Changes in content and synthesis of collagen types and proteoglycans in osteoarthritis of the knee joint and comparison of quantitative analysis with Photoshop-based image analysis

Arch Orthop Trauma Surg. 2010 Apr;130(4):557-64. doi: 10.1007/s00402-009-0981-y. Epub 2009 Oct 17.


Introduction: The different cartilage layers vary in synthesis of proteoglycan and of the distinct types of collagen with the predominant collagen Type II with its associated collagens, e.g. types IX and XI, produced by normal chondrocytes. It was demonstrated that proteoglycan decreases in degenerative tissue and a switch from collagen type II to type I occurs. The aim of this study was to evaluate the correlation of real-time (RT)-PCR and Photoshop-based image analysis in detecting such lesions and find new aspects about their distribution.

Patients: We performed immunohistochemistry and histology with cartilage tissue samples from 20 patients suffering from osteoarthritis compared with 20 healthy biopsies. Furthermore, we quantified our results on the gene expression of collagen type I and II and aggrecan with the help of real-time (RT)-PCR. Proteoglycan content was measured colorimetrically. Using Adobe Photoshop the digitized images of histology and immunohistochemistry stains of collagen type I and II were stored on an external data storage device. The area occupied by any specific colour range can be specified and compared in a relative manner directly from the histogram using the "magic wand tool" in the select similar menu. In the image grow menu gray levels or luminosity (colour) of all pixels within the selected area, including mean, median and standard deviation, etc. are depicted. Statistical Analysis was performed using the t test.

Method: With the help of immunohistochemistry, RT-PCR and quantitative RT- PCR we found that not only collagen type II, but also collagen type I is synthesized by the cells of the diseased cartilage tissue, shown by increasing amounts of collagen type I mRNA especially in the later stages of osteoarthritis.

Results: A decrease of collagen type II is visible especially in the upper fibrillated area of the advanced osteoarthritic samples, which leads to an overall decrease. Analysis of proteoglycan showed a loss of the overall content and a quite uniform staining in the different zones compared to the healthy cartilage with a classical zonal formation. Correlation analysis of the proteoglycan Photoshop measurements with the RT-PCR using Spearman correlation analysis revealed strong correlation for Safranin O and collagen type I, medium for collagen type II and glycoprotein but weak correlation between PCR aggrecan results.

Conclusion: Photoshop-based image analysis might become a valuable supplement for well known histopathological grading systems of lesioned articular cartilage.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aggrecans / analysis
  • Aggrecans / biosynthesis*
  • Arthroplasty, Replacement, Knee
  • Cartilage, Articular / metabolism*
  • Cartilage, Articular / pathology
  • Collagen / analysis
  • Collagen / biosynthesis
  • Collagen Type I / analysis
  • Collagen Type I / biosynthesis*
  • Collagen Type II / analysis
  • Collagen Type II / biosynthesis*
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Immunohistochemistry
  • Knee Joint / chemistry*
  • Male
  • Middle Aged
  • Osteoarthritis, Knee / metabolism*
  • Osteoarthritis, Knee / pathology
  • Osteoarthritis, Knee / surgery
  • Proteoglycans / analysis
  • Proteoglycans / biosynthesis
  • Reverse Transcriptase Polymerase Chain Reaction


  • Aggrecans
  • Collagen Type I
  • Collagen Type II
  • Proteoglycans
  • Collagen