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Updated: Apr 18, 2026

Synovial Fluid Analysis to Identify Osteoarthritis
Published on: October 20, 2022
Lysosomal enzymes in serum and synovial fluid in patients with osteoarthritis
Dorota Olszewska-Slonina1, Stanislaw Jung, Dariusz Matewski
1Department of Pathobiochemistry and Clinical Chemistry, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun , Bydgoszcz , Poland.
Objective:
To assess the activity of arylsulfatase (AS), acid phosphatase (ACP), cathepsin D (CAT-D) and alpha-1 antitrypsin (AAT) in blood serum and synovial fluid (SF) of patients with hip or knee osteoarthritis (OA).
Methods:
The study included 43 subjects with OA (35 hip OA, 8 knee OA), submitted total joint replacement. The control group consisted of 58 subjects with no past history of musculoskeletal disorders.
Results:
The OA blood serum samples showed a significantly higher level of lysosomal enzymes activity than in the control group (AS by 17.8%, AAT by 42.4%); only the CAT-D activity decreased by 50%). AS, ACP and CAT-D activities were about two-fold higher in SF when compared with blood of OA patients. The differences between the genders were visible in the SF: Total protein concentration, activity of ACP (both higher in OA men) and activity of CAT-D (higher in OA women). Between the involved hip and knee, there were no significant differences in all estimated parameters in the blood serum of the OA group. In regard to the SF, only ACP activity was significantly higher in patients with a hip involved.
Conclusions:
The osteoarthritic SF enzymatic profile differs from that in normal joints. The OA in joints is not reflected in the systemic response. Our preliminary results suggest further studies on role of lysosomal enzymes (ACP and AS) as biomarkers for the detection of osteoarthritis.
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