Extended reports
Validity of histopathological grading of articular cartilage from
osteoarthritic knee joints
a Osteoarthritis
Research Unit, Institute for Inflammation Research, National University
Hospital/Rigshospitalet, Copenhagen, Denmark, b Department
of Pathology, National University Hospital/Rigshospitalet, Copenhagen,
Denmark, c Department of
Pathology, University of Edinburgh, Medical School, Edinburgh, United
Kingdom
Correspondence to: Dr K Ostergaard, Osteoarthrits Research Unit, 7541, Institute for Inflammation Research, RHIMA-Centre, National University Hospital/Rigshospitalet, Tagensvej 20, DK-2200 Copenhagen N, Denmark.
Accepted for publication 4 November 1998
OBJECTIVES
To
determine the validity of the histological-histochemical grading system
(HHGS) for osteoarthritic (OA) articular cartilage.
METHODSHuman
articular cartilage was obtained from macroscopically normal (n = 13)
and OA (n = 21) knee joints. Sections of central and peripheral regions
of normal samples were produced. Sections of regions containing severe,
moderate, and mild OA changes were produced from each OA sample. A
total of 89 sections were graded by means of the HHGS (0-14) twice by
three observers.
RESULTSAverage scores
for regions designated severe (8.64) and moderate (5.83) OA were less
than the expected (10-14 and 6-9, respectively) according to the
HHGS, whereas average scores for the region designated mild (5.29) OA
and central and peripheral regions (2.19) of normal cartilage were
higher than expected (2-5 and 0-1, respectively). The HHGS was
capable of differentiating between articular cartilage from
macroscopically normal and OA joints and between the region designated
severe OA and other regions. However, the HHGS did not adequately
differentiate between regions designated mild and moderate OA. Values
for sensitivity, specificity, and efficiency for all regions varied considerably.
CONCLUSIONThe HHGS is
valid for normal and severe OA cartilage, but does not permit
distinction between mild and moderate OA changes in articular cartilage.
© 1999 by Annals of the Rheumatic Diseases
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