الفهرس | Only 14 pages are availabe for public view |
Abstract Osteoarthritis is the most common type of adult joint disease, and is increasing in frequency and severity. Although osteoarthritis is commonly described as noninflammatory joint disease, synovial inflammation is increasingly recognized as contributing to the symptoms and progression of osteoarthritis. Osteoarthritis pathophysiology is complex. However, these inflammatory processes were interpreted mainly as a bystander, and not as a driving force in osteoarthritis pathogenesis. A set of new studies has raised interest in this topic and aimed to map these inflammatory processes more precisely. Studies have shown that patients with inflammation show faster osteoarthritis progression, confirming the hypothesis that inflammation has an impact on disease progression A major problem in cartilage repair is the lack of chondrogenic cells migrating from healthy tissue into defects and being essentially avascular. Microscopic examination in early osteoarthritis revealed for more than half of patients with synovial biopsy through arthroscopic technique having synovitis lesions with mononuclear infiltrates, diffuse fibrosis, thickening of the lining layer, macrophages appearance and vessels neoformation as well. Aiming to figure out the role of leukocytes in prediction, diagnoses and prognosis of osteoarthritis. Finding whether leukocytes may serve as biomarkers for both early diagnosis and, perhaps more importantly, identification of osteoarthritis patients at higher risk for disease progression. Two hundred knees of patients with symptoms and signs suggestive of Osteoarthritis were collected from outpatient clinic of Orthopaedics Department, Ain Shams University Hospitals. In clinic practice, plain radiographs are a readily available and cost-effective means of assessing the knee joint. In combination with the patient’s symptoms and physical exam, radiographs are used to grade the severity of knee OA along with the KOOS questionnaire. Inclusion criteria: 1. Radiological findings: narrowing of joint space, subchondral sclerosis and bony osteophyts. 2. Joint swelling on inspection, crepitus and tenderness on palpation. Exclusion criteria: 1- History of any previous injections of the Knee. 2- Previous knee injury or surgery. 3- Rheumatoid arthritis 4-Cancer especially hematopoietic or of bone. The study was conducted on 200 patients diagnosed with primary osteoarthritis. All patients will be subjected to the following: Full medical history taking and thorough clinical examination, stressing on joints examination. Plain x-rays for both knees, synovial fluid tapping for detection of leucocytes, and KOOS questionnaire filling. Result shows that there was highly statistically significant increase in synovial fluid white cell count with the increase of severity. There was statistically significant relation found between severity of osteoarthritis and age while no statistically significant relation found with sex or BMI. Side of knee examined and appearance of synovial fluid aspiration samples did not show significant relation with severity of osteoarthritis. There was highly statistically significant inverse relation found between severity of osteoarthritis and KOOS score. |