Differences in synovial fibrosis relative to range of motion in knee osteoarthritis patients

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Journal of orthopaedic research


This study tests if differences exist in the severity of synovial fibrosis between patients undergoing total knee arthroplasty (TKA) for osteoarthritis (OA) to help explain disparate deficits in pre- and post-operative range of motion (ROM) between patient groups. 117 knee OA patients were grouped by female (n=74) and male (n=43) or those who self-reported as Black (n=48) or White (n=69). ROM was measured pre- and post-TKA. Condyles and synovium collected during TKA were scored histologically for OA severity and synovitis. Fibrosis was measured from picrosirius-stained sections of synovium. Data were analyzed using Mann-Whitney, parametric, and Spearman’s rho tests with alpha at 0.05. We found no significant differences between patient age, BMI, radiographic scores, or deformity type when grouped by sex or race, or between ROM metrics or OA severity when grouped by sex. Notably, higher synovitis was measured in women (p=0.039) than men. White patients had greater ROM before (p=0.046) and after surgery (p=0.021) relative to Black patients. Fibrosis, but not OA severity and synovitis scores, for the total patient sample negatively correlated with pre-operative (rs=−0.330; p=0.0003) but not post-operative (rs=−0.032; p=0.7627) ROM. Black patients manifested more fibrosis than White patients (p<0.0001), without significant differences between sexes.

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