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a Rheumatology Unit, City Hospital, Hucknall Road,
Nottingham NG5 1PB, United Kingdom , b Biochemistry Division, Kennedy Institute of
Rheumatology, 6 Bute Gardens, Hammersmith, London W6 7DW, United
Kingdom
Correspondence to: Professor M Doherty.
Accepted for publication 28 October 1996
OBJECTIVE
To determine if a single time point
estimation of chondroitin sulphate (CS) or keratan sulphate (KS)
epitopes, hyaluronan (HA), or total glycosaminoglycans (GAG) in
knee synovial fluid at time of hospital referral can predict subsequent
radiographic progression of knee osteoarthritis.
METHODSTwo groups of hospital referred patients
with knee osteoarthritis were compared: (1) a "progressive" group
(n = 45), showing further reduction in radiographic joint space of
at least one grade (0-3) in at least one compartment; and (2) a
"non-progressive" group (n = 25) in whom radiographs showed no
change during the mean follow up period of 2.3 years (median 2, range 1 to 5 years). Knee synovial fluid obtained at the first visit was
examined by ELISA for: CS epitopes, using monoclonal
antibodies 3B3 and 7D4; KS epitope, using monoclonal antibody 5D4; and
HA, using biotinylated HA binding region of cartilage proteoglycan.
Total sulphated GAG were measured by dye binding with 1:9
dimethylmethylene blue.
RESULTSIn patients with bilateral synovial fluid
data right and left knee values were closely correlated for all
variables. There were no significant differences between CS and KS
epitopes, HA, total sulphated GAG, or ratios of individual CS or KS
epitopes to total GAG, between progressive and non-progressive groups.
CONCLUSIONSSingle time point estimation of CS,
KS, HA, or total GAG in synovial fluid does not distinguish
radiographically progressive and non-progressive knee osteoarthritis
patients followed for two years.
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