Markers of Articular Cartilage Injury and Healing

Sports Medicine and Arthroscopy Review

Volumn 2, Issue 1, 1994, Pages 13-28

  Thonar, Eugene J M A ^a   Kuettner, Klaus E ^a   Williams, James M ^a  

^a RUSH MEDICAL COLLEGE   (United States)

Author keywords

Articular cartilage; Healing; Injury; Joint fluid; Marker; Serum

Indexed keywords

EID: 0013595428     PISSN: 10628592     EISSN: 15381951     Source Type: Journal    
DOI: 10.1097/00132585-199400210-00002     Document Type: Article

References (108)

1. Mow VC, Setton LA, Ratcliffe A, Howell DS, Buckwalter JA. Structure-function relationships of articular cartilage and the effects of joint instability and trauma on cartilage function. In: Brandt KD, et. Cartilage changes in osteoar-thritis. Indianapolis: Indiana University School of Medicine, 1990:22-42.
2. Dieppe P, Cushnaghan J, McAlindon T. Epidemiology, clinical course, and outcome of knee osteoarthritis. In: Kuettner KE, Schleyerbach R, Peyron JG, Hascall VC, eds. Articular cartilage and osteoarthritis. New York: Raven Press, 1992:617-27.
3. Thonar EJ-MA, Shinmei M, Lohmander LS. Body fluid markers of cartilage changes in osteoarthritis. Rheum Dis Clin North Am 1993;19:635-57.
4. Lohmander LS. Molecular markers of cartilage turnover. A role in monitoring and diagnosis of osteoarthritis. In: Kuettner KE, Schleyerbach R, Peyron JG, Hascall VC, eds. Articular cartilage and osteoarthritis. New York: Raven Press, 1992:653-67.
5. Namey TC. Nuclear medicine, and special radiologic imaging and technique in the diagnosis of rheumatic diseases. In: Kelley WN, Harris ED, Ruddy S, Sledge CB, eds. Textbook of rheumatology. Vol 1. Philadelphia: WB Saunders, 1985:608-40.
6. Adams ME, Li DKB. Magnetic resonance imaging of joint lesions. In: Kuettner KE, Schleyerbach R, Hascall VC, eds. Articular cartilage biochemistry. New York: Raven Press, 1986:331-48.
7. Thonar EJ-MA, Williams JM, Maldonado BA, et al. Serum keratan sulfate concentration as a measure of the catabo-lism of cartilage proteoglycans. In: Kresina TF, ed. Monoclonal antibodies, cytokines, and arthritis: mediators of inflammation and therapy. New York: Marcel Dekker, 1991: 373-98.
8. Forslind K, Eberhardt K, Jonsson A, Saxne T. Increase serum concentrations of cartilage oligomeric matrix protein. A prognostic marker in early rheumatoid arthritis. Br J Rheumatol 1992;31:593-8.
9. Saxne T, Heinegård D, Wollheim FA. Therapeutic effects on cartilage metabolism in arthritis as measured by release of proteoglycan structures into the synovial fluid. Ann Rheum Dis 1986;45:491-7.
10. Saxne T, Heinegård D, Wollheim FA, Pettersson H. Differences in cartilage proteoglycan level in synovial fluid in early rheumatoid arthritis and reactive arthritis. Lancet 1985;1:127-8.
11. Saxne T, Heinegård D. Involvement of nonarticular cartilage, as demonstrated by release of a cartilage-specific protein, in rheumatoid arthritis. Arthritis Rheum 1989;32: 1080-6.
12. Saxne T, Heinegård D. Synovial fluid analysis of two groups of proteoglycan epitopes distinguishes early and late cartilage lesions. Arthritis Rheum 1992;35:385-90.
13. Saxne T, Heinegård D. Cartilage oligomeric matrix protein: a novel marker of cartilage turnover detectable in synovial fluid and blood. Br J Rheumatol 1992;31:583-91.
14. Ishiguro N, Uebelhart D, Thonar EJ-MA, Williams JM. Immunolocalization of atypical chondroitin sulfate chains reacting with the 3-B-3 monoclonal antibody following chy-mopapain-induced injury in the rabbit. In: Transcripts of the 38th Annual Meeting of the Orthopedic Research Society. 1992:278.
15. Slater RR, Caterson B, Lachiewicz P, Bayliss MT. The occurrence of 3-B-3(−) and 7-D-4 epitopes as markers of arthritis in humans. In: Transcripts of the 38th Annual Meeting of the Orthopedic Research Society. 1992:277.
