Osteoarthritis (OA), a degenerative disease, is associated with reduced quality of life and amounts to enormous familial and social burden (1). OA pathology revolves around altered or impaired cytokine signalling (2) particularly IL-1β and TNF-α, leading to synovitis, an inflammatory condition, which destabilizes the process of cartilage remodelling leading to cartilage loss. Cartilage being aneural and avasculardepends upon nutrients, enzymes, cytokines and growth factors available through SF (3). We here report investigations on two elderly ladies diagnosed having bilateral knee OA; at ‘stage 4’ on Kellgren& Lawrence grading (KL), a terminal stage of disease and operated for Total Knee Replacement (TKR). The patients were at equal radiological staging and their blood parameters were comparable. This enabled us to estimate markers retained in SF throughout the chain of events culminating towards the total cartilage loss. It is worth mentioning here that the patients were on anti-inflammatory medications for long periods, which might have affected the levels of inflammatory mediators (4).
