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Synovial Fluid Profile at the Time of Anterior Cruciate Ligament Reconstruction and Its Association With Cartilage Matrix Composition 3 Years After Surgery.

Publication ,  Journal Article
Amano, K; Huebner, JL; Stabler, TV; Tanaka, M; McCulloch, CE; Lobach, I; Lane, NE; Kraus, VB; Ma, CB; Li, X
Published in: Am J Sports Med
March 2018

BACKGROUND: Anterior cruciate ligament tears can lead to posttraumatic osteoarthritis. In addition to biomechanical factors, changes in biochemical profiles within the knee joint after injury and anterior cruciate ligament reconstruction (ACLR) may play a role in accelerating joint degeneration. Hypothesis/Purpose: It was hypothesized that cartilage matrix composition after ACLR is associated with the degree of inflammatory response after initial injury. This study evaluated the association between the inflammatory response after injury-as indicated by cytokine, metalloproteinase, and cartilage degradation marker concentrations in synovial fluid-and articular cartilage degeneration, measured by T1ρ and T2 quantitative magnetic resonance imaging up to 3 years after ACLR. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: Twenty-six subjects from a longitudinal cohort study who underwent ACLR at a mean 8.5 weeks after injury (range, 4-19 weeks) had synovial fluid aspirated at the time of surgery. Immunoassays quantified biomarkers in synovial fluid. T1ρ and T2 values of articular cartilage were calculated with magnetic resonance scans acquired prior to surgery and at 6 months and 1, 2, and 3 years after surgery. Pearson correlation coefficients were calculated among the various biomarkers. K-means clustering was used to group subjects with similar biomarker profiles. Generalized estimating equations were used to find the overall differences in T1ρ and T2 values throughout these first 3 years after surgery between the clusters while controlling for other factors. RESULTS: Significant and strong correlations were observed between several cytokines (interleukin 6 [IL-6], IL-8, IL-10, and tumor necrosis factor α) and 2 matrix metalloproteinases (MMP-1 and MMP-3) ( P < .05). Moderate correlations were found among combinations of C-terminal crosslinked telopeptide type II collagen, N-terminal telopeptide, cartilage oligomeric matrix protein, and sulfated glycosaminoglycan ( P < .05). Two clusters were generated, 1 of which was characterized by lower concentrations of cytokines (IL-6, IL-8, IL-10, tumor necrosis factor α) and MMP-1 and MMP-3 and higher sulfated glycosaminoglycan. This cluster was associated with significantly higher T1ρ and T2 values in the medial tibial and patellar cartilage over the first 3 years after ACLR. CONCLUSION: At the time of ACLR surgery, profiles of synovial fluid inflammatory cytokines, degradative enzymes, and cartilage breakdown products show promise as predictors of abnormal cartilage tissue integrity (increased T1ρ and T2 values) throughout the first 3 years after surgery. CLINICAL RELEVANCE: The results suggest an intricate relationship between inflammation and cartilage turnover, which can in turn be influenced by timing after injury and patient factors.

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Published In

Am J Sports Med

DOI

EISSN

1552-3365

Publication Date

March 2018

Volume

46

Issue

4

Start / End Page

890 / 899

Location

United States

Related Subject Headings

  • Young Adult
  • Tibia
  • Synovial Fluid
  • Osteoarthritis
  • Orthopedics
  • Male
  • Magnetic Resonance Imaging
  • Longitudinal Studies
  • Knee Joint
  • Inflammation
 

Citation

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Amano, K., Huebner, J. L., Stabler, T. V., Tanaka, M., McCulloch, C. E., Lobach, I., … Li, X. (2018). Synovial Fluid Profile at the Time of Anterior Cruciate Ligament Reconstruction and Its Association With Cartilage Matrix Composition 3 Years After Surgery. Am J Sports Med, 46(4), 890–899. https://doi.org/10.1177/0363546517749834
Amano, Keiko, Janet L. Huebner, Thomas V. Stabler, Matthew Tanaka, Charles E. McCulloch, Iryna Lobach, Nancy E. Lane, Virginia B. Kraus, C Benjamin Ma, and Xiaojuan Li. “Synovial Fluid Profile at the Time of Anterior Cruciate Ligament Reconstruction and Its Association With Cartilage Matrix Composition 3 Years After Surgery.Am J Sports Med 46, no. 4 (March 2018): 890–99. https://doi.org/10.1177/0363546517749834.
Amano K, Huebner JL, Stabler TV, Tanaka M, McCulloch CE, Lobach I, et al. Synovial Fluid Profile at the Time of Anterior Cruciate Ligament Reconstruction and Its Association With Cartilage Matrix Composition 3 Years After Surgery. Am J Sports Med. 2018 Mar;46(4):890–9.
Amano, Keiko, et al. “Synovial Fluid Profile at the Time of Anterior Cruciate Ligament Reconstruction and Its Association With Cartilage Matrix Composition 3 Years After Surgery.Am J Sports Med, vol. 46, no. 4, Mar. 2018, pp. 890–99. Pubmed, doi:10.1177/0363546517749834.
Amano K, Huebner JL, Stabler TV, Tanaka M, McCulloch CE, Lobach I, Lane NE, Kraus VB, Ma CB, Li X. Synovial Fluid Profile at the Time of Anterior Cruciate Ligament Reconstruction and Its Association With Cartilage Matrix Composition 3 Years After Surgery. Am J Sports Med. 2018 Mar;46(4):890–899.
Journal cover image

Published In

Am J Sports Med

DOI

EISSN

1552-3365

Publication Date

March 2018

Volume

46

Issue

4

Start / End Page

890 / 899

Location

United States

Related Subject Headings

  • Young Adult
  • Tibia
  • Synovial Fluid
  • Osteoarthritis
  • Orthopedics
  • Male
  • Magnetic Resonance Imaging
  • Longitudinal Studies
  • Knee Joint
  • Inflammation