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[Study on correlation between the pathological changes under arthroscopy and the cytokine levels in the knee osteoarthritis of the Blood Stasis type].

OBJECTIVE
To explore the correlation between cytokine levels and the pathological changes under arthroscopy in knee osteoarthritis of Blood Stasis type.


METHODS
From 2009.2 to 2010.3, 90 patients with knee osteoarthritis were reviewed. Among the patients, 17 patients were male and 73 patients were female, ranging in age from 40 to 70 years, averaged 57.2 years, the duration of the disease ranged from 1 month to 10 years, with a mean of 3.4 years. Thirty-one patients had osteoarthritis in left knee, and 59 patients in right knee. The patients had the syndrome of blood stasis. All the patients had pain and morning stiffness; most patients had joint interlocking; and all the patients didn't have joint swelling. The synovial fluid was collected before surgery, and ELISA was used to detect the contents of interleukin-1beta and transforming growth factor-beta1. At the same time, the pathological changes of the joint were observed under the arthroscopy. Based on the above datum analysis, the severity of knee osteoarthritis of blood stasis type was studied, and the correlation between different types of pathological changes under arthroscopy and cytokine levels was analyzed.


RESULTS
The contents of IL-1beta and TGF-beta1 in synovial fluid were (28.18 +/- 5.57) pg/ml and (51.69 +/- 6.56) pg/ml respectively. The level of IL-1beta of grade III-IV cartilage degeneration was (30.65 +/- 3.48) pg/ml, which was significantly higher than (20.55 +/- 3.50) pg/ml of grade I-II cartilage degeneration group; the level of TGF-beta1 of grade I-II cartilage degeneration was (58.18 +/- 3.98) pg/ml,which was significantly higher than (49.59 +/- 5.83) pg/ml of grade II-IV cartilage degeneration group. IL-1beta and cartilage degeneration was positively correlated, the correlation coefficient was 0.744; TGF-beta1 and cartilage degeneration was negatively correlated, the correlation coefficient was -0.563. The level of IL-1beta of grade II-III synovial hyperplasia was (33.48 +/- 2.95) pg/ml, which was significantly higher than (25.40 +/- 4.50) pg/ml of grade I synovial hyperplasia group; IL-beta was positively correlated with synovial hyperplasia, the cor- relation coefficient was 0.801. The levels of IL-1beta of grade I osteophyte formation was (34.18 +/- 2.69) pg/ml, which was significantly higher than (25.74 +/- 4.48) pg/ml of grade 0 osteophyte formation group; the level of TGF-beta 1 of grade 0 osteophyte formation was (53.11 +/- 6.78) pg/ml, which was higher than (48.21 +/- 4.47) pg/ml of grade I osteophyte formation group. IL-1beta was positively correlated with osteophyte formation, the correlation coefficient was 0.762; TGF-beta1 was negatively correlated with osteophyte formation, the correlation coefficient was - 0.340.


CONCLUSION
All the patients with knee osteoarthritis identified as blood stasis syndrome have pathological changes such as articular cartilage degeneration and synovial hyperplasia. The level of IL-1beta has important reference value to estimate the severity of cartilage degeneration, synovial hyperplasia and osteophyte proliferation.