16. Lohmander LS, Lark MW, Dahlberg L, Walakovits LA, Roos H. Cartilage matrix metabolism in osteoarthritis: markers in synovial fluid, serum and urine. Clin Biochem 1992;25:167-74.
17. Manicourt DH, Lenz ME, Thonar EJ-MA. Levels of serum keratan sulfate rise rapidly and remain elevated following anterior cruciate ligament transection in the dog. J Rheumatol 1991;18:1872-6.
18. Ratcliffe A, Billingham MEJ, Saed-Nejad F, Muir H, Har-dingham TE. Increased release of matrix components from articular cartilage in experimental canine osteoarthritis. J Orthop Res 1992;10:350-8.
19. Thonar EJ-MA, Manicourt DM, Williams JM, et al. Serum keratan sulfate: a measure of cartilage proteoglycan metabolism. In: Kuettner KE, Schleyerbach R, Peyron JG, Hascall VC, eds. Articular cartilage and osteoarthritis. New York: Raven Press, 1992:429-45.
20. Hunziker EB. Articular cartilage structure in humans and experimental animals. In: Kuettner KE, Schleyerbach R, Peyron JG, Hascall VC, eds. Articular cartilage and os-teoarthritis. New York: Raven Press, 1992:183-99.
21. Kuettner KE, Thonar EJ-MA, Aydelotte MB. Modern aspects of articular cartilage biochemistry. In: Brandt KD, ed. Cartilage changes in osteoarthritis. Indianapolis: Indiana University School of Medicine, 1990:3-11.
22. Poole CA. The chondrocyte and its pericellular microenvi-ronment. In: Kuettner KE, Schleyerbach R, Peyron JG, Hascall VC, eds. Articular cartilage and osteoarthritis. New York: Raven Press, 1992:201-20.
23. Heinegård D, Pimental ER. Cartilage matrix proteins. In: Kuettner KE, Schleyerbach R, Peyron JG, Hascall VC, eds. Articular cartilage and osteoarthritis. New York: Raven Press, 1992:95-111.
24. Bayliss MT. Metabolism of animal and human osteoar-thritic cartilage. In: Kuettner KE, Schleyerbach R, Peyron JG, Hascall VC, eds. Articular cartilage and osteoarthritis. New York: Raven Press, 1992:487-500.
25. Thonar EJ-MA, Kuettner KE. Biochemical basis of age-related changes in proteoglycans. In: Wight TN, Mecham RP, eds. Biology of proteoglycans. Orlando: Academic Press, 1987:211-46.
26. Eyre DR, Wu JJ, Niyibizi C, Chun L. The cartilage colla-gens: analysis of their cross-linking interactions and matrix organization. In: Maroudas A, Kuettner KE, eds. Methods in cartilage research. New York: Academic Press, 1990: 28-33.
27. van der Rest M. From the gene to the protein: the discovery of type XII collagen. In: Maroudas A, Kuettner KE, eds. Methods in cartilage research. New York: Academic Press, 1990:190-3.
28. Heinegård D, Oldberg A. Structure and biology of cartilage and bone matrix noncollagenous macromolecules. FASEB J 1989;3:2042-51.
29. Argraves WS, Deak F, Sparks K, Kiss I, Goettinck PF. Structural features of cartilage matrix protein deduced from cDNA. Proc Natl Acad Sci USA 1987;84:464-8.
30. Fife R. Identification of cartilage matrix glycoprotein in synovial fluid in human osteoarthritis. Arthritis Rheum 1988;31:553-6.
31. Sommarin Y, Larsson T, Heinegard D. Chondrocyte-matrix interactions. Exp Cell Res 1989;184:181-92.
32. Pfaffle M, Ruggiero F, Hofmann H, et al. Biosynthesis, secretion and extracellular localization of anchorin CII, a collagen-binding protein of the calpactin family. EMBO J 1988;7:2335-42.
33. Poole AR, Pidoux I, Reiner A, Choi H, Rosenberg LC. Association of an extracellular protein (chondrocalcin) with the calcification of cartilage in endochondral bone formation. J Cell Biol 1984;98:54-65.
34. Morales TI. Polypeptide regulators of matrix homeostasis in articular cartilage. In: Kuettner KE, Schleyerbach R, Peyron JG, Hascall VC, eds. Articular cartilage and osteoarthritis. New York: Raven Press, 1992:265-79.
