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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Biomarker Changes in ACL Deficient Knees Compared with Contralaterals
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Biomarker Changes in ACL Deficient Knees Compared with Contralaterals

机译：与对侧相比，ACL缺陷膝盖的生物标志物变化

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Objectives: Introduction: Though outcomes following ACL reconstruction are largely positive, patients’ post-operative recovery is highly variable, and is typically based off generalized timetables derived from population data. In an attempt to individualize prognostic estimates and establish how biomarker concentrations may change with injury, we sampled knee joint synovial fluid from patients with ACL tears with and without associated cartilage injuries and compared biomarker concentrations to samples obtained from the contralateral non-injured knee. Methods: 480 patients indicated for knee arthroscopy had samples drawn to form a synovial fluid database. If no injury history or symptoms were present in the contralateral knee, samples were drawn as well. For the current study, only patients that had confirmed ACL injury at the time of arthroscopy were included. Associated cartilage injury location, size and depth was documented. Synovial fluid samples were centrifuged, and the concentrations of 20 biomarkers were determined using a multiplex magnetic bead immunoassay. Concentrations were then compared between the three study groups (ACL tear with cartilage injury, ACL tears without cartilage injury, and healthy contralateral knees) using a Welch ANOVA test with pairwise comparisons. Results: The study included samples from 132 knees: 34 ACL tears without cartilage injury (mean age 34.0 years); 28 ACL tears with cartilage injury (mean age 36.3 years), and 72 contralateral knees (41.1 years). ANOVA testing demonstrated significant differences among groups for: MMP-3 (p>001); TIMP-1 (p=.001); TIMP-2 (p=.015); FGF-2 (p=.011); IL-6 (p=.001); and MIP-1b (p=.001). Pairwise comparisons demonstrated no significant differences between ACL tears with, and without cartilage damage, but did show both types of ACL tears had significantly higher concentrations of MMP-3, TIMP-1, IL-6, and MIP-1b than contralaterals. ACL tears without cartilage damage had significantly lower concentrations of TIMP-2 and FGF-2 (13) than contralaterals (Table 1). Conclusion: The course from surgery to symptomatic relief and functional improvement following ACL reconstruction is highly variable. Data from the current study demonstrated that cytokine concentrations are significantly different between ACL tears (+/- cartilage damage) and healthy knees. These validated differences can help establish synovial fluid biomarker analysis as a method for injury stratification ultimately providing patient-specific prognostic data.
机译：目的：简介：尽管ACL重建后的结果在很大程度上是积极的，但患者的术后恢复情况却存在很大差异，并且通常基于人口数据得出的一般时间表。为了个性化预测预后并确定生物标记物浓度随损伤而变化的方法，我们从患有和未伴有软骨损伤的ACL眼泪患者中抽取了膝关节滑液，并将生物标记物浓度与从对侧非损伤性膝关节获得的样品进行了比较。方法：480名接受膝关节镜检查的患者抽取了样本，以形成滑液数据库。如果对侧膝关节没有损伤史或症状，则也抽取样本。对于本研究，仅包括在关节镜检查时已确认ACL损伤的患者。记录了相关的软骨损伤位置，大小和深度。将滑液样品离心，并使用多重磁珠免疫测定法测定20种生物标志物的浓度。然后使用成对比较的Welch ANOVA测试比较​​三个研究组（软骨损伤的ACL泪，无软骨损伤的ACL泪和健康的对侧膝盖）之间的浓度。结果：该研究包括来自132个膝盖的样本：34个ACL撕裂而没有软骨损伤（平均年龄34.0岁）;伴有软骨损伤的28条ACL眼泪（平均年龄36.3岁）和对侧膝盖72条（41.1岁）。方差分析测试表明，各组之间在MMP-3（p> 001）; TIMP-1（p = .001）; TIMP-2（p = .015）; FGF-2（p = .011）; IL-6（p = .001）;和MIP-1b（p = .001）。成对比较显示，有软骨损伤和无软骨损伤的ACL泪液之间无显着差异，但确实显示两种类型的ACL泪液的MMP-3，TIMP-1，IL-6和MIP-1b的浓度均明显高于对侧。没有软骨损伤的ACL眼泪的TIMP-2和FGF-2浓度显着低于对侧（表1）。结论：ACL重建后从手术到症状缓解及功能改善的过程变化很大。来自当前研究的数据表明，ACL撕裂（+/-软骨损伤）和健康的膝盖之间的细胞因子浓度显着不同。这些经过验证的差异可以帮助建立滑液生物标志物分析作为损伤分层的方法，最终提供患者特定的预后数据。

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