PMID- 32490633
OWN - NLM
STAT- MEDLINE
DCOM- 20210712
LR  - 20210712
IS  - 1303-6165 (Electronic)
IS  - 1300-0144 (Print)
IS  - 1300-0144 (Linking)
VI  - 50
IP  - 5
DP  - 2020 Aug 26
TI  - The utility of synovial fluid levels of ADAMTS9 and ADAMTS4 in predicting 
      treatment responses to intraarticular steroid injections in patients with knee 
      osteoarthritis.
PG  - 1330-1336
LID - 10.3906/sag-1809-108 [doi]
AB  - BACKGROUND/AIM: This study aims to identify the role of synovial fluid levels of 
      a disintegrin and metalloproteinase with thrombospondin motifs 9 (ADAMTS9) and a 
      disintegrin and metalloproteinase with thrombospondin motifs 4 (ADAMTS4) for the 
      prediction of intraarticular steroid injection success in knee osteoarthritis 
      (OA). MATERIAL AND METHODS: A total of eighty-four advanced stage knee OA 
      patients (42 with stage 3 OA and 42 with stage 4 OA) were enrolled in the study. 
      Baseline and posttreatment outcomes were determined using Western Ontario and 
      McMaster Universities Osteoarthritis Index (WOMAC). Pretreatment