Phonoarthrography,musculoskeletal ultrasonography,and biochemical biomarkers for the evaluation of knee cartilage in osteoarthritis |
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Authors: | Hassan M Bassiouni Mamoun El-Deeb Nasser Kenawy Ehab Abdul-Azim Mamdouh Khairy |
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Institution: | (1) Department of Rheumatology, Al-Azhar University 4, Shohada St, Mohandesin, Cairo, Egypt;(2) El-Sahel Teaching Hospital, Cairo, Egypt;(3) SGH Riyad, Cairo, Egypt;(4) Azhar University, Cairo, Egypt |
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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. |
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