BackgroundDespite distinct aetiologies of joint diseases, the osteoarthritic end-stage of primary osteoarthritis and rheumatoid arthritis are described using similar radiological features. However, primary and secondary osteoarthritis may be different at the bone-cartilage unit depending on the pathogenesis.ObjectivesThe main purpose was to investigate the histological differences in the bone-cartilage unit of the hip joint in patients with primary osteoarthritis and patients with secondary osteoarthritis due to rheumatoid arthritis.MethodsFemoral heads were obtained during arthroplasty from 12 patients with primary osteoarthritis and six patients with secondary osteoarthritis due to rheumatoid arthritis. Twelve femoral heads from healthy age- and sex-matched subjects were obtained post-mortem. Femoral heads were investigated, using stereological methods to provide unbiased quantitative data. The femoral head, articular cartilage, calcified cartilage, subchondral bone, and osteophytes were measured.Table 1:Volume and thickness of the bone-cartilage unit, femoral head volume and osteophyte area in healthy subjects (HS), osteoarthritis (OA) and rheumatoid arthritis (RA) patients.
Healthy subjects
(n = 12)
Osteoarthritis
(n = 12)
Rheumatoid arthritis
(n = 6)
ANOVA
OA vs
RA
HS vs
RA
HS vs
OA
Mean [95%CI]
P - value
Age (years)62[60;65]62 [59;65]63[60;65]
0.984
———
Gender (M:F)6:66:63:3
1.000
———
Femoral head volume (cm3
)52.0[39.6;64.3]43.6[37.3;50.0]41.1[33.6;48.7]0.233———
Articular cartilage volume (cm3
)7.4[5.9;8.9]5.1[4.0;6.1]2.9[1.6;4.3]
<
0.001
0.012
<
0.001
0.021
Articular cartilage thickness (µm)1413[1244;1582]1134[931;1338]721[403;1040]
<
0.001
0.029
<
0.001
0.086
Subchondral bone thickness (µm)227[172;282]406[285;527]409[186;632]
0.021
1.0000.099
0.034
Calcified cartilage thickness (µm)108[81.1;143]119[94.1;151]56.6[25.3;127]
0.016†
0.017
0.046
1.000
Osteophyte area (mm2
)8.8[2.2;35.7]70.9[41.4;121]49.2[4.7;513]
0.008†1.0000.073
0.006
Data are presented as mean [95%CI], Statistical significance was found using one-way aNOVA. The Post-hoc Bonferroni test was used to identify intergroup differences. †Data not normally distributed was log-transformed and presented as geometric mean [95%CI].Data are presented as mean [95%CI], Statistical significance was found using one-way aNOVA. The Post-hoc Bonferroni test was used to identify intergroup differences. †Data not normally distributed was log-transformed and presented as geometric mean [95%CI].ConclusionPatients with secondary osteoarthritis due to rheumatoid arthritis had thinner articular cartilage and calcified cartilage but were otherwise not significantly different from patients with primary osteoarthritis. Thus, the inflammatory joint in rheumatoid arthritis was associated with a more pronounced loss of cartilage than the degenerative joint disease in primary osteoarthritis. The thicker calcified cartilage in primary osteoarthritis has been attributed to endochondral ossification; this does not seem to be the case in rheumatoid arthritis.Ack...