Synovial tissue and cartilage collection for experimental purposes

Rheumatoid arthritis is a chronic inflammatory disease mainly affecting the
joints, leading to joint destruction, defomity and disability.
The etiology is unknown, although it is known that inflammatory cells, their
products and other mediators that are produced in the synovium play an
important role in the pathogenetic process.
Since RA and other arthritides primarily involve the synovium, synovial tissue
analysis provides insight into the pathogenesis of the disease process.
Therefore, descriptive studies of rheumatoid synovium contribute to an
understanding of the events that take place in vivo and complement experimental
animal studies and in vitro studies.
To evaluate if synovial tissue changes are specific for RA, it is necessary to
compare RA synovial tissue with synovial tissue of other inflammatory diseases,
such as psoriatic arthritis and spondyloarthritis, as well as non-inflammatory
synovial tissue, such as of patients with osteoarthritis, traumatic joint
lesions, or bone tumors. Moreover, the specificity of RA synovitis may be
related to the specific functional behaviour of synovial cells towards
chondrocytes and cartilage molecules.

To collect synovial tissue and cartilage from patients with non-inflammatory
joint diseases, that can be used in different studies as control for the
evaluation of changes in RA synovial tissue, in order to gain more insight in
the pathogenetic processes involved in RA and other inflammatory joint
diseases.

Synovial tissue and cartilage specimens will be collected:
1) During orthopedic surgery synovial tissue will be collected through a biopsy
technique in all patients undergoing arthroscopy because of joint pathology.
2) In all patients undergoing amputation of a (part of a) limb synovial tissue
and cartilage will be collected from the limb after (orthopedic) surgery.
In addition, clinical evaluation will be performed and demographic and disease
activity parameters will be collected.

Synovial biopsies will be collected and processed using a standard protocol for
formalin fixation to allow standard histological evaluation and samples will be
frozen en bloc for immunohistochemistry, PCR, micro-array and protein
expression analysis. Samples will be collected for fibroblast like synoviocyte
cell culture using a standard protocol. Cartilage will be used for isolation of
chondrocytes for in vitro culture using a standard protocol.

In patients undergoing orthopedic or vascular surgery on medical indication
synovial tissue and/or cartilage will be collected.
1) During orthopedic surgery synovial tissue will be collected through a biopsy
technique in all patients undergoing arthroscopy because of joint pathology.
2) In all patients undergoing amputation of a (part of a) limb synovial tissue
and cartilage will be collected from the limb after (orthopedic/vascular)
surgery.

There is no additional burden or risk.