Abstract
To explore the relationship of hyaluronan level in synovial fluid of the knee with the degree of synovitis and cartilage injury.
A total of 104 knees in 102 patients with knee osteoarthritis or other knee diseases was studied. The hyaluronan level in the synovial fluid of the knees was measured with enzyme linked immunoassay. The pathology of the synovium and articular cartilage was evaluated with Ayral’s score system and Outerbridge’s score system under arthroscopy. The data were analyzed by t’-test or nonparametric test, ANOVA, Pearson or Spearman correlation and multiple liner regression.
The results showed that the hyaluronan level in the synovial fluid of the knees was correlated positively with Ayral’s score (beta’A=0.497, P< 0.001) and negatively with accumulative Outerbridge’s score (beta’O=-0.364, P< 0.001), especially Ayral’s synovitis score in 104 cases. The hyaluronan level in the synovial fluid of the knees was higher in those with Ayral’s score > and = 60 than in those with the score< 60 (P< 0.001). The hyaluronan level in the synovial fluid of the knees was lower in those with accumulative Outerbridge’s score > and = 10 than in those with the score < 10 (P< 0.05). The level of hyaluro-nan in the synovial fluid in the knees with Ayral’s score > and = 60 was correlated negatively with accumulative Outerbridge’s score (beta’O=-0.437, P< 0.001) and positively with Ayral’s score (beta’A=0.339, P< 0.01), especially accumulative Outerbridge’s score.
Compared with other knee diseases, the hyaluronan level of OA knees was lower (P< 0.05). However, Ayral’s score and accumulative Outerbridge’s score were higher in OA knees (P< 0.001).
The hyaluronan level in the synovial fluid of the knee can reflect the degree of synovitis and accumulative cartilage injury, especially synovitis. It reflects the degree of accumulative cartilage injury mainly when synovitis is more severe. The decrease of the hyaluronan level in the synovial fluid of OA knee is results of integrating effect of the synovitis and cartilage injury.
Correspondence should be addressed to Mr Carlos Wigderowitz, Senior Lecturer, University Department of Orthopaedic and Trauma Surgery, Ninewells Hospital and Medical School, Dundee DD1 9SY.