35. Maroudas A, Palla G, Gilav E. Racemization of aspartic acid in human articular cartilage. Connect Tissue Res 1992; 27:1-8.
36. Håuselmann HJ, Schmid TM, Aydelotte MB, Kuettner KE, Thonar EJ-MA. Phenotypic stability of adult chondro-cytes after long-term culture in alginate. Osteoarth Cartilage 1992;1:2.
37. Håuselmann HJ, Fernandes RJ, Mok SS, et al. Phenotypic stability of bovine articular chondrocytes in long-term cultures of alginate. J Cell Sci (in press).
38. Hascall VC, Sandy JD, Handley CJ. Regulation of proteoglycan metabolism in articular cartilage. In: Mow C, Rat-cliffe A, eds. Structure and function of articular cartilage. Boca Raton: CRC Press Inc. (in press).
39. Dean DD, Martel-Pelletier J, Pelletier J-P, Howell DS, Woessner JF. Evidence for metalloproteinase and metallo-proteinase inhibitor imbalance in human osteoarthritis cartilage. J Clin Invest 1989;84:678-85.
40. Pelletier J-P, Mineau F, Faure M-P, Martel-Pelletier J. Imbalance between the mechanisms of activation and inhibition of metalloproteinases in the early lesions of experimental osteoarthritis. Arthritis Rheum 1990;33:1466-76.
41. Shinmei M, Inamori Y, Yoshihara Y, Kikuchi T, Hay-akawa T. The potential of cartilage markers in joint fluid for drug evaluation. In: Kuettner KE, Schleyerbach R, Peyron JG, Hascall VC, eds. Articular cartilage and osteoarthritis. New York: Raven Press, 1992:597-609.
42. Werb Z. The biologic role of metalloproteinases and their inhibitors. In: Kuettner KE, Schleyerbach R, Peyron JG, Hascall VC, eds. Articular cartilage and osteoarthritis. New York: Raven Press, 1992:295-304.
43. Lohmander LS. Markers of cartilage metabolism in arthro-sis. Acta Orthop Scand 1991;62:623-32.
44. Sandy JD, Flannery CR, Neame PJ, Lohmander LS. The structure of aggrecan fragments in human synovial fluid. Evidence for the involvement in osteoarthritis of a novel proteinase which cleaves the GLU 373-ALA 374 bond of the interglobular domain. J Clin Invest 1992;89:1512-6.
45. Okada Y, Shinmei M, Tanaka O, et al. Localization of matrix metalloproteinase 3 (Stromelysin) in osteoarthritic cartilage and synovium. Lab Invest 1992;66:680-90.
46. Lohmander LS, Hoerrner LA, Lark MW. Metalloproteinases, tissue inhibitor and proteoglycan fragments in knee synovial fluid in human osteoarthritis. Arthritis Rheum 1993;36:181-9.
47. Lohmander LS, Hoerrner LA, Dahlberg L, et al. Stromelysin, tissue inhibitor and proteoglycan fragments in human knee joint fluid after injury. J Rheumatol 1993;20:1362-8.
48. Lohmander LS, Hoerrner LA, Dahlberg L, et al. Temporal patterns of stromelysin, tissue inhibitor and proteoglycan fragments in synovial fluid after injury to knee cruciate ligament or meniscus. J Orthop Res (in press).
49. Walakovits LA, Moore VL, Bhardwaj N, Gallick GS, Lark MW. Detection of stromelysin and collagenase in synovial fluid from patients with rheumatoid arthritis and posttrau-matic knee injury. Arthritis Rheum 1992;35:35-42.
50. Flannery CR, Lark MW, Sandy JD. Identification of a stromelysin cleavage site within the interglobular domain of human aggrecan: evidence for proteolysis at this site in vivo in human articular cartilage. J Biol Chem 1992;267:1008-14.
51. Bayliss MT, Holmes MW, Muir H. Age-related changes in the stoichiometry of binding region, link protein and hyal-uronic acid in human articular cartilage. In: Transcripts of the 35th Annual Meeting of the Orthopedic Research Society. 1989:32.
52. Roughley PJ, Poole AR, Campbell IK, Mort JS. The pro-teolytic generation of hyaluronic acid-binding regions derived from the proteoglycans of human articular cartilage as a consequence of ageing. In: Transcripts of the 32nd Annual Meeting of the Orthopedic Research Society. 1986:209.
53. Thonar EJ-MA, Giant TT. Serum keratan sulfate-a marker of predisposition to polyarticular osteoarthritis. Clin Biochem 1992;25:175-80.
