PMID- 26524935 OWN - NLM STAT- MEDLINE DCOM- 20161027 LR - 20220408 IS - 1526-3231 (Electronic) IS - 0749-8063 (Linking) VI - 32 IP - 3 DP - 2016 Mar TI - Correlation of Synovial Fluid Biomarkers With Cartilage Pathology and Associated Outcomes in Knee Arthroscopy. PG - 475-85 LID - S0749-8063(15)00738-0 [pii] LID - 10.1016/j.arthro.2015.08.033 [doi] AB - PURPOSE: To correlate the intraoperative concentrations of 20 synovial fluid biomarkers with preoperative symptoms, intraoperative findings, and postoperative outcomes in patients undergoing knee arthroscopy, with comparisons made to samples obtained from asymptomatic knees. METHODS: Synovial fluid samples were obtained from 81 patients undergoing knee arthroscopy meeting the inclusion criteria, which included 70 samples from operative knees and 32 samples from contralateral knees. Preoperatively, baseline data obtained from clinical questionnaires including a visual analog scale (VAS) score, the Lysholm score, and the Knee Injury and Osteoarthritis Outcome Score-Physical Function Short Form were recorded. Synovial fluid was collected from both the operative knee and asymptomatic contralateral knee. Synovial fluid was stored with a protease inhibitor at -80 degrees C until analysis. Intraoperative findings, procedures performed, and International Cartilage Repair Society (ICRS) cartilage status scores in all operative knees were documented. The concentrations of the following 20 biomarkers were measured using a multiplex magnetic bead immunoassay: matrix metalloproteinase (MMP) 3; MMP-13; tissue inhibitor of metalloproteinase (TIMP) 1; TIMP-2; TIMP-3; TIMP-4; fibroblast growth factor 2; eotaxin; interferon gamma; interleukin (IL) 10; platelet-derived growth factor BB; IL-1 receptor antagonist; IL-1beta; IL-6; monocyte chemotactic protein 1 (MCP-1); macrophage inflammatory protein 1alpha; macrophage inflammatory protein 1beta; RANTES (regulated upon activation, normal T cell expressed and secreted); tumor necrosis factor alpha; and vascular endothelial growth factor. Clinical outcome scores were obtained in 83% of patients at a mean of 17 months' follow-up postoperatively. Analysis of variance and Pearson correlation analysis were performed to determine statistical significance between preoperative data, intraoperative findings, postoperative outcomes, and synovial fluid biomarker concentrations compared with asymptomatic contralateral knees. RESULTS: Analysis was performed on 70 operative and 32 contralateral samples. There were strong positive correlations between ICRS score and age, symptom duration, VAS score, and Knee Injury and Osteoarthritis Outcome Score-Physical Function Short Form. A strong positive correlation was found between MCP-1 and IL-6 concentrations, intraoperative ICRS score, and continued pain at the time of final follow-up. MCP-1 and IL-6 were the strongest predictors of severe cartilage lesions, whereas IL-1 receptor antagonist was inversely related. MMP-3 levels were consistently elevated in all operative samples and directly correlated to increased preoperative VAS scores. RANTES, vascular endothelial growth factor, and platelet-derived growth factor BB were the strongest predictors of postoperative improvement at final follow-up regardless of injury and cartilage status. CONCLUSIONS: Synovial fluid biomarkers have the capacity to reflect the intra-articular environment before surgery and potentially predict postoperative clinical outcomes. Recognition of key molecular players may yield future therapeutic targets, and large clinical trials exploring these discoveries are anticipated. LEVEL OF EVIDENCE: Level III, therapeutic case-control study. CI - Copyright (c) 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved. FAU - Cuellar, Vanessa G AU - Cuellar VG AD - Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York, U.S.A. FAU - Cuellar, Jason M AU - Cuellar JM AD - Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York, U.S.A. FAU - Kirsch, Thorsten AU - Kirsch T AD - Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York, U.S.A. FAU - Strauss, Eric J AU - Strauss EJ AD - Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York, U.S.A.. Electronic address: eric.strauss@nyumc.org. LA - eng PT - Journal Article DEP - 20151030 PL - United States TA - Arthroscopy JT - Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association JID - 8506498 RN - 0 (Biomarkers) SB - IM CIN - Arthroscopy. 2016 Mar;32(3):486. PMID: 26945955 MH - Adult MH - Arthroscopy/*methods MH - Biomarkers/*metabolism MH - Cartilage/*pathology MH - Female MH - Follow-Up Studies MH - Humans MH - Knee Injuries/*diagnosis/metabolism/pathology MH - Knee Joint/*metabolism/pathology MH - Male MH - Middle Aged MH - Osteoarthritis, Knee/diagnosis/metabolism MH - Prospective Studies MH - Synovial Fluid/*metabolism EDAT- 2015/11/04 06:00 MHDA- 2016/11/01 06:00 CRDT- 2015/11/04 06:00 PHST- 2014/12/12 00:00 [received] PHST- 2015/07/27 00:00 [revised] PHST- 2015/08/25 00:00 [accepted] PHST- 2015/11/04 06:00 [entrez] PHST- 2015/11/04 06:00 [pubmed] PHST- 2016/11/01 06:00 [medline] AID - S0749-8063(15)00738-0 [pii] AID - 10.1016/j.arthro.2015.08.033 [doi] PST - ppublish SO - Arthroscopy. 2016 Mar;32(3):475-85. doi: 10.1016/j.arthro.2015.08.033. Epub 2015 Oct 30.