RecruitingNot ApplicableNCT07473414

Synovial Tissue as a Biomarker in the Early Management of Osteoarthritis

Sponsor

Nantes University Hospital

Enrollment

30 participants

Start Date

May 26, 2026

Study Type

INTERVENTIONAL

Conditions

Osteoarthritis

Summary

Osteoarthritis is a common disease whose prevalence continues to increase. To date, there is no medical treatment that has proven effective, and only symptomatic treatments exist, mainly to reduce pain. Arthroplasty, a costly and invasive surgical procedure, is often unavoidable in advanced stages of the disease. More than just a degenerative disease of the cartilage, osteoarthritis is now recognised as a heterogeneous disease causing multi-tissue damage of varying intensity. Synovitis plays a particularly important role in the onset and progression of osteoarthritis and has been closely correlated with radiographic severity, pain and loss of joint function. The investigators have identified several synovial histological pathotypes based on the type of synovial cell infiltrate and its distribution in samples from advanced osteoarthritis (surgical waste from prosthesis implantation). The investiogators' studies show that the presence of these pathotypes appears to be related to the clinical phenotype of patients. Analysis of synovial tissue at earlier stages of the disease is now essential to advance the understanding of the role of synovitis in osteoarthritis and its link to the clinical phenotype of patients. The objective of this protocol is to describe the different synovial histological pathotypes present in the early stages of osteoarthritis; To this end, the investigators will establish a cohort of osteoarthritis patients with a collection of synovial tissue samples obtained by ultrasound-guided needle biopsy in an outpatient setting, a well-tolerated procedure with simple follow-up, as well as blood sampling.

Eligibility

Min Age: 18 Years

Inclusion Criteria7

Diagnosis of early osteoarthritis defined by the following clinical criteria:
score ≤ 85% in at least two of the four categories of the KOOS questionnaire: pain, symptoms/signs, function and quality of life;
presence of tenderness on palpation of the joint space or crepitus (clinical examination);
Kellgren and Lawrence (KL) score of 0 or 3 (X-rays).
Referred for therapeutic management including an intra-articular injection in the affected knee
Patient affiliated with a social security scheme
Patient able to understand the protocol and having signed an informed consent form.

Exclusion Criteria8

Minors
Adults under guardianship or trusteeship
Pregnant women
Breastfeeding women
Protected patients
Curative anticoagulation
Thrombocytopenia < 50,000 platelets/mm3
Patients who object to participating in the study.

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Interventions

OTHERsynovial biopsies

The procedure for performing ultrasound-guided synovial biopsies is as follows: * This is performed under local anaesthetic, in the consultation room, under strict aseptic conditions in five stages. * After tracing anaesthesia up to the capsule, 2 to 3 mL of lidocaine are injected intra-articularly. * A 13G coaxial needle is then positioned in the joint cavity, allowing multiple biopsies to be performed without causing tissue damage along the needle path. * Samples are taken using a 14G semi-automatic Tru-Cut with a notch allowing the collection of 1 mm x 2 cm synovial samples. The aim is to perform histological, immunohistochemical, cell culture and high-throughput analyses. Ideally, 6 to 12 additional biopsies will be performed for research purposes.