الفهرس 
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Abstract
Osteoarthritis (OA) is a chronic degenerative condition of mobile joints, primarily a non-inflammatory disorder characterized by an imbalance between the synthesis and degradation of articular cartilage leading to classic pathological change of wearing away and destruction of cartilage (Brandet et al, 2009) .
OA is characterized by cartilage erosion, development of osteophytes, changes in the subchondral bone and synovial fluid, and the involvement of a variety of inflammatory components . OA is generally considered to have a complicated framework that includes genetic, hormonal, metabolic and biomechanical factors and specific risk factors such as age, gender, obesity, and past injury have been identified. (Fahlman et al., 2013) .
The etiology of this disease is related to genetic association ( Lanyon et al. , 2000 ) . Growth Differentiation Factor 5 gene (GDF5) regulates the expression of the GDF5 protein which is closely related to Bone Morphogenic protein (BMP). It has a role in regulation of the chondrogenesis and the defect in this gene might be correlated to the abnormal joint development (Puxton et al, 2001) .
Moreover, it has been reported that the polymorphism in GDF5 gene is related with low expression of the GDF5 protein in knee joint (Miyamoto et al.,2007).
The aim of this study was to detect the association of GDF5 gene polymorphism with the osteoarthritis of knee joint and its correlation with severity of the disease through assessments of clinical and radiographic scores .
The present study was conducted on Fifty adult patients (41 females and 9 males), suffering from OA as defined by The ACR classification criteria for OA of the knee and Fifty healthy adults (41 females and 9 males) served as a control group.
All patients included in this study were subjected to full history taking, clinical examination , radiological investigations of both knees & GDF5 gene polymorphism using real time polymerase chain reaction (RT-PCR) .
The results obtained were statistically analyzed and summarized as follows:
• The homozygous mutant type (TT) was more frequently represented among OA patients (40.0%) in compared to (24.0 %) in controls , the difference wasn’t statistically significant .
• The heterozygous mutant type (CT) was more frequently represented among healthy controls (50.0 %) compared to (32.0%) in OA patients , the difference wasn’t statistically significant .
• The TT genotype was more likely to be associated with morning stiffness , but there was no statistically significant relation with morning stiffness .
• There was no statistical significant relation between diabetes ,hypertension and the polymorphism in GDF5 gene .
• The tenderness score was higher in cases with TT genotype and the difference was statistically significant in the RT. Knee but not in the LT. knee .
• The VAS score was higher in cases with TT genotype than in CC & CT genotypes , the difference was statistically significant .
• The WOMAC Score was significantly higher in patients with TT genotype compared to patients with CC & CT genotypes and the difference was statistically significant.
• The K-L Scores of patients with TT genotype were significantly higher than that of patients with CC & CT genotypes in both RT. & LT knees .
• There was statistically significant correlation between WOMAC Score and age of the patients .
• There was statistically significant correlation between VAS Score and WOMAC score
• There was statistically significant correlation between VAS Score and RT. & LT. K –L Score.