Immunohistochemical characterization of reparative tissue present in human osteoarthritic tissue

Studies involving disease progression in osteoarthritis (OA) have typically focused on the deterioration of native articular cartilage (AC) rather than the de novo cartilage which is frequently present. In general, there are two categories of de novo tissue observed in OA: (1) a pannus-like fibrocartilage that overlays native AC and (2) osteophytes. In this study, 30 AC samples representing a range of disease stages consistent with early to intermediate OA were examined for the occurrence of pannus-like tissue. All AC samples were examined immunohistochemically and compared with cartilage from three mature-looking osteophytes. To accomplish this, serial cartilage sections, derived from total knee arthroplasty specimens, were stained with hematoxylin and eosin and probed with antibodies raised against collagen type I, collagen type II, and aggrecan. Pannus-like tissue ranging from fibrous tissue to fibrocartilage was observed in 3 out of 30 AC samples. The appearance of this tissue was restricted to cartilage displaying signs of intermediate deterioration consistent with Outerbridge grade 2. Collagen type I, collagen type II, and aggrecan were abundant in both pannus-like tissue and osteophyte cartilage. In OA, the intrinsic repair process can yield a range of tissue types between fibrous tissue and fibrocartilage that is well integrated with the underlying, eroded AC. The absence of repair tissue from osteoarthritic samples representing the early stages of AC deterioration indicated that a relationship exists between macroscopic damage and a localized cellular repair response. Several histological and immunohistochemical similarities were also observed between the pannus-like tissue and osteophyte-derived cartilage, suggesting a common developmental process.