PT  - JOURNAL ARTICLE
AU  - Sunita Suri
AU  - Sarah E Gill
AU  - Sally Massena de Camin
AU  - Daniel F McWilliams
AU  - Deborah Wilson
AU  - David A Walsh
TI  - Neurovascular invasion at the osteochondral junction and in osteophytes in osteoarthritis
AID  - 10.1136/ard.2006.063354
DP  - 2007 Nov 01
TA  - Annals of the Rheumatic Diseases
PG  - 1423--1428
VI  - 66
IP  - 11
4099  - http://ard.bmj.com/content/66/11/1423.short
4100  - http://ard.bmj.com/content/66/11/1423.full
SO  - Ann Rheum Dis2007 Nov 01; 66
AB  - Background: Normal adult articular cartilage is thought to be avascular and aneural.Objective: To describe neurovascular structures at the osteochondral junction and in osteophytes in tibiofemoral osteoarthritis (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 seven 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 both present within vascular channels in the articular cartilage, in both 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.