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. 1999 Apr;58(4):208–213. doi: 10.1136/ard.58.4.208

Validity of histopathological grading of articular cartilage from osteoarthritic knee joints

K Ostergaard 1, C Andersen 1, J Petersen 1, K Bendtzen 1, D Salter 1
PMCID: PMC1752860  PMID: 10364898

Abstract

OBJECTIVES—To determine the validity of the histological-histochemical grading system (HHGS) for osteoarthritic (OA) articular cartilage.
METHODS—Human articular cartilage was obtained from macroscopically normal (n = 13) and OA (n = 21) knee joints. Sections of central and peripheral regions of normal samples were produced. Sections of regions containing severe, moderate, and mild OA changes were produced from each OA sample. A total of 89 sections were graded by means of the HHGS (0-14) twice by three observers.
RESULTS—Average scores for regions designated severe (8.64) and moderate (5.83) OA were less than the expected (10-14 and 6-9, respectively) according to the HHGS, whereas average scores for the region designated mild (5.29) OA and central and peripheral regions (2.19) of normal cartilage were higher than expected (2-5 and 0-1, respectively). The HHGS was capable of differentiating between articular cartilage from macroscopically normal and OA joints and between the region designated severe OA and other regions. However, the HHGS did not adequately differentiate between regions designated mild and moderate OA. Values for sensitivity, specificity, and efficiency for all regions varied considerably.
CONCLUSION—The HHGS is valid for normal and severe OA cartilage, but does not permit distinction between mild and moderate OA changes in articular cartilage.

 Keywords: histopathology; osteoarthritis; reliability; validity

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Figure 1  .

Figure 1  

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Section of osteoarthritic articular cartilage. OA articular cartilage and adjacent subchondral bone from a 79 years old woman. (A) The section includes a region of denuded bone and a shoulder of residual cartilage ending in a region of articular cartilage that on macroscopic examination appears intact. The shoulder of residual cartilage is divided into regions designated mild (B), moderate (C), and severe (D) OA changes as shown in the figure. Deparaffinised section stained with haematoxylin and eosin (bar marker: 800 µm).

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