Arthritis / 2015 / Article / Tab 2

Review Article

A Systematic Review Investigating the Presence of Inflammatory Synovitis in Hip and Knee Joint Replacement Surgery

Table 2

Study design and characteristics.

StudyOA/RASurgical interventionImaging modalitySynovial tissue scoringMarkers measuredClinical scoring systemResult

Benito et al., 2005 [22]OATKR or arthroscopyXRN/AInflammatory cell infiltrate, blood vessel formation, angiogenic factors, NF-kB activation, TNFα, IL-1β, COX-1, COX-2, and fibroblast like synoviocytes (FLS) NAEarly OA tissue exhibited greater lining layer thickness and greater CD4+ T cell and CD68+ macrophage infiltration; also more numerous blood vessels and VEGF and ICAM-I expression and greater numbers of cells producing TNFα and IL-1β; FLS functionally similar in early and late OA

De Lange-Brokaar et al., 2013 (abstract) [18, 19]OAArthroscopyContrast enhanced MRIGuermazi et al. MRI scoring systemN/AVAS painKnee synovitis severity on MRI correlated with macroscopic and microscopic histological synovitis features but not with VAS pain

De Lange-Brokaar et al., 2013 (abstract) [18, 19]OAArthroscopy or TKRContrast enhanced MRIGuermazi et al. MRI scoring systemN/ADifferent patterns of knee synovitis were correlated to knee pain scoring systems

De Lange-Brokaar et al., 2014 [10]OAArthroscopy or TKRGd-DOTA MRI 3TKrenn et al. system, lining cell layer, synovial stroma, and inflammatory infiltrate graded 0–3N/AN/ASynovitis severity on MRI correlated with macro- and microscopic features of synovitis in knee OA

Liang et al., 2009 (abstract) [23]OATKR or arthroscopy or Anterior Cruciate Ligament (ACL) reconstructionN/ASynovial CD31, NF-xB, MMP-1, COX-2, IL-1β, and TGF-βJKOMSynovium MMP-1, COX-2, and IL-1β expression in end stage OA reduced in comparison to those of progressive OA; expression of TGF-β in the synovium of end stage OA was significantly increased in comparison to that of progressive OA; the MMP-1, IL-1β, and TGF-β expression in the synovium significantly correlated with the radiographic and clinical manifestations of knee OA

Lambert et al., 2014 [28]OATKRN/ASurgeon graded macroscopic criteria by Ayral et al. normal, reactive, and inflamedCytokines, chemokines, enzymes, anabolism, catabolism, and angiogenesis compounds N/AInflammation, cartilage metabolism, Wnt signalling, and angiogenesis pathways were upregulated in areas of inflamed synovium

Liu et al., 2010 [11]OATKRGd-MRI 1.5THistological parameters 0–3N/AJKOM, VAS, and WOMACNeither synovitis nor Gd-MRI score correlates with pain VAS score or WOMAC; they only correlated with JKOM score

Oehler et al., 2002 [27]OATKR or arthroscopyN/AScored 0–4, immunohistochemistryInflammatory infiltratesN/A4 subtypes of synoviopathy characterised; hyperplastic in early OA; inflammatory in early and late OA; fibrotic and detritus rich in late OA

Østergaard et al., 1998 [9]OA and RAKnee arthroscopy or arthrotomyGd-DTPA MRI 1.5THistological parameters 0–3 N/AN/ADynamic MRI can be used to determine synovial inflammation but could not differentiate between moderate and severe inflammation

Scanzello et al., 2009 [24]OATKRXRN/AIL-15, IL-6, IL-1β, TNFα, IL-2, IL-21, MMP-1, and MMP-3N/ALymphocytic infiltrates found in all early OA specimens but only in some end stage specimens; IL-15 significantly higher in early OA patients

Smith et al., 1997 [26]OATKR or arthroscopyN/AScored 0–4, immunohistochemistryIL-1α, IL-1β, TNFα, and IL-1raN/ASynovial membrane inflammation more severe with advanced OA

Takase et al., 2012 [16]OA and RATKRGSUS, PDUS, and Gd-DTPA 1.5T MRIOMERACT-RAMRIS (0–3), histopathology 0–3 Immunohistochemistry CD68, Ki-67, and CD31 N/AGSUS, PDUS, and MRI correlated with pathological total synovitis score; only PDUS and MRI showed high correlation with immunohistochemical parameters (CD68 for inflammatory cell infiltrate, Ki-67 for synovial lining cell thickness, and CD31 for vascularity)

Tanavalee et al., 2011 [30]OATKRN/AN/ASerum CRP, ESR, and IL-6American Knee Society score and knee surface temperatureSynovectomy at the time of TKR does not benefit the outcome nor shorten the duration of the inflammatory response

Walther et al., 2001 [15]OA AND RATKRPower Doppler sonography (PDS)Vascularity graded 1–4N/AN/APDS reliable in qualitative grading of synovial tissue vascularity in knees

Walther et al., 2002 [14]OA and RATHRPDSVascularity graded 1–4N/AN/APDS reliable in qualitative grading of synovial tissue vascularity in hips

Waldstein et al., 2014 [17]OATKRMRI 1.5 or 3TWORMS scoring system; Krenn et al. synovium grading system, lining cell layer, synovial stroma, and inflammatory infiltrate graded 0–3Synovial WBC count, Mankin cartilage grading system; aggregate and dynamic modulus cartilage biomechanicsN/ACartilage mechanically inferior in knees with WBC >150 WBCs/mL compared to knees with <150 WBCs/mL; MRI and histopathologic synovitis grades did not correlate with each other or aggregate or dynamic cartilage modulus