Phonoarthrography, musculoskeletal ultrasonography, and biochemical biomarkers for the evaluation of knee cartilage in osteoarthritis

Abstract

The aim of this study was to examine the relationship among three different parameters used to assess cartilage in osteoarthritis (OA) of the knee. These parameters are phonoarthrography (Phono-A), musculoskeletal ultrasonography (MSUS) from the 4 condyles, and biochemical markers; notably, matrix metalloproteinase-3 (MMP-3) and tissue inhibitor of proteinase (TIMP-1). A total of 100 knees with chronic idiopathic OA diagnosed according to the American College of Rheumatology (ACR) criteria were studied, together with 50 normal knees. The knee sounds were recorded by Phono-A and the cartilage thickness was measured by MSUS. All patients and controls had MMP-3 and TIMP-1 measured in a blood sample, using an enzyme-linked immunosorbent assay (ELISA). Conventional knee X-rays were obtained for diagnosis and for Kellgren-Lawrence (K-L) grading purposes. The results showed that Phono-A values were inversely correlated with cartilage thickness, both of these being sensitive parameters for cartilage degeneration. Phono-A values were higher in patients than in controls, denoting more degeneration of cartilage, and the cartilage thickness of all 4 condyles showed significant reductions in patients compared with normal controls. Most of the patients were categorized as grade 2 (36%) and grade 3 (30%) of the K-L classification. Mean levels of MMP-3 and TIMP-1 were significantly elevated in both groups but they were not correlated with each other. MMP-3 continued to rise with increasing radiological grades until grade 4, where it fell unexpectedly. In conclusion, Phono-A and cartilage thickness measured by MSUS seem to support each other. They can be used as parameters for following up cartilage in OA of the knees. The first deals with the roughness of the cartilage surface and the second with its thickness, complementing each other. MMP-3 continues to rise in early and middle grades of OA, denoting cartilage destruction.

Correlation between synovial fluid cytokine concentrations and limb function in normal dogs and in dogs with lameness from spontaneous osteoarthritis

“…Several reports have described elevations of MMP-1 and MMP-3 in human patients, with OA affecting a variety of joints and with different severity. 33,34 Particular MMP have been identified in higher concentrations in synovial fluid of osteoarthritic joints compared with normal joints and remain elevated for long periods of time in injured joints, thus having the potential to be reliable indicators of joint environment changes after treatment. 35 In addition, the consistency in elevation has led authors to propose the application of MMP as markers throughout the progression of OA.…”