title: Radiological and histological analysis of two replaced interphalangeal joints with active subchondral bone resorption in erosive hand osteoarthritis: a novel mechanism?
abstract: The aim of this study was to describe the histological features of erosive hand osteoarthritis (EHOA), which is considered an aggressive subset of hand osteoarthritis (OA) characterized by severe local inflammation and degeneration of the distal and proximal interphalangeal joints. Two patients with EHOA underwent replacement with a cement-free press fit ceramic prosthesis of a proximal interphalangeal joint (PIPJ). Clinical and radiological data were collected and histological examination was performed. Radiological examination with histological correlation showed complete erosion of the articular cartilage with focal presence of peripheral fibrocartilaginous resurfacing, sclerosis, and remodeling of the exposed bone, osteoclastic activity with resorptive lacunae in the subchondral bone and around degenerative fibromyxoid pseudocysts, coarse trabeculation of the cancellous bone, and marginal osteophytes. The synovial membrane showed non-specific mild hypertrophy and mildly cellular fibromyxoid stroma. The histological findings in patients with EHOA suggest a pathogenesis of cartilage resorption from the subchondral bone, via osteoclastic-mediated activity and formation of periarticular reactive fibrocartilaginous proliferation with partial resurfacing of the articular surface.
authors.affiliation: Rheumatology Unit, Department of Medicine-DIMED, University Hospital of Padova, Via Giustiniani, 2, 35128, Padova, Italy.|Laboratory of Immunorheumatology and Tissue Regeneration, Rizzoli Orthopedic Research Institute, Bologna, 40136, Bologna, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Favero
authors.affiliation: Department of Pathology and Laboratory Medicine, Hospital for Special Surgery, New York, NY, USA.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Perino
authors.affiliation: Department of Diagnostic Medical Sciences, Section of Special Pathology, University of Padova, Via Giustiniani, 2, 35128, Padova, Italy.
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Valente
authors.affiliation: Department of Medical and Surgical Specialties, Hand Unit, Institute of Plastic Surgery, University of Padova, Via Giustiniani, 2, 35128, Padova, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Tiengo
authors.affiliation: Rheumatology Unit, Department of Medicine-DIMED, University Hospital of Padova, Via Giustiniani, 2, 35128, Padova, Italy. roberta.ramonda@unipd.it.
authors.forename: Roberta
authors.initials: R
authors.lastname: Ramonda
mesh_terms: D000368:Aged; D050806:Arthroplasty, Replacement, Finger / Q000379:methods*; D001862:Bone Resorption; D005260:Female; D005384:Finger Joint / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007558:Italy; D007595:Joint Prosthesis; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Erosive hand osteoarthritis; Finger replacement arthroplasty; Hand joints; Histology; Interphalangeal joint of finger