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Neurovascular invasion at the osteochondral junction and in osteophytes in osteoarthritis
  1. Sunita Suri (sunita.suri{at}nottingham.ac.uk)
  1. University of Nottingham, United Kingdom
    1. Sarah E Gill (sarah_gill100{at}yahoo.co.uk)
    1. University of Nottingham, United Kingdom
      1. Sally Massena de Camin (mzyvscm{at}gwmail.nottingham.ac.uk)
      1. University of Nottingham, United Kingdom
        1. Deborah Wilson (deborah.wilson{at}sfh-tr.nhs.uk)
        1. Sherwood Forest NHS Trust, United Kingdom
          1. Daniel Frederick McWilliams (dan.mcwilliams{at}nottingham.ac.uk)
          1. University of Nottingham, United Kingdom
            1. David Andrew Walsh (david.walsh{at}nottingham.ac.uk)
            1. University of Nottingham, United Kingdom

              Abstract

              Objective: Normal adult articular cartilage is thought to be avascular and aneural. This study describes neurovascular structures at the osteochondral junction and in osteophytes in tibiofemoral OA displaying a range of severity of cartilage changes.

              Methods:Articular surfaces were obtained from 40 patients at total knee joint replacement surgery for tibiofemoral OA (TKR) and 7 patients post mortem (PM). Antibodies directed against CD34 (vascular endothelium), protein gene product 9.5 (pan-neuronal marker), substance P and calcitonin gene-related peptide (sensory nerves) and C-flanking peptide of neuropeptide Y (sympathetic nerves) were used to localise blood vessels and nerves by immunohistochemistry. Severity of OA cartilage changes was graded histologically.

              Results:TKR and PM samples displayed a range of OA cartilage changes including tidemark breaching by vascular channels. Sympathetic and sensory nerves were each present within vascular channels in the articular cartilage, both in mild and severe OA. Perivascular and free nerve fibres, and nerve trunks were observed within the subchondral bone marrow, and within the marrow cavities of osteophytes. Sensory and sympathetic nerves displayed similar distributions in each region studied.

              Conclusion: Vascularisation and the associated innervation of articular cartilage may contribute to tibiofemoral pain in OA across a wide range of structural disease severity.

              • blood vessel
              • cartilage
              • nerve
              • osteoarthritis
              • osteophyte

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