Association between synovial tissue damage and pain in late-stage knee osteoarthritis: A cross-sectional study,Osteoarthritis and Cartilage

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Association between synovial tissue damage and pain in late-stage knee osteoarthritis: A cross-sectional study
Osteoarthritis and Cartilage ( IF 7.2 ) Pub Date : 2024-07-04 , DOI: 10.1016/j.joca.2024.06.015
Holly T Philpott ₁ , Trevor B Birmingham ₁ , McKenzie M Carter ₂ , Matthew J Cecchini ₃ , J Robert Giffin ₄ , Edward M Vasarhelyi ₅ , Steven J MacDonald ₄ , Brent A Lanting ₅ , C Thomas Appleton ₆ ,

Affiliation

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.
Pathology & Laboratory Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Bone and Joint Institute, University of Western Ontario, London Health Sciences Centre-University Hospital, London, ON N6A 5B5, Canada; Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON, 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; Department of Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.

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.

中文翻译：

晚期膝骨关节炎滑膜组织损伤与疼痛之间的关联：一项横断面研究

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，并测试它们与滑膜炎超声 (US) 成像测量和患者报告的膝骨关节炎 (OA) 疼痛测量的关联。在对 122 名因晚期疼痛（Kellgren-Lawrence 3 级或 4 级）膝关节 OA 接受手术的患者进行的横断面研究中，我们将美国滑膜炎 (n = 118) 和疼痛（膝关节损伤和骨关节炎结果评分）的测量值与滑膜组织活检中炎症与滑膜组织损伤的组织病理学测量。在控制协变量的同时，使用线性或逻辑回归评估组织病理学特征与美国炎症或疼痛测量值的关联。炎症的组织病理学特征与中度/重度 US 滑膜炎的较高几率相关（比值比 [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 滑膜炎的较低几率相关（ OR = 0.77 [95%CI 0.57, 1.03]）。滑膜组织损伤的组织病理学评分较差与更多疼痛相关（−1.47 [95%CI -2.88, -0.05]），即使在调整滑膜炎症时也是如此（−1.61 [95%CI -3.12, -0.10]）。滑膜组织损伤与晚期膝关节骨关节炎的疼痛相关，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缓解骨关节炎疾病治疗的一个重要目标。

更新日期：2024-07-04

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