| Sumario: | Purpose: Studies of disease-modifying osteoarthritis drug (DMOAD) safety and effectiveness have relied on surrogate markers of disease activity (medical history, physical examination, radiographs, and magnetic resonance imaging). These often have low interobserver reliability and provide no information about cartilage quality. Assessment of cartilage histomorphology is a potentially valuable method for evaluating the extent of osteoarthritis (OA) and the effect of DMOADS on OA. Data on 126 arthroscopically guided small diameter (2 mm) Jamshidi needle cartilage biopsies from 32 patients (63 procedures with 2 biopsies obtained at each procedure) are reported.Type of Study: Retrospective analysis and description of technique.Methods: One hundred and twenty-six arthroscopically guided Jamshidi needle biopsies of articular cartilage were performed in 32 volunteers (10 men, 22 women; age range, 43-81 years) with Kellgren-Lawrence radiographic stage 1-3 OA of the knee in a randomized double-blinded placebo controlled study of insulin-like growth factor (IGF-1). Biopsies were obtained before treatment and also after 13 weeks of intra- articular injections. Patients were randomized to one of the 3 treatment groups: IGF given weekly or biweekly or placebo. Biopsies were obtained from the weight-bearing portion of the medial femoral condyle using a 2-mm Jamshidi needle and consisted of 2-mm diameter plugs of cartilage and underlying subchondral bone.Results: Adequate material for interpretation was obtained from the biopsies. The data obtained from the biopsies were comparable to the information obtained from larger conventional sections harvested in a companion study (wedge biopsies using a scalpel) before and after total knee arthroplasty. Ten cases of postprocedure hemarthrosis, all of which resolved spontaneously, were the only complications noted. The cases of hemarthrosis were seen only in the first 10 cases before strict complete non-weight-bearing restrictions were applied. Pain and WOMAC measurements worsened in fewer than 50% of patients during the 13 week course of the study. No other adverse clinical sequelae related to the study knee have been noted at between 24 to 48 months of follow-up.Conclusions: Arthroscopically-guided Jamshidi needle biopsy of articular cartilage from the weight-bearing surface of the medial femoral condyle may have potential utility for assessing the efficacy of DMOADs.
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