Pathology of bone epiphyses and frequency of various damage degree cases in patients with rheumatoid arthritis complicated by knee joint frontal deformities
DOI:
https://doi.org/10.14739/2310-1237.2020.2.212802Keywords:
rheumatoid arthritis, knee joint, valgus deformity, varus deformity, histological investigation, statistical data analysisAbstract
Aim: based on several semi-quantitative morphometric indices, which represent pathological changes in femoral and tibial condyles, to determine pathological changes occurrence frequencies of damaged knee joints, complicated by frontal deformations.
Materials and methods. Resected femoral and tibial condyles, obtained during knee replacement in 38 patients with rheumatoid arthritis and deformations of knee joints in frontal plane, served as material of current study. The following research methods were used: clinical examination, histological with semi-quantitative morphometric indices determination; statistical with determination of mean parameters, frequency of occurrence of cases with different gradations of indicators expression and their differences.
Results. Groups of rheumatoid arthritis patients with lesions of knee joints complicated by deformities in frontal plane of different forms (valgus – varus), had significant differences by several clinical and clinical-visual indices. Pathological changes of epiphyses which are reflected by such morphometric parameters as “pannus structure and inflammation”, “inflammatory activity in subchondral spongiosa” and “stage of dystrophic-destructive changes of the joint surface” with different frequency and severity occur in the tissues of all rheumatoid arthritis patients with knee injuries, complicated by frontal deformations.
In condyles from bones of one type, that form knee joint, compared in varus and valgus deformities, occurrence frequency of varying severity cases of separate morphometric indices varies in condyles according to different degree of compression. In condyles from bones of one type, which form knee joint, compared in different bones (femur and tibia) in cases of valgus deformity there was higher occurrence frequency of cases with more expressed indicator of “pannus structure and inflammation” in tibial condyles, in cases of varus deformity – in femoral condyles (independent of degree of compression).
Conclusions. Results of study showed that degree of both clinical and morphometric indices of tibia and femur condyles condition in patients with rheumatoid arthritis and knee joint frontal deformities has no constant, unambiguous tendencies, and occurrence frequencies of cases with high and low degrees vary in wide limits.
References
Korb-Pap, A., Bertrand, J., Sherwood, J., & Pap, T. (2016). Stable activation of fibroblasts in rheumatic arthritis - causes and consequences. Rheumatology, 55, 64-67. https://doi.org/10.1093/rheumatology/kew347
McHugh, K. P., Shen, Z., Crotti, T. N., Flannery, M. R., O'Sullivan, R. P., Purdue, P. E., & Goldring, S. R. (2010). The role of cell-substrate interaction in regulating osteoclast activation: potential implications in targeting bone loss in rheumatoid arthritis. Annals of the Rheumatic Diseases, 69, 83-85. https://doi.org/10.1136/ard.2009.120188
Harre, U., & Schett, G. (2017). Cellular and molecular pathways of structural damage in rheumatoid arthritis. Seminars in Immunopathology, 39(4), 355-363. https://doi.org/10.1007/s00281-017-0634-0
Ostrowska, M., Maśliński, W., Prochorec-Sobieszek, M., Nieciecki, M., & Sudoł-Szopińska, I. (2018). Cartilage and bone damage in rheumatoid arthritis. Reumatologia, 56(2), 111-120. https://doi.org/10.5114/reum.2018.75523
Hryhorovskyi, V. V., Babko, A. M., & Gerasymenko, A. M. (2019). Morfolohichni pokaznyky patolohichnykh zmin kulshovoho suhloba, yikh chastota ta koreliatsiini zalezhnosti mizh pokaznykamy histomorfometrii sponhiozy holivky stehnovoi kistky u khvorykh na revmatoidnyi artryt [Morphological indices of pathological changes of the hip joint, the frequency of their occurrence and correlations with indicators of femoral head spongiosa histomorphometry in patients with rheumatoid arthritis]. Ukrainskyi revmatolohichnyi zhurnal, (1), 49-59. [in Ukrainian].