54. Page-Thomas DP, Bard D, King B, Dingle JT. Clearance of proteoglycans from joint cavitis. Ann Rheum Dis 1987;46: 934-7.
55. Levick JR. The “clearance” of macromolecular substances such as cartilage markers from synovial fluid and serum. In: Maroudas A, Kuettner KE, eds. Methods in cartilage research. New York: Academic Press, 1990:352-7.
56. Levick JR. Synovial fluid. Determinants of volume turnover and material concentration. In: Kuettner KE, Schleyerbach R, Peyron JG, Hascall VC, eds. Articular cartilage and osteoarthritis. New York: Raven Press, 1992:529-41.
57. Maldonado BA, Williams JM, Otten LM, Flannery M, Kuettner KE, Thonar EJ-MA. Differences in the rate of clearance of different KS-bearing molecules injected intravenously in rabbits. In: Transcripts of the 35th Annual Meeting of the Orthopedic Research Society. 1989:161.
58. Block JA, Schnitzer TJ, Andersson GBJ, et al. The effect of chemonucleolysis on serum keratan sulfate levels in humans. Arthritis Rheum 1989;32:100-4.
59. Fukuda K, Otten L, Lenz ME, Thonar EJ-MA. Age-related differences in the content of antigenic and non-antigenic keratan sulfate in aggrecan from human articular cartilage. In: Transcripts of the 39th Annual Meeting of the Orthopedic Research Society. 1993:217.
60. Williams JM, Downey C, Thonar EJ-MA. Increase in levels of serum keratan sulfate following cartilage proteoglycan degradation in the rabbit knee joint. Arthritis Rheum 1988; 31:557-60.
61. Williams JM, Uebelhart D, Ongchi DR, Kuettner KE, Thonar EJ-MA. Animal models of articular cartilage repair. In: Kuettner KE, Schleyerbach R, Peyron JG, Hascall VC, eds. Articular cartilage and osteoarthritis. New York: Raven Press, 1992:511-26.
62. Uebelhart D, Thonar EJ-MA, Pietryla DW, Williams JM. Rise in urinary levels of pyridinium crosslinks of collagen following chymopapain-induced degradation of articular cartilage in the rabbit knee. Osteoarth Cartilage 1993;11:705-16.
63. Williams J, Ongchi DR, Thonar EJ-MA. Repair of articular cartilage injury following intra-articular chymopapain-induced matrix proteoglycan loss. J Orthop Res 1993;11: 705-16.
64. Attencia LJ, McDevitt CA, Nile WB, Sokoloff L. Cartilage content of an immature dog. Connect Tissue Res 1989;18: 235-42.
65. Campion GV, McCrae F, Schnitzer TJ, Lenz ME, Dieppe PA, Thonar EJ-MA. Levels of keratan sulfate in the serum and synovial fluid of patients with osteoarthritis of the knee. Arthritis Rheum 1991;34:1254-9.
66. Sweet MBE, Coelho A, Schnitzler CM, et al. Serum keratan sulfate in osteoarthritis patients. Arthritis Rheum 1988; 31:648-52.
67. Sárközi A-M, Hamori G, Fülöp C, Buzas E, Brozik M, Merátey K. Serum keratan sulfate studies and their significance in the evaluation of cartilage degradation in degenerative and inflammatory joint diseases. Orv Hetil 1993;134:461-7.
68. Manicourt DH, Triki R, Fukuda K, Devogelaer J-P, Nagant de Deuxchaisnes C, Thonar EJ-MA. Levels of circulating tumor necrosis factor alpha and interleukin-6 in patients with rheumatoid arthritis: relationship to serum levels of hyaluronan and antigenic keratan sulfate. Arthritis Rheum 1993;36:490-9.
69. Motoyoshi H, Tanaka S, Nagata Y, Yamasaki H, Fukuda K, Kita H. Age-related alteration in levels of keratan sulfate in sera of orthopaedic patients. J Jpn Orthop Assoc 1989;63:1464-8.
70. Thonar EJ-MA, Schnitzer TJ, Kuettner KE. Quantification of keratan sulfate in blood as a marker of cartilage metabolism. J Rheum 1987;14:23-4.
71. Seibel MJ, Towbin H, Braun DG, Kiefer B, Muller W, Paulsson M. Serum keratan sulphate in rheumatoid arthritis and different clinical subsets of osteoarthritis. In: Greiling H, Scott JE, eds. Keratan sulphate. Chemistry, biology, chemical pathology. London: The Biochemical Society, 1989:191-8.
