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SAT0079 Validity of arthroscopic grading system of chondropaty in knee osteoarthritis: correlation with histopathological findings
  1. C Acebes1,
  2. I Palacios1,
  3. E Delgado2,
  4. G Herrero-Beaumont1
  1. 1Rheumatology, Fundación Jiménez Díaz, Madrid
  2. 2Histopathology, Universidad Autonoma, Madrid, Spain

Abstract

Background Clinical research in osteoarthritis (OA) requires objective methods able to evaluate cartilage status. Arthroscopic evaluation of the articular cartilage would be a reliable instrument for the measurement of the quantity, integrity or quality of articular cartilage in knee OA.

Objectives To correlate an arthroscopic grading system of chondropathy (CHGS) with the histopathological findings of the same cartilage lesions in order to establish the validity of this procedure.

Methods Articular cartilage of medial compartments of three OA knee joints were magnified evaluated and recorded using a 2,7 mm scope. 34 different areas of lesion were individualised and fissures; III: deep fissures; IV: exposure of subchondral bone.73 sections ofarthroscopically normal and OA cartilage were microscopically examined and graded twice by two observers according to Mankin’s histopathological grading system (0–14)(MHHGS). Mathematic categorization in five groups was done to correlate with chondroscopic grades of lesion: normal (0–2), mild (3–5), moderate (6–8), severe (9–11), and very severe (12–14).

Results Intra and interobserver variability for MHHGS score was determined with Sperman’s correlation coefficient for both observers: r = 0,890 p < 0,001; r = 0,835 p < 0,001 and r = 0,906 p < 0,001; r = 0,822 p < 0,001. Average MHHGS score for chondroscopic grade 0 (1,7 ± 0,59 n = 20), grade I(3,62 ± 2,33 n = 28), grade II (6,82 ± 1,75 n = 52) were as expected, but for grade III (8,13 ± 2,13 n = 34) and grade IV (11,5 ± 3,18 n = 14) were lower. Correlation between CHGS and MHHGS scores were measure computing the kappa index for categorical variables for both observers: kp = 0,50 kp = 0,58.

Conclusion CHGS score of cartilage might be considered a relevant tool of OA outcome for research. The low tendency to overstimate lesions in advanced stages may be related to the mathematic categorization of the histopathological score.

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