BIOCHEMICAL MARKERS IN SYNOVIAL-FLUID IDENTIFY EARLY OSTEOARTHRITIS OF THE GLENOHUMERAL JOINT

The objective of this study on the glenohumeral joint was to assess th e (1) accuracy of clinical diagnosis of osteoarthritis compared with a rthroscopic diagnosis, and (2) the ability of biochemical markers in s ynovial fluid to detect osteoarthritis, Patients (96) were examined cl inically and the preoperative diagnosis of osteoarthritis was recorded , At surgery (arthroscopy or arthroplasty), the glenohumeral joint was inspected for signs of osteoarthritis, and the joint osteoarthritis g rade (I-IV) was recorded, At surgery, synovial fluid lavage was obtain ed from the joint, and later analyzed to determine levels of aggrecan components: total sulfated glycosaminoglycan and keratan sulfate epito pe, link protein and the chondroitin sulfate epitope recognized by ant ibody 3B3 (3B3(-)), Compared with arthroscopic diagnosis of osteoarthr itis, the results showed that the clinical diagnosis did not wrongly i dentify joints without osteoarthritis, and was always able to identify joints with advanced (Grade IV) osteoarthritis, Grade II osteoarthrit is was rarely identified (10% of the time), and Grade III osteoarthrit is was identified 50% of the time, Biochemical assessment of the synov ial fluid showed that the catabolic markers (sulfated glycosaminoglyca n, keratan sulfate and link protein) were elevated in fluids from join ts with moderate (Grade III) and advanced osteoarthritis (Grade IV), a nd the 3B3(-) epitope was elevated in Grades II, III, and IV, These re sults show that arthroscopic diagnosis for osteoarthritis of the gleno humeral joint is particularly useful for early and moderate osteoarthr itis, where clinical (nonarthroscopic) diagnosis is poor, and that bio chemical analysis of the synovial fluids corresponds well to arthrosco pic diagnosis of shoulder osteoarthritis.