Siqueira Marcelo B P, Frangiamore Salvatore, Klika Alison K, Gajewski Nicholas, Barsoum Wael K, Higuera Carlos A
Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.
J Knee Surg. 2017 Feb;30(2):128-133. doi: 10.1055/s-0036-1583269. Epub 2016 Apr 28.
Degenerative osteoarthritis (OA) has been associated with elevated synovial fluid cytokines. It is unclear whether traumatic knee injuries are a trigger to the chemical process that leads to OA. The purpose of this study was to compare the synovial fluid cytokine levels between knees undergoing arthroscopy due to a documented inciting injury and knees undergoing primary arthroplasty due to end-stage OA without a previous inciting injury. Synovial fluid samples were prospectively collected from knees undergoing arthroscopic surgeries due to ligamentous or meniscal knee injuries (knee injury group, = 16) and primary arthroplasty due to OA (end-stage OA group, = 14). In the knee injury group, patients had none or minimal OA and at least 30 days from the inciting injury. Exclusion criteria for both groups included inflammatory arthropathy ( = 1) and insufficient fluid for analysis ( = 1). In addition to synovial fluid cytokines, preoperative demographic, clinical, and functional data (Knee Injury and Osteoarthritis Outcome Score [KOOS]) were collected and compared between the groups. The end-stage OA group had higher age ( < 0.0001), body mass index ( = 0.0061), Charlson comorbidity index (<0.0001), and OA classification ( < 0.0001). Preoperative KOOS were similar between the groups. Interleukin-6 (IL-6) and IL-8 were elevated in the end-stage OA group compared with the knee injury group ( = 0.04 and 0.006, respectively). Granulocyte-macrophage colony-stimulating factor, interferon gamma, IL-1β, IL-12p70, IL-2, IL-10, and tumor necrosis factor alpha were not statistically different between the groups. A similar synovial fluid cytokine profile was found between the two groups. The elevation of IL-6 and IL-8 in the end-stage OA group indicates the potential role that these proinflammatory cytokines may have in long-term cartilage damage.
退行性骨关节炎(OA)与滑液细胞因子升高有关。目前尚不清楚膝关节创伤性损伤是否是导致OA的化学过程的触发因素。本研究的目的是比较因有记录的诱发损伤而接受关节镜检查的膝关节与因终末期OA且无先前诱发损伤而接受初次关节置换术的膝关节之间的滑液细胞因子水平。前瞻性地收集了因膝关节韧带或半月板损伤而接受关节镜手术的膝关节(膝关节损伤组,n = 16)和因OA接受初次关节置换术的膝关节(终末期OA组,n = 14)的滑液样本。在膝关节损伤组中,患者无OA或仅有轻微OA,且距诱发损伤至少30天。两组的排除标准包括炎性关节病(n = 1)和分析用滑液不足(n = 1)。除滑液细胞因子外,还收集了术前人口统计学、临床和功能数据(膝关节损伤和骨关节炎结局评分[KOOS])并在两组之间进行比较。终末期OA组年龄更大(P < 0.0001)、体重指数更高(P = 0.0061)、Charlson合并症指数更高(P < 0.0001)且OA分级更高(P < 0.0001)。术前两组的KOOS相似。与膝关节损伤组相比,终末期OA组白细胞介素-6(IL-6)和IL-8升高(分别为P = 0.04和0.006)。两组之间粒细胞-巨噬细胞集落刺激因子(GM-CSF)、干扰素γ(IFN-γ)、IL-1β、IL-12p70、IL-2、IL-10和肿瘤坏死因子α(TNF-α)无统计学差异。两组间滑液细胞因子谱相似。终末期OA组中IL-6和IL-8的升高表明这些促炎细胞因子可能在长期软骨损伤中发挥的潜在作用。