Histopathological subgroups in knee osteoarthritis

Wyatt, L.A. and Morerton, B.J. and Mapp, Paul I. and Wilson, D. and Hill, R. and Ferguson, Eamonn and Scammell, Brigitte E. and Walsh, D.A. (2016) Histopathological subgroups in knee osteoarthritis. Osteoarthritis and Cartilage, 25 (1). pp. 14-22. ISSN 1522-9653

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Abstract

Objective: Osteoarthritis (OA) is a heterogeneous, multi-tissue disease. We hypothesised that different histopathological features characterise different stages during knee OA progression, and that discrete subgroups can be defined based on validated measures of OA histopathological features.

Design: Medial tibial plateaux and synovium were from 343 post-mortem (PM) and 143 OA arthroplasty donations. A ‘chondropathy/osteophyte’ group (n = 217) was classified as PM cases with osteophytes or macroscopic medial tibiofemoral chondropathy lesions ≥grade 3 to represent pre-surgical (early) OA. ‘Non-arthritic’ controls (n = 48) were identified from the remaining PM cases. Mankin histopathological scores were subjected to Rasch analysis and supplemented with histopathological scores for subchondral bone marrow replacement and synovitis. Item weightings were derived by principle components analysis (PCA). Histopathological subgroups were sought using latent class analysis (LCA).

Results: Chondropathy, synovitis and osteochondral pathology were each associated with OA at arthroplasty, but each was also identified in some ‘non-arthritic’ controls. Tidemark breaching in the chondropathy/osteophyte group was greater than in non-arthritic controls. Three histopathological subgroups were identified, characterised as ‘mild OA’, or ‘severe OA’ with mild or moderate/severe synovitis.

Conclusions: Presence and severity of synovitis helps define distinct histopathological OA subgroups. The absence of a discrete ‘normal’ subgroup indicates a pathological continuum between normality and OA status. Identifying specific pathological processes and their clinical correlates in OA subgroups has potential to accelerate the development of more effective therapies.

Item Type: Article
Keywords: Osteoarthritis; Early osteoarthritis; Synovitis; Cartilage; Bone; Phenotype
Schools/Departments: University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Division of Rehabilitation and Ageing
University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Division of Rheumatology, Orthopaedics and Dermatology
University of Nottingham, UK > Faculty of Science > School of Psychology
Identification Number: 10.1016/j.joca.2016.09.021
Depositing User: Eprints, Support
Date Deposited: 31 Oct 2016 12:02
Last Modified: 03 Aug 2017 08:38
URI: http://eprints.nottingham.ac.uk/id/eprint/38082

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