Correlation between synovial vascular endothelial growth factor, clinical, functional and radiological manifestations in knee osteoarthritis

Aim of the work: To correlate between synovial vascular endothelial growth factor (VEGF), clinical, functional and radiological findings in knee osteoarthritis (KOA) patients. Patients and methods: Twenty patients with primary KOA were clinically examined and the modified Ritchie articular index (RAI) recorded. The knees were examined and knee pain evaluated by the visual analog scale (VAS) and tenderness by the knee subscale of the RAI. The Western Ontario Mc Master scale (WOMAC) was recorded and the Kellgren-Lawrence grading used to assess radiographic severity. The synovial level of VEGF was assessed using ELISA. Results: The mean age was 56.15 ± 7.77 years and body mass index 28.1 ± 4.04. All patients had knee effusion; 40% were bilateral and 60% unilateral. The mean duration of knee pain was 3.01 ± 1.43 years; duration of morning stiffness was 15.75 ± 3.72 min. The mean WOMAC was 44.22 ± 11.46 and modified RAI 5.45 ± 2.94. The mean knee subscale of RAI was 2.9 ± 1.16 and VAS for knee pain 5.7 ± 2.92. The mean synovial VEGF level was 693.71 ± 314.63 pg/ml. There was a significant increase in the synovial VEGF compared to the reference value (p = 0.0001). There was a significant correlation between the synovial VEGF and patients' age (p = 0.04), knee pain duration (p = 0.025), morning stiffness (p < 0.0001), modified RAI (p = 0.0001), knee subscale of RAI (p < 0.0001), VAS for knee pain (p < 0.0001) and WOMAC (p = 0.0001). There was a significant negative correlation between synovial VEGF and muscle strength grading (p = 0.0001) and a significant correlation with the radiological assessment (p = 0.0001). Conclusion: Synovial VEGF significantly correlated with clinical manifestations, functional impact, as well as radiological changes of KOA.