The degenerated glenohumeral joint.

IF 4.7 2区 医学 Q2 CELL & TISSUE ENGINEERING Bone & Joint Research Pub Date : 2024-10-21 DOI:10.1302/2046-3758.1310.BJR-2024-0026.R1
Stefan Toegel, Luca Martelanz, Juergen Alphonsus, Lena Hirtler, Ruth Gruebl-Barabas, Melanie Cezanne, Mario Rothbauer, Philipp Heuberer, Reinhard Windhager, Leo Pauzenberger
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Abstract

Aims: This study aimed to define the histopathology of degenerated humeral head cartilage and synovial inflammation of the glenohumeral joint in patients with omarthrosis (OmA) and cuff tear arthropathy (CTA). Additionally, the potential of immunohistochemical tissue biomarkers in reflecting the degeneration status of humeral head cartilage was evaluated.

Methods: Specimens of the humeral head and synovial tissue from 12 patients with OmA, seven patients with CTA, and four body donors were processed histologically for examination using different histopathological scores. Osteochondral sections were immunohistochemically stained for collagen type I, collagen type II, collagen neoepitope C1,2C, collagen type X, and osteocalcin, prior to semiquantitative analysis. Matrix metalloproteinase (MMP)-1, MMP-3, and MMP-13 levels were analyzed in synovial fluid using enzyme-linked immunosorbent assay (ELISA).

Results: Cartilage degeneration of the humeral head was associated with the histological presentation of: 1) pannus overgrowing the cartilage surface; 2) pores in the subchondral bone plate; and 3) chondrocyte clusters in OmA patients. In contrast, hyperplasia of the synovial lining layer was revealed as a significant indicator of inflammatory processes predominantly in CTA. The abundancy of collagen I, collagen II, and the C1,2C neoepitope correlated significantly with the histopathological degeneration of humeral head cartilage. No evidence for differences in MMP levels between OmA and CTA patients was found.

Conclusion: This study provides a comprehensive histological characterization of humeral cartilage and synovial tissue within the glenohumeral joint, both in normal and diseased states. It highlights synovitis and pannus formation as histopathological hallmarks of OmA and CTA, indicating their roles as drivers of joint inflammation and cartilage degradation, and as targets for therapeutic strategies such as rotator cuff reconstruction and synovectomy.

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退化的盂肱关节
目的:本研究旨在确定肱骨头软骨退行性变和盂肱关节滑膜炎症患者的组织病理学特征。此外,还评估了免疫组化组织生物标志物在反映肱骨头软骨退化状况方面的潜力:方法:对 12 名 OmA 患者、7 名 CTA 患者和 4 名遗体捐献者的肱骨头和滑膜组织标本进行组织学处理,并采用不同的组织病理学评分标准进行检查。对骨软骨切片进行免疫组化染色,检测 I 型胶原、II 型胶原、胶原新表位 C1、2C、X 型胶原和骨钙素,然后进行半定量分析。使用酶联免疫吸附试验(ELISA)分析滑液中基质金属蛋白酶(MMP)-1、MMP-3和MMP-13的水平:结果:肱骨头软骨退变与以下组织学表现有关:在 OmA 患者中,1)软骨表面增生的脓疱;2)软骨下骨板中的孔隙;3)软骨细胞簇。相比之下,滑膜内层的增生是炎症过程的一个重要指标,主要出现在 CTA 中。胶原蛋白 I、胶原蛋白 II 和 C1、2C 新表位的丰度与肱骨头软骨的组织病理学退化有显著相关性。没有证据表明 OmA 和 CTA 患者的 MMP 水平存在差异:本研究提供了盂肱关节内肱骨软骨和滑膜组织在正常和患病状态下的全面组织学特征。它强调了滑膜炎和脓肿的形成是 OmA 和 CTA 的组织病理学特征,表明它们是关节炎症和软骨退化的驱动因素,也是肩袖重建和滑膜切除等治疗策略的目标。
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来源期刊
Bone & Joint Research
Bone & Joint Research CELL & TISSUE ENGINEERING-ORTHOPEDICS
CiteScore
7.40
自引率
23.90%
发文量
156
审稿时长
12 weeks
期刊介绍: The gold open access journal for the musculoskeletal sciences. Included in PubMed and available in PubMed Central.
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