chondroitin sulfate supplementation on knee pain and self-reported knee function in middle-aged and older Japanese adults: a randomized, double-blind, placebo-controlled trial

“…Total assessment scores range from 0 points (best) to 100 points (worst). A previous study confirmed the superiority of the JKOM scale for evaluating the disability of Japanese patients with knee OA compared with the WOMAC and VAS pain scales [11].…”

Osteoarthritis as a Cause of Locomotive Syndrome: Its Influence on Functional Mobility and Activities of Daily Living

“…13), we also showed that synovitis is associated with symptoms in advanced-to endstage knee OA [53]. We examined whether synovitis in knee OA assessed by histological examinations and enhanced MRI correlated with the disability of patients with end-stage knee OA who underwent joint replacement surgery.…”

“…The expression levels of TGF-b in the sublining layer of the medial perimeniscal synovial tissue in the patients Table 7 Correlation between the total histological synovitis score (HSS) and the whole-organ magnetic resonance imaging score (WORMS) in patients with end-stage knee OA receiving TKA [55] MRI-detected OA pathologies HSS Fig. 14 A simple regression analysis comparing the histological and enhanced MRIevaluated synovitis score with the JKOM score in patients with end-stage knee OA [53]. MRI magnetic resonance imaging, ROI region of interest, JKOM Japanese Knee Osteoarthritis Measure.…”