الفهرس 
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Abstract
Osteoarthritis (OA) is one of the most prevalent joint diseases that is expected to become more common with aging and overweight populations. Inflammation of the synovium, destruction of the extracellular matrix, articular cartilage degradation, and remodeling of the subchondral bone tissue are characteristics of OA. Additionally, angiogenesis plays an important role in the pathophysiology of osteoarthritis (Mabey et al., 2014).
Angiogenesis through angiogenic factors such as VEGF facilitate plasma extravasation and inflammatory cell recruitment. Angiogenesis at osteochondral junction leads to endochondral ossification and the formation of osteophytes. Angiogenesis and joint damage further exacerbate inflammation (Bonnet and Walsh., 2005).
We aimed to detect vascular endothelial growth factor (VEGF) levels in serum and synovial fluid of patients with knee OA and to determine the relationship of VEGF levels with disease severity in knee OA.
Thirty OA patients and 30 healthy controls were included in this study in which measures of disease activity, severity and functional indices were assessed. Synovial fluid was aspirated from the affected knee joint in OA patients for measuring VEGF level in the synovial fluid by (ELISA). Also serum VEGF level is measured by (ELISA) for patients and controls.
There was no significant difference between serum VEGF levels in OA patients and healthy controls, synovial fluid VEGF level was significantly higher than serum VEGF of OA patients.
According to Kellgren-Lawrence (KL) grading fourteen patients had KL grade 2, 10 had KL grade 3, and 6 had KL grade 4. There was positive correlation between synovial and serum VEGF and radiographic severity by Kellgren-Lawrence (KL) score, synovial and serum VEGF level was significantly higher in patients with KL grade 4 than with KL grade 2 and 3.
from the result of our study we can conclude that:
• VEGF is increased locally in synovial fluid due to in situ production within the knee joint; it may be useful for monitoring OA severity.
• Vascular endothelial growth factor levels in both plasma and synovial fluid were positively correlated with the radiographic grading and severity of knee OA. Therefore, VEGF could play a substantial role in the development and progression of knee OA.
• Since VEGF could be a potential candidate of biochemical markers for the assessment of OA severity. It could be useful in diagnosis of advanced and severe osteoarthritis and in prediction for progression of the disease.
• Vascular endothelial growth factor contributes to the pathogenesis of osteoarthritis and it could be a potential therapeutic target of osteoarthritis.