Correlation between arthroscopic diagnosis of osteoarthritis and synovitis of the human temporomandibular joint and keratan sulfate levels in the synovial fluid
Correlation between arthroscopic diagnosis of osteoarthritis and synovitis of the human temporomandibular joint and keratan sulfate levels in the synovial fluid
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DOI：
10.1016/s0278-2391(97)90526-7
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发表时间：
1997-03-01
影响因子：
1.9
通讯作者：
Ratcliffe, A
中科院分区：
文献类型：
--
作者：
Israel, HA;Diamond, BE;Ratcliffe, A
目的：本研究的具体目的是确定关节镜诊断滑膜炎与骨性关节炎之间是否存在联系，以及滑膜炎的存在是否会影响关节软骨的退化程度，如滑膜液中硫酸角蛋白的水平。患者和方法：对88例有明显疼痛或功能障碍且保守治疗无效的患者的114个关节进行了关节镜手术，在关节镜检查前立即获取滑液并用于测定硫酸角蛋白的水平，关节镜检查包括评估有无骨关节炎和滑膜炎。关节镜检查90%的关节存在滑膜炎，62%的关节存在骨性关节炎，57%的关节同时存在骨性关节炎和滑膜炎。关节镜检查诊断为滑膜炎的关节滑液中的硫酸角蛋白水平明显低于骨关节炎关节。骨性关节炎患者关节滑液中硫酸角蛋白的含量明显高于非骨关节炎患者。结论：骨关节炎和滑膜炎是常见的诊断，且常同时存在于有症状的患者中。骨关节炎与硫酸角蛋白水平升高有关；然而，在伴发滑膜炎的患者中，硫酸角蛋白水平升高较少。
Purpose: The specific aims of this investigation were to determine if there is a relationship between an arthroscopic diagnosis of synovitis and osteoarthritis, and if the presence of synovitis influences the level of cartilage degradation, as evidenced by keratan sulfate levels in the synovial fluid.Patients and Methods: Arthroscopic surgery was performed on 114 temporomandibular joints in 88 patients who had significant pain or dysfunction and whose condition had failed to improve with conservative treatment, Synovial fluid aspirates were obtained immediately before arthroscopy and used for the determination of keratan sulfate levels, Arthroscopic examination included assessment of the presence or absence of osteoarthritis and synovitis.Results. Synovitis was present in 90% of joints, and osteoarthritis was present in 62% of joints examined arthroscopically, Both osteoarthritis and synovitis existed in 57% of the joints. Joints with an arthroscopic diagnosis of synovitis had significantly lower levels of keratan sulfate in the synovial fluid aspirates than joints with osteoarthritis. Synovial fluid aspirates from temporomandibular joints with osteoarthritis had significantly higher levels of keratan sulfate than synovial fluids from joints without osteoarthritis.Conclusions: Osteoarthritis and synovitis are common diagnoses and are often present concurrently in patients with symptomatic temporomandibular joints. Osteoarthritis is associated with elevated keratan sulfate levels; however, the elevation of keratan sulfate is less in patients with concomitant synovitis.