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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...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2020
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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. |
format | Online Article Text |
id | pubmed-7401171 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
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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