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Synovial Fluid Biomarkers at the Time of Arthroscopy Predict 5-Year Outcomes

OBJECTIVES: Injury-induced molecular changes in the intra-articular microenvironment of the knee are thought to play a role in the development of post-traumatic osteoarthritis. The purpose of this study was to evaluate the association between post-traumatic synovial fluid biomarker concentrations an...

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Autores principales: Manjunath, Amit, Markus, Danielle, Berlinberg, Elyse, Kenny, Lena, Strauss, Eric, Kingery, Matthew
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7401171/
http://dx.doi.org/10.1177/2325967120S00337
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author Manjunath, Amit
Markus, Danielle
Berlinberg, Elyse
Kenny, Lena
Strauss, Eric
Kingery, Matthew
author_facet Manjunath, Amit
Markus, Danielle
Berlinberg, Elyse
Kenny, Lena
Strauss, Eric
Kingery, Matthew
author_sort Manjunath, Amit
collection PubMed
description OBJECTIVES: Injury-induced molecular changes in the intra-articular microenvironment of the knee are thought to play a role in the development of post-traumatic osteoarthritis. The purpose of this study was to evaluate the association between post-traumatic synovial fluid biomarker concentrations and intermediate-term functional outcomes. METHODS: Patients undergoing primary knee arthroscopy for ACL injury, meniscus injury, and/or focal chondral lesions were prospectively enrolled. Synovial fluid aspirate, collected immediately prior to surgical incision, was processed and analyzed using a multiplex magnetic bead immunoassay to determine the concentration of 10 pre-determined cytokines and chemokines. Patients with a minimum of five years of postoperative follow-up were surveyed with Visual Analog Pain Scale (VAS), Lysholm Knee Scoring Scale, and Knee Injury and Osteoarthritis Outcome Score Physical Function Shortform (KOOS-PS). Stepwise regression was used to fit a linear regression model and model accuracy was evaluated using k-fold cross validation. RESULTS: 39 patients (mean age: 41.56 +/- 15.98 years, mean postoperative follow-up: 6.79 +/- 0.72 years) were included in the study. Mean Lysholm, KOOS-PS, and VAS scores were 83.67 +/- 17.64, 88.37 +/- 12.79, and 11.03 +/- 19.84, respectively. 11 patients had undergone further ipsilateral knee surgery during the follow-up period. Of the remaining 28 patients, a model consisting of VEGF, TIMP-2, and MMP-3 was found to most accurately predict intermediate-term functional outcomes. Regardless of the type or extent of injury, these three biomarkers were able to explain 60.35%, 34.75%, and 39.38% of the variability in Lysholm, KOOS-PS, and VAS scores, respectively. CONCLUSIONS: By measuring the concentrations of MMP-3, TIMP-2, and VEGF at the time of surgery, functional outcomes and level of pain can be predicted at 5 years postoperatively with moderate accuracy. This suggests that these biomarkers may play an important role in the development of post-traumatic osteoarthritis and may serve as potential targets for therapeutic intervention.
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spelling pubmed-74011712020-08-10 Synovial Fluid Biomarkers at the Time of Arthroscopy Predict 5-Year Outcomes Manjunath, Amit Markus, Danielle Berlinberg, Elyse Kenny, Lena Strauss, Eric Kingery, Matthew Orthop J Sports Med Article OBJECTIVES: Injury-induced molecular changes in the intra-articular microenvironment of the knee are thought to play a role in the development of post-traumatic osteoarthritis. The purpose of this study was to evaluate the association between post-traumatic synovial fluid biomarker concentrations and intermediate-term functional outcomes. METHODS: Patients undergoing primary knee arthroscopy for ACL injury, meniscus injury, and/or focal chondral lesions were prospectively enrolled. Synovial fluid aspirate, collected immediately prior to surgical incision, was processed and analyzed using a multiplex magnetic bead immunoassay to determine the concentration of 10 pre-determined cytokines and chemokines. Patients with a minimum of five years of postoperative follow-up were surveyed with Visual Analog Pain Scale (VAS), Lysholm Knee Scoring Scale, and Knee Injury and Osteoarthritis Outcome Score Physical Function Shortform (KOOS-PS). Stepwise regression was used to fit a linear regression model and model accuracy was evaluated using k-fold cross validation. RESULTS: 39 patients (mean age: 41.56 +/- 15.98 years, mean postoperative follow-up: 6.79 +/- 0.72 years) were included in the study. Mean Lysholm, KOOS-PS, and VAS scores were 83.67 +/- 17.64, 88.37 +/- 12.79, and 11.03 +/- 19.84, respectively. 11 patients had undergone further ipsilateral knee surgery during the follow-up period. Of the remaining 28 patients, a model consisting of VEGF, TIMP-2, and MMP-3 was found to most accurately predict intermediate-term functional outcomes. Regardless of the type or extent of injury, these three biomarkers were able to explain 60.35%, 34.75%, and 39.38% of the variability in Lysholm, KOOS-PS, and VAS scores, respectively. CONCLUSIONS: By measuring the concentrations of MMP-3, TIMP-2, and VEGF at the time of surgery, functional outcomes and level of pain can be predicted at 5 years postoperatively with moderate accuracy. This suggests that these biomarkers may play an important role in the development of post-traumatic osteoarthritis and may serve as potential targets for therapeutic intervention. SAGE Publications 2020-07-31 /pmc/articles/PMC7401171/ http://dx.doi.org/10.1177/2325967120S00337 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc-nd/4.0/ This open-access article is published and distributed under the Creative Commons Attribution - NonCommercial - No Derivatives License (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits the noncommercial use, distribution, and reproduction of the article in any medium, provided the original author and source are credited. You may not alter, transform, or build upon this article without the permission of the Author(s). For article reuse guidelines, please visit SAGE’s website at http://www.sagepub.com/journals-permissions.
spellingShingle Article
Manjunath, Amit
Markus, Danielle
Berlinberg, Elyse
Kenny, Lena
Strauss, Eric
Kingery, Matthew
Synovial Fluid Biomarkers at the Time of Arthroscopy Predict 5-Year Outcomes
title Synovial Fluid Biomarkers at the Time of Arthroscopy Predict 5-Year Outcomes
title_full Synovial Fluid Biomarkers at the Time of Arthroscopy Predict 5-Year Outcomes
title_fullStr Synovial Fluid Biomarkers at the Time of Arthroscopy Predict 5-Year Outcomes
title_full_unstemmed Synovial Fluid Biomarkers at the Time of Arthroscopy Predict 5-Year Outcomes
title_short Synovial Fluid Biomarkers at the Time of Arthroscopy Predict 5-Year Outcomes
title_sort synovial fluid biomarkers at the time of arthroscopy predict 5-year outcomes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7401171/
http://dx.doi.org/10.1177/2325967120S00337
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