LIPID PEROXIDATION PROFILE OF SYNOVIAL FLUID IN PATIENTS WITH GONARTHROSIS ACCOMPANIED BY DEFECTS OF ARTICULAR SURFACE

Background. An important role in the pathogenesis of degenerative-dystrophic diseases of the knee joint is attributed to microcirculation disorders that result from increased and nonuniform mechanical load. With the progress of the disease, this leads to the development of venous stasis, local ischemia and oxidative stress. These pathological processes are not the only, but an important factor in the pathogenesis of osteoarthrosis. Disorders in the mineral density of the subchondral bone promote destruction of articular cartilage with formation of its defects that are manifested not only by a loss of the articular cartilage, but also by alterations in the bone tissue. Aim. Determination of indicators of lipoperoxidation products and activity of the catalase enzyme in the synovial fluid of patients with degenerative diseases of the knee joint, accompanied by joint surface defects. Materials and Methods. Materials: synovial fluid (SF) from 102 patients. Among them - group I without defects of articular surfaces: men-13 and women-65 (average age 64.4±2.8). Group II-with joint surface defects: men-5 and women-19 (average age 67.4±3.1 years). For the control group, samples were taken from the SF of dead people: 22 men and 8 women (average age 68.4±1.92 years). Indicators of lipoperoxidation products and activity of the catalase enzyme were determined. Median values were calculated in the observation groups. The statistical significance of differences was analyzed using a nonparametric Wilcoxon test. Results. In patients of both studied groups, significant multidirectional disorders in the system of lipid peroxidation and in antioxidant system were found. The different profiles of lipoperoxidation in patients with and without defects of articular surfaces are obviously reflected in different degrees of preservation of articular tissues and first of all, of the articular cartilage. Conclusion. The composition of the synovial fluid of patients with pronounced articular surface defects significantly differs in the lipoperoxidation profile from that in patients with degenerative-dystrophic joint lesions, but without joint surface defects (activity of catalase and a significant accumulation of primary products of lipid peroxidation). The data of biochemical examination of patients with degenerative-dystrophic joint lesions in combination with clinical and radiographic data permit to characterize the degree of preservation of articular cartilage.