Glycosaminoglycan measured from synovial fluid serves as a useful indicator for progression of Osteoarthritis and complements Kellgren–Lawrence Score

Plain radiography is the first choice for diagnosis and monitoring of knee-osteoarthritis (OA) while, Kellgren–Lawrence score (KL) is most widely used to grade OA severity. However, incompetency for reproducibility of joint space measurement in longitudinal assessment and non-linearity of KL-score s...

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Bibliographic Details
Published in:BBA clinical 2016-12, Vol.6, p.1-4
Main Authors: Kulkarni, Priya, Deshpande, Shantanu, Koppikar, Soumya, Patil, Sanjay, Ingale, Dhanashri, Harsulkar, Abhay
Format: Article
Language:English
Subjects:
Glycosaminoglycan
Joint-space-narrowing
Kellgren–Lawrence score
Knee-osteoarthritis
Radiography
Regular
Synovial-fluid
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Summary:Plain radiography is the first choice for diagnosis and monitoring of knee-osteoarthritis (OA) while, Kellgren–Lawrence score (KL) is most widely used to grade OA severity. However, incompetency for reproducibility of joint space measurement in longitudinal assessment and non-linearity of KL-score system, limits radiography-based early diagnosis of the disease. Glycosaminoglycan (GAG) is direct cartilage-degradation product, which can be measured biochemically. We strived to correlate KL-score and GAG from OA patients to compliment KL-system. We obtained 34 synovial-fluid (SF) samples from 28 OA patients (few bilateral) with different disease severity using arthrocetesis. All patients were categorised using radiographic KL-score-system. SFs were further analysed for GAG estimation using 1,2-dimethylmethylene blue (DMMB) assay. A substantial increase in GAG was noted in KL-grade-II and III, comparing grade-I patients, indicating amplified cartilage-degradation. KL-grade-IV patients revealed further rise in GAG reflecting more cartilage-loss. Another category of grade-IV patients with lower GAG were also detected, indicating close to total cartilage-loss. Accurate diagnosis of cartilage-loss remains a challenge with OA due to limitations of KL-system; thus no target intervention is available to arrest active cartilage-loss. We propose, GAG-estimation in OA patients, characterizes accurate biochemical depiction of cartilage degeneration. General Significance: Radiology often fails to reveal an accurate cartilage loss, associated with OA. GAG levels from the SFs of OA patients' serve as a useful marker, which parallels cartilage degeneration and strengthen radiographic grading system, ultimately [Display omitted]
ISSN:2214-6474
2214-6474
DOI:10.1016/j.bbacli.2016.05.002