BMC Musculoskeletal Disorders · IF 2.3 · July 30, 2026 · LoE IV
Synovial oxidative stress biomarkers are not associated with radiological severity in knee osteoarthritis: a prospective cross-sectional study
Hakan Yolaçan, Hüseyin Erdal, Serkan Güler — Aksaray University
This cross-sectional study of 98 patients aged 50+ with knee osteoarthritis compared synovial fluid oxidative stress markers (thiols, disulfide, total antioxidant status, total oxidant status, oxidative stress index, glutathione peroxidase) between early-stage (KL 1-2) and late-stage (KL 3-4) disease. Only total oxidant status differed significantly on unadjusted comparison (p=0.007), but this and all other biomarkers lost significance after multivariable regression, ANCOVA adjustment, and Benjamini-Hochberg correction, while WOMAC and VAS scores remained strongly and independently associated with radiographic stage.
AI summary · from the full text · reviewed by Pukhraj Gaheer, Medical Student, Queen's University before publishing
Why it mattersIt suggests that hopes for a synovial biochemical biomarker to substitute for or supplement radiographic/clinical staging of knee osteoarthritis are not yet supported, reinforcing that clinical scores remain the practical tool for assessing severity.
Conclusion strengthConfirms prior evidence
This identifies a risk factor rather than testing a treatment, so it cannot support a change in what we do.
Presenting this at rounds? Start here
- ?If synovial oxidative stress markers do not track radiographic severity, should clinicians rely solely on WOMAC/VAS scores and radiographs when counseling patients about disease progression?
- ?Given that oxidative stress may still contribute to OA pathophysiology without reflecting staging, how should this influence decisions about antioxidant-targeted adjunct therapies in knee OA management?