PROTEOGLYCANS IN THE SYNOVIAL-FLUID OF THE TEMPOROMANDIBULAR-JOINT ASAN INDICATOR OF CHANGES IN CARTILAGE METABOLISM DURING PRIMARY AND SECONDARY OSTEOARTHRITIS

Purpose: The specific aim of this investigation was to assess differen ces between primary and secondary osteoarthritis (OA) of the temperoma ndibular joint (TMJ) using clinical evaluation and synovial fluid anal ysis for proteoglycans. Materials and Methods: Arthroscopic surgery wa s performed on 101 TMJs from patients with significant pain or dysfunc tion and who had failed to respond to treatment, Joints were assessed for primary and secondary osteoarthritis. Synovial fluid aspirates wer e obtained and analyzed to determine the levels of keratan sulfate (KS ) epitope and a novel 3B3(-) epitope by enzyme-linked immunosorbent as say (ELISA). Results: Fifty-four patients and 67 joints had OA diagnos ed by both clinical examination and arthroscopy, Primary OA was diagno sed in 14 joints (20%), and the remaining 53 joints were regarded as h aving secondary OA. No differences were detected in the levels of KS i n the synovial fluid from the primary and secondary OA joints. Further more, the 3B3(-) epitope was not detectable in the synovial fluid aspi rates of any TMJ. Conclusion: Secondary OA is a common disorder of the TMJ. However, there is no apparent difference in the metabolism of th e joints with primary and secondary OA as assessed by proteoglycans in the synovial fluid. The apparent absence of the 3b3(-) epitope, in co ntrast to its presence in OA of other major synovial joints, suggests that there are some differences between the cartilage metabolism of th e TMJ and these other joints during OA.