Structural condition of synovial medium of joint in patients with III stage coxarthrosis

Aim. To study peculiarities of synovial medium of a joint in patients with III stage coxarthrosis (CA) using methods of ultrasound and biochemical examination.

Materials and Methods. Ultrasound examination (US) of hip joints (n=18) and biochemical examination of synovial fluid (n=12) were conducted in patients with posttraumatic III stage CA. Echographic examination was carried out using diagnostic devices Voluson 730 PRO (Austria) and Hitachi (Japan) equipped with transductor with 7.5 MHz frequency. Total protein was measured in alkaline medium with copper sulfate. Protein fractions of synovial fluid were separated using a method of separation of a mixture of proteins to fractions or to individual proteins. The activity of catalase enzyme was determined by speed of degradation of hydrogen peroxide and of liberation of cell from its excess. Processes of peroxide oxidation of lipids (POL) were assessed by measurement of the content of the primary (diene conjugates, DC) and secondary (malondialdehyde, MDA) products of POL. Products of lipoperoxidation and of oxidative modification of proteins were presented as an estimated coefficient of sum and ratios. Lipid spectrum (cholesterol, triglycerides) was measu-red using a colorimetric method.

Results. There were revealed structural disorders in the synovial medium of the joint. US data showed thickening of synovial and fibrous membranes of the joint capsule by 60 and 40% of the age-related norm, separation of fibers of the fibrous membrane of the joint. Biochemical examination of synovial fluid revealed reduction in the activity of enzymes of antioxidant system and accumulation of peroxidation products which evidences development of a local oxidative stress in the joint medium. In development of destructive processes in the region of joints affected by arthrosis, the activity of free radical processes considerably increases which leads to decompensation of antioxidant mechanisms with development of imbalance in the anti-oxidant protection system.

Conclusion. In clinical practice, diagnosis of degenerative-dystrophic processes in the joint, along with X-ray data, should also include the results of biochemical and ultrasound methods of examination.