Revisiting osteoarthritis as an inflammatory disease: characterization of synovitis grading and synovial pathotypes in surgical specimens
Authors' conclusion
Advanced OA displays marked synovial heterogeneity, with immune infiltration patterns that parallel systemic inflammatory signatures.
Study context
- Population
- Synovial tissue from osteoarthritis (OA) patients undergoing hip or knee arthroplasty, or other joint surgery
- Participants
- 244 samples
- Exposure
- Synovial pathotypes: lympho-myeloid vs diffuse-myeloid vs pauci-immune
- Outcome
- Synovitis grade and pathotype distribution
Methodological detailsstandardized histology (Krenn score), semi-quantitative immunohistochemistry, multivariable logistic regression
- Standardized histology (Krenn score)
- Semi-quantitative immunohistochemistry
- Multivariable logistic regression
Main finding
As reported in the abstract
- High-grade synovitis
- 64.3%
Observational data: associations, not effects.
Further findings
Predictors of lympho-myeloid pathotype (multivariable model)
- Higher BMI, OR
- 1.11 (95% CI 1.01-1.22)
- No associations for inflammatory markers, Kellgren-Lawrence grade or preoperative pain
Safety
Postoperative complications
- Not different across pathotypes
Original publication
Revisiting osteoarthritis as an inflammatory disease: characterization of synovitis grading and synovial pathotypes in surgical specimens. Arthritis Res Ther. Published 28 April 2026. doi:10.
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