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Purpose: To demonstrate the superficial hyperechoic band (SHEB) in articular cartilage by usingultrasonography (US) and to assess its correlation with histological images. Methods: In total, 47 regions of interest (ROIs) were analyzed from six tibial osteochondralspecimens (OCSs) that were obtained after total knee arthroplasty. Ultrasonograms wereobtained for each OCS. Then, matching histological sections from all specimens were obtainedfor comparison with the ultrasonograms. Two types of histological staining were used: Safranin-Ostain (SO) to identify glycosaminoglycans (GAG) and Masson’s trichrome stain (MT) to identifycollagen. In step 1, two observers evaluated whether there was an SHEB in each ROI. In step 2,the two observers evaluated which histological staining method correlated better with the SHEBby using the ImageJ software. Results: In step 1 of the analysis, 20 out of 47 ROIs showed an SHEB (42.6%, kappa=0.579). Step 2 showed that the SHEB correlated significantly better with the topographical variation instainability in SO staining, indicating the GAG distribution, than with MT staining, indicating thecollagen distribution (P<0.05, kappa=0.722). Conclusion: The SHEB that is frequently seen in human articular cartilage on high-resolution UScorrelated better with variations in SO staining than with variations in MT staining. Thus, wesuggest that a SHEB is predominantly related to changes in GAG. Identifying an SHEB by USis a promising method for assessing the thickness of articular cartilage or for monitoring early osteoarthritis.

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