Anterior cruciate ligament reconstruction reinitiates an inflammatory and chondrodegenerative process in the knee joint

Autor: Caitlin E.-W. Conley, Darren L. Johnson, Christian Lattermann, Cale A. Jacobs, Emily R. Hunt, Mary Lloyd Ireland
Rok vydání: 2020
Předmět:
Zdroj: Journal of Orthopaedic Research. 39:1281-1288
ISSN: 1554-527X
0736-0266
DOI: 10.1002/jor.24783
Popis: Anterior cruciate ligament (ACL) injury leads to a sustained increase in synovial fluid concentrations of inflammatory cytokines and biomarkers of cartilage breakdown. While this has been documented post-injury, it remains unclear whether ACL reconstruction surgery contributes to the inflammatory process and/or cartilage breakdown. This study is a secondary analysis of 14 patients (nine males/five females, mean age = 9, mean BMI = 28) enrolled in an IRB-approved randomized clinical trial. Arthrocentesis was performed at initial presentation (mean = 6 days post-injury), immediately prior to surgery (mean = 23 days post-injury), 1-week post-surgery, and 1-month post-surgery. Enzyme-linked immunosorbant assay kits were used to determine concentrations of carboxy-terminal telopeptides of type II collagen (CTXII), interleukin-6 (IL-6), and IL-1β in the synovial fluid. The log-transformed IL-1β was not normally distributed; therefore, changes between time points were evaluated using a non-parametric Kruskal-Wallis one-way ANOVA. IL-1β concentrations significantly increased from the day of surgery to the first postoperative time point (P ≤ .001) and significantly decreased at the 4-week postoperative visit (P = .03). IL-1β concentrations at the 4-week postoperative visit remained significantly greater than both preoperative time points (P .05). IL-6 concentrations at 1-week post-surgery were significantly higher than at initial presentation (P = .013), the day of surgery (P .001), and 4 weeks after surgery (P = .002). CTX-II concentrations did not differ between the first three-time points (P .99) but significantly increased at 4 weeks post-surgery (P .01). ACL reconstruction appears to reinitiate an inflammatory response followed by an increase in markers for cartilage degradation. ACL reconstruction appears to initiate a second "inflammatory hit" resulting in increased chondral breakdown suggesting that post-operative chondroprotection may be needed.
Databáze: OpenAIRE
Externí odkaz: