Relevance between arthroscopic pathology and clinical characteristics in knee osteoarthritis

Arthroscopy can be used to identify accurately cartilage and synovial changes in knee osteoarthritis (OA). The objective of this study was to find the correlation between arthroscopically established knee chondropathy and synovitis and the corresponding algofunctional characteristics in OA.

41 patients with OA in only one knee joint were investigated. The diagnosis of knee OA fulfilled the clinical, laboratory and radiological ARA criteria. Low pressure arthroscopy of the affected knee was performed under local anaesthesia. Chondropathy was evaluated according to the method of R E Outerbridge. Synovial inflammation was assessed by the scoring system of S. Lindblad and E. Hedfors.

We found statistically significant correlation (Spearman's rho test) between chondropathy of the knee and the following clinical indices: pain at night, pain after standing 30 minutes, pain on walking, pain on getting up from a chair without help of arms, maximum walking distance. We failed to demonstrate statistical significant correlation between chondropathy and morning stiffness and activities of daily living. There was also no statistical correlation between knee synovitis and any of the Lequesne's clinical indices.

The arthroscopically established scores of the cartilage pathology were consistent with most of the clinical algofunctional symptoms. The degree of synovitis in our study was not correlated with clinical activity symptoms of OA, according to Leguesne. Five positive algofunctional Lequesne's scores corresponded to heavy breakdown of knee cartilage in OA.