Estrogen and osteoarthritis: a study of synovial estradiol and estradiol receptor binding in human osteoarthritic knees.

Estrogen appears to be a risk factor in knee osteoarthritis (OA). Results from 21 patients revealed that synovial estradiol level was highly related to the severity of OA. Increased estradiol receptor bindings in the medial compartment of the femoral condylar and tibia plateau cartilages were observed; the increase was significantly higher in the medial than in the lateral compartment (p less than 0.05). Although the synovial estradiol level was significantly lower in women with OA than in men with OA (p less than 0.01), postmenopausal women were hypothesized to be more susceptible to OA, since the possible existence of synovial testosterone might counteract the high estradiol synovial level in men, which results in a lower incidence of knee OA in men than in postmenopausal women. We suggest that excessive synovial estradiol and higher estradiol receptor bindings may be involved in the development of knee OA, particularly in postmenopausal women.