A study to assess relationship between Synovial fluid lipid peroxidation marker and the severity of knee osteoarthritis

Abstract

Osteoarthritis is the most common cause of pain due to arthritis in women. Its high prevalence especially in the postmenopausal women, and the high rate of disability associated with the disease makes it a diagnostic and therapeutic priority. A hospital based cross sectional study was conducted in Burdwan Medical College, West Bengal, India on 76 postmenopausal women aged 45-70 years suffering from Osteoarthritis (OA) of the knee joint, which was diagnosed from symptoms, clinical examinations and radiographic findings. 150 subjects undergoing knee joint arthroscopy for chronic knee pain, meniscal tears or anterior cruciate ligament reconstruction were taken as control .Synovial fluid malondialdehyde (MDA) was measured as an index of synovial fluid lipid peroxidation. The width of knee joint space was measured from the radiographic plates to assess the disease severity. Knee joint radiographs were evaluated with the Kellgren-Lawrence grading scale .Furthermore both were correlated with oxidative stress parameters ,synovial fluid MDA levels to find out possible association between the oxidative stress induced damage and the disease progression. Results showed that there was a significant increase in MDA levels in patients with knee joint osteoarthritis as compared to the controls. Synovial MDA showed positive correlation with Kellgren-Lawrence grading and negative correlation with knee joint space width. The joint space width decreased and synovial MDA increase with increasing Kellgren-Lawrence grad. especially in the elderly, and the high rate of disability related to disease makes it a leading cause of disability, suffering and morbidity. Over 40% of the Indian populations in the age group of 70 years or above suffer from osteoarthritis 3 it is characterized by low-grade inflammation resulting in pain in the joints. Pain is caused due to wear and destruction of the joint cartilage as well as destruction or decrease of synovial fluid that lubricates those joints. Current concepts of the pathogenic mechanisms of OA suggest that there is a shift in the homeostatic balance between the destruction and synthesis of bone and cartilage, with a net progressive destruction of these tissues 4 Recent studies of the biology of chondrocytes show that these cells actively produce reactive oxygen species (ROS), including superoxide anions, hydrogen peroxide, hydroxyl radicals, and nitric oxide 5 which may be detected in the synovial fluid of the knee joint. However, few studies have been done to establish the relationship between oxidative stress and clinical severity of disease. Aim of this study was to analyze the relationship between oxidative stress in the knee joints and the clinical severity of osteoarthritis. The clinical severity of OA was evaluated by measuring the width of knee joint space and by utilizing the Kellgren-Lawrence grading scale. The width of knee joint space was measured from the radiographs of the same. The severity of OA was graded by the Kellgren-Lawrence grading scale 6