72. Spector TD, Woodward L, Hall GM, et al. Keratan sulphate in rheumatoid arthritis, osteoarthritis, and inflammatory diseases. Ann Rheum Dis 1992;51:1134-7.
73. Tyler JA. IGF1 can decrease degradation and promote synthesis of proteoglycan in cartilage exposed to cytokines. Biochem J 1989;260:543-8.
74. Thonar EJ-MA, Lenz ME, Klintworth GK, et al. Quantification of keratan sulfate in blood as a marker of cartilage catabolism. Arthritis Rheum 1985;28:1367-76.
75. Chen L-M, Williams JM, Bach Jr B, Manicourt D, Thonar EJ-MA. Regional differences in the rise in blood levels of keratan sulfate and hyaluronan after chymopapain-induced knee joint injury. In: Transcripts of the 39th Annual Meeting of the Orthopedic Research Society. 1993:712.
76. Eyre DR, Dickson IR, Van Ness KP. Collagen crosslinking in human bone and articular cartilage. Age-related changes in the content of mature hydroxypyridinium residues. Biochem J 1988;252:495-500.
77. Seibel MJ, Duncan A, Robins SP. Urinary hydroxypyridinium crosslinks provide indices of cartilage and bone involvement in arthritic disease. J Rheumatol 1989;16:964-70.
78. Thompson PW, Spector TD, James IT, Henderson E, Hart DJ. Urinary collagen cross-links reflect the radiographic severity of knee osteoarthritis. Br J Rheumatol 1992;31: 759-61.
79. Uebelhart D, Gineyts E, Chatpuy M-C, Delmas P. Urinary excretion of pyridinium crosslinks: a new marker of bone resorption in metabolic bone disease. Bone Miner 1990;8: 87-96.
80. Thonar EJ-MA, Pachman LM, Lenz ME, Hayford J, Lynch P, Kuettner KE. Age-related changes in the concentration of serum keratan sulfate in children. J Clin Chem Clin Biochem 1988;26:57-63.
81. Yoshida K, Miyauchi S, Kikuchi H, Tawada A, Tokuyasu A. Analysis of unsaturated disaccharides produced from chondroitin sulfates in rabbit plasma by high performance liquid chromatography. Anal Biochem 1989;177:327-32.
82. Robins SP, McLaren AM, Nicol P, Seibel MJ. Pyridinium cross-link measurements in serum and synovial fluid of patients with osteoarthritis. In: Kuettner KE, Schleyerbach R, Peyron JG, Hascall VC, eds. Articular cartilage and osteoarthritis. New York: Raven Press, 1992:738-9.
83. Lohmander LS. Proteoglycans of joint cartilage. Structure, function, turnover and role as markers of joint disease. Baillieres Clin Rheumatol 1988;2:37-62.
84. Lohmander LS, Dahlberg L, Ryd L, Heinegard D. Increased level of proteoglycan fragments in knee joint fluid after joint injury. Arthritis Rheum 1989;32:1434-42.
85. Ongchi DS, Thonar EJ-MA, Johnson C, Williams JM, Bach Jr B, Schnitzer TJ. Keratan sulfate content of synovial fluid after knee injury. In: Kuettner KE, Schleyerbach R, Peyron JG, Hascall VC, eds. Articular cartilage and osteoarthritis. New York: Raven Press, 1992:734-5.
86. Shinmei M, Miyauchi S, Machida A, et al. Quantitation of chondroitin 4-sulfate and chondroitin 6-sulfate in pathologic joint fluid. Arthritis Rheum (in press).
87. Shinmei M, Okada Y, Masuda K, et al. The mechanism of cartilage degradation in osteoarthritic joints. Semin Arthritis Rheum 1990;19:16-20.
88. Hinek A, Reiner A, Poole AR. The calcification of cartilage matrix in chondrocyte culture: studies of the C-propeptide of type II collagen (chondrocalcin). J Cell Biol 1987;104: 1435-41.
89. Shinmei M, Inamori Y, Yoshiwara Y, Kikuchi T, Hay-akawa T, Shimomura Y. Molecular markers of joint disease: significance of the level of type II collagen C-propeptide, chondroitin sulfate and TIMP in joint fluid. In: Transactions of the Annual Meeting of the Japanese Orthopedic Society. 1991:443.
