Scholarlink

Background <p>Early knee osteoarthritis (KOA) is difficult to diagnose due to the limited sensitivity of conventional imaging and the heterogeneous presentation. This exploratory study aimed to characterize patients with early KOA symptoms by integrating arthroscopy, MRI, and synovial histopathology, and to assess the complementary value of these modalities.</p> Methods <p>We included 130 adults (&gt; 18 years) with knee pain lasting &gt; 3 months and inconclusive clinical and radiographic findings. Exclusion criteria included advanced radiographic OA (Kellgren–Lawrence grade &gt; 2), previous diagnoses of musculoskeletal, rheumatic disorders or previous knee injury or surgery. MRI was performed before arthroscopy. Isolated minor findings (small focal cartilage defects or mild meniscal changes without structural disruption) were not considered exclusionary. All patients underwent diagnostic arthroscopy, and synovial biopsies were obtained from the medial patella and infrapatellar fat pad.</p> Results <p>Based on arthroscopic Outerbridge scoring, 24 patients were classified as early KOA (grades 0–2) and 55 as moderate KOA (grades 3–4). Arthroscopy detected early cartilage lesions in 60% of cases, compared with 35% by MRI. MRI WORMS scores for non-cartilaginous structures did not differ between groups. Synovial fibrosis and macrophage infiltration were higher in moderate KOA and correlated with WOMAC pain.</p> Conclusion <p>Arthroscopy was more sensitive than MRI for early cartilage damage, while MRI provided complementary information on non-cartilaginous structures. Synovial inflammation and fibrosis were already present at early stages. An integrated approach combining arthroscopy, MRI, and synovial histopathology enables refined structural and biological characterization of early KOA and may support patient stratification in disease-modifying trials.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Integration of gold standard arthroscopy, MRI and synovial histopathology outcomes for enhancing early knee osteoarthritis diagnosis

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年2月20日

查看全文
  • Gabriel Herrero-Beaumont,
  • Javier Fernández-Jara,
  • Javier Llorca,
  • Irene Sanchez-Platero,
  • María Garmendia,
  • Juan Ignacio Masa,
  • Álvaro Auñón,
  • Patricia Rodriguez-Zamorano,
  • Aránzazu Mediero,
  • Felipe López-Oliva,
  • Nasser Al-Daghri,
  • Nicola Veronese,
  • Jean-Yves Reginster,
  • Raquel Largo

摘要

Background

Early knee osteoarthritis (KOA) is difficult to diagnose due to the limited sensitivity of conventional imaging and the heterogeneous presentation. This exploratory study aimed to characterize patients with early KOA symptoms by integrating arthroscopy, MRI, and synovial histopathology, and to assess the complementary value of these modalities.

Methods

We included 130 adults (> 18 years) with knee pain lasting > 3 months and inconclusive clinical and radiographic findings. Exclusion criteria included advanced radiographic OA (Kellgren–Lawrence grade > 2), previous diagnoses of musculoskeletal, rheumatic disorders or previous knee injury or surgery. MRI was performed before arthroscopy. Isolated minor findings (small focal cartilage defects or mild meniscal changes without structural disruption) were not considered exclusionary. All patients underwent diagnostic arthroscopy, and synovial biopsies were obtained from the medial patella and infrapatellar fat pad.

Results

Based on arthroscopic Outerbridge scoring, 24 patients were classified as early KOA (grades 0–2) and 55 as moderate KOA (grades 3–4). Arthroscopy detected early cartilage lesions in 60% of cases, compared with 35% by MRI. MRI WORMS scores for non-cartilaginous structures did not differ between groups. Synovial fibrosis and macrophage infiltration were higher in moderate KOA and correlated with WOMAC pain.

Conclusion

Arthroscopy was more sensitive than MRI for early cartilage damage, while MRI provided complementary information on non-cartilaginous structures. Synovial inflammation and fibrosis were already present at early stages. An integrated approach combining arthroscopy, MRI, and synovial histopathology enables refined structural and biological characterization of early KOA and may support patient stratification in disease-modifying trials.