Prospective clinical trial of patients who underwent ankle arthroscopy with articular diseases to match clinical and radiological scores with intra-articular cytokines

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• 作者：Ralf Henkelmann ; Hagen Schmal ; Ingo H. Pilz ; Gian M. Salzmann…
• 关键词：Ankle ; Synovial fluid ; Aggrecan ; BMP ; 2 ; MMP ; 13 ; IGF ; 1 ; Osteochondritis dissecans ; Osteoarthritis
• 刊名：International Orthopaedics
• 出版年：2015
• 出版时间：August 2015
• 年：2015
• 卷：39
• 期：8
• 页码：1631-1637
• 全文大小：264 KB
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• 作者单位：Ralf Henkelmann (1)
  Hagen Schmal (2)
  Ingo H. Pilz (2)
  Gian M. Salzmann (2)
  David Dovi-Akue (2)
  Norbert P. Südkamp (2)
  
  1. Clinic of Orthopaedic, Trauma and Plastic Surgery, University of Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany
  2. Department of Orthopaedic and Trauma Surgery, University of Freiburg Medical Center, Hugstetter Str. 55, 79106, Freiburg, Germany
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Orthopedics
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-5195

文摘

Objective There is still a lack of reliable data on cytokine concentrations in the ankle and their value for prognosis. Methods In a prospective clinical trial, lavage fluids were collected from 49 patients with an arthroscopy of the ankle. The fluids were investigated by ELISA for cytokine levels. Clinical scores (FFI, AOFAS) were evaluated both pre-operatively and then again 12 months after surgery (n--3, 88%). Radiological changes were noted with the Kellgren-Lawrence-Score (KLS) and the Ankle Osteoarthritis Scoring System (AOSS). Based on the difference between the pre- and postoperative clinical scores, two groups were defined according to whether they had benefited from the surgical therapy (Δ score ?10) or not (Δ score < 10). Results The average clinical scores had improved to a statistically significant extent in the one-year follow-up (p-lt;-.01). BMP-2 (p--.02), IGF-1 (p--.04), BMP-7 (p--.01) and aggrecan (p = 0.04) showed significant correlations with pre-operative clinical and radiological scores (p--.02, p--.01, p--.01, p = 0.01). Furthermore, BMP-2 (p--.01), IGF-1/TPC (p--.03) and aggrecan (p--.01) correlated with scores after one year (p = 0.02, p--.01). High aggrecan concentrations were associated with a low clinical and a high radiological score at both time points, both indicating progress of cartilage degeneration in contrast to BMP-2 or IGF-1. Furthermore, MMP-13 concentrations were significantly higher in the non-benefit group (p = 0.02). Conclusion BMP-2, IGF-1, aggrecan and MMP-13 seem to be involved in the degenerative process of cartilage in the ankle joint. Additionally, high synovial MMP-13 concentrations indicate a worse clinical outcome.