90. Shinmei M, Ito K, Matsuyama S, Sakota K. Type II procollagen C-peptide in the joint fluid. Laboratory Examination 1991;35:1293-8.
91. Shinmei M, Ito K, Matsuyama S, et al. Carboxy-terminal Type II procollagen peptide levels in joint fluids as a marker of collagen biosynthesis of cartilage in joint diseases. Osteoarth Cartilage (in press).
92. Shinmei M, Nagaya I, Miyanaga, et al. Clinical usefulness of the measurement of Type-II procollagen carboxypeptide (C-II propeptide. pColl-II-C) in synovial fluid as a marker of collagen metabolism in cartilage. Ryumaki 1992;32:453-60.
93. Brandt KD, Thonar EJ-MA. Lack of association between serum keratan sulfate concentrations and cartilage changes of osteoarthritis after transection of the anterior cruciate ligament in the dog. Arthritis Rheum 1989;32:647-51.
94. Brandt KD, Meyers SL, Burr D, Albrecht M. Osteoar-thritic changes in canine articular cartilage, subchondral bone, and synovium fifty-four months after transection of the anterior cruciate ligament. Arthritis Rheum 1991;34: 1560-70.
95. Camey SL, Billingham MEJ, Muir H, Sandy JD. Demonstration of increased proteoglycan turnover in cartilage ex-plants from dogs with experimental osteoarthritis. J Orthop Res 1984;2:201-6.
96. Sandy JD, Adams ME, Billingham MEJ, Plaas A, Muir H. In vivo and in vitro stimulation of chondrocyte biosynthetic activity in early experimental arthritis. Arthritis Rheum 1984;27:388-97.
97. Manicourt DH, Pita JC, Thonar EJ-MA, Howell DS. Pro-teoglycans nondissociatively extracted from different zones of canine normal articular cartilage: variations in the sedimentation profile of aggregates with degree of physiological stress. Connect Tissue Res 1991;26:1-16.
98. von der Mark K, Kirsch T, Nerlich RA, et al. Type X collagen synthesis in human osteoarthritic cartilage. Arthritis Rheum 1992;35:806-11.
99. Dahlberg L, Ryd L, Heinegård D, Lohmander LS. Proteoglycan fragments in joint fluid-influence of arthrosis and inflammation. Acta Orthop Scand 1992;63:417-23.
100. Gevers G, Dequeker J. Collagen and non-collagenous protein content (osteocalcin, sialoprotein, proteoglycan) in the iliac crest bone and serum osteocalcin in women with and without hand osteoarthritis. Collagen Rel Res 1987;7:435-42.
101. Radin EL, Paul IL. Does cartilage compliance reduce skeletal impact loads? Arthritis Rheum 1970;13:139-44.
102. Grundnes O, Reikerås O. Repeated bone trauma and property of healing: biomechanical testing in osteotomy repair in rats. Eur J Musculoskel Res 1992;1:183-7.
103. Carroll GJ. Spectrophotometric measurement of proteogly-cans in osteoarthritic synovial fluid. Ann Rheum Dis 1987; 46:375-9.
104. Carroll GJ, Bell MC, Laing BA, McCappin S, Blumer C, Leslie A. Reduction of the concentrations and total amount of keratan sulphate in synovial fluid from patients with osteoarthritis during treatment with piroxicam. Ann Rheum Dis 1992;51:850-4.
105. Ratcliffe A, Israel HA, Saed-Nejad F, Seibel MJ. Keratan sulfate epitope levels are elevated in synovial fluids from joints with arthroscopically diagnosed early osteoarthritis. In: Transcripts of the 37th Annual Meeting of the Orthopedic Research Society. 1991:228.
106. Witter J, Roughley PJ, Webber C, Roberts N, Keystone E, Poole AR. The immunologic detection and characterization of cartilage proteoglycan degradation products in synovial fluids of patients with arthritis. Arthritis Rheum 1987;30: 519-29.
107. Caterson B, Hughes CE, Johnstone B, Mort JS. Immuno-logical markers of cartilage proteoglycan metabolism in animal and human osteoarthritis. In: Kuettner KE, Schleyer-bach R, Peyron JG, Hascall VC, eds. Articular cartilage and osteoarthritis. New York: Raven Press, 1992:415-27.
108. Goldberg RL, Huff JP, Lenz ME, Glickman P, Katz P, Thonar EJ-MA. Elevated plasma levels of hyaluronate in patients with osteoarthritis and rheumatoid arthritis. Arthritis Rheum 1991;34:799-807.