Meng, X. H., Wang, Z., Zhang, X. N., Xu, J., & Hu, Y. C. (2018). Rheumatoid Arthritis of Knee Joints: MRI-Pathological Correlation. Orthopaedic Surgery, 10(3), 247-254. https://doi.org/10.1111/os.12389
Panchenko, L. M., Avtomeenko, Ye. M., Babko, A. M., Gerasimenko, S. I., Herasymenko, A. M., & Polishko, V. P. (2018). Pokaznyky osteohennoi aktyvnosti stovburovykh stromalnykh klityn kiskovoho mozku u khvorykh na revmatoidnyi atrtryt za naiavnosti frontalnykh deformatsii kolinnoho suhloba [The indexes of osteogenic stem cells activity in patients with rheumatoid arthritis and frontal knee deformities]. Ortopediya, travmatologiya i protezirovanie, (1), 29-35. [in Ukrainian]. https://doi.org/10.15674/0030-59872018141-46
Hryhorovskyi, V. V., Gerasimenko, A. S., Panchenko, L. M., & Lyutko, O. B. (2015). Koreliatsii histomorfometrychnykh pokaznykiv sponhiozy suhlobovykh kintsiv stehnovoii kistky i resultativ klinichnykh ta laboratornykh doslidzhen u khvorykh na revmatoidnyi artryt [Correlations of histomorphometrical indicators of spongiosa of the femur articular parts and the results of clinical and laboratory studies in patients with rheumatoid arthritis]. Ortopediya, travmatologiya i protezirovanie, (3), 36-45. [in Ukrainian]. https://doi.org/10.15674/0030-59872015336-45
Hillen, J., Geyer, C., Heitzmann, M., Beckmann, D., Krause, A., Winkler, I., Pavenstadt, H., Bremer, C., Pap, T., & Korb-Pap, A. (2017). Structural cartilage damage attracts circulating rheumatoid arthritis synovial fibroblasts into affected joints. Arthritis Research & Therapy, 19, Article 40. https://doi.org/10.1186/s13075-017-1245-9
Shimizu, S., Shiozawa, S., Shiozawa, K., Imura, S., & Fujita, T. (1985). Quantitative histologic studies on the pathogenesis of periarticular osteoporosis in rheumatoid arthritis. Arthritis and Rheumatism, 28(1), 25-31. https://doi.org/10.1002/art.1780280105
Chou, P. H., Chen, W. M., Chen, C. F., Chiang, C. C., Liu, C. L., & Chen, T. H. (2012). Clinical Comparison of Valgus and Varus Deformities in Primary Total Knee Arthroplasty Following Midvastus Approach. Journal of Arthroplasty, 27(4), 604-612. https://doi.org/10.1016/j.arth.2011.06.015
Amin, M. A., Fox, D. A., & Ruth, J. H. (2017). Synovial cellular and molecular markers in rheumatoid arthritis. Seminars in Immunopathology, 39(4), 385-393. https://doi.org/10.1007/s00281-017-0631-3
Alunno, A., Carubbi, F., Giacomelli, R., & Gerli, R. (2017). Cytokines in the pathogenesis of rheumatoid arthritis: new players and therapeutic targets. BMC rheumatology, 1, 3. https://doi.org/10.1186/s41927-017-0001-8
Herz, B., Albrecht, A., Englbrecht, M., Welsch, G. H., Uder, M., Renner, N., Schlechtweg, P., Paul, D., Lauer, L., Engelke, K., Janka, R., Rech, J., Schett, G., & Finzel, S. (2014). Osteitis and synovitis, but not bone erosion, is associated with proteoglycan loss and microstructure damage in the cartilage of patients with rheumatoid arthritis. Annals of the rheumatic diseases, 73(6), 1101–1106. https://doi.org/10.1136/annrheumdis-2012-202850
Kroger, H., Arnala, I., Rehnberg, V., Hamalainen, M., & Alhava, E. (1994). Histomorphometry of periarticular bone in rheumatoid arthritis. Annales Chirurgiae Et Gynaecologiae, 83(1), 56-62.
Li, G., Ma, Y., Cheng, T. S., Landao-Bassonga, E., Qin, A., Pavlos, N. J., Zhang, C., Zheng, Q., & Zheng, M. H. (2014). Identical subchondral bone microarchitecture pattern with increased bone resorption in rheumatoid arthritis as compared to osteoarthritis. Osteoarthritis and Cartilage, 22(12), 2083-2092. https://doi.org/10.1016/j.joca.2014.08.015
Pap, T., & Korb-Pap, A. (2015). Cartilage damage in osteoarthritis and rheumatoid arthritis-two unequal siblings. Nature Reviews Rheumatology, 11(10), 606-615. https://doi.org/10.1038/nrrheum.2015.95
Brawer, A. E., & Goel, N. (2016). The onset of rheumatoid arthritis following trauma. Open Access Rheumatology-Research and Reviews, 8, 77-80. https://doi.org/10.2147/oarrr.s110560
Downloads
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (SeeThe Effect of Open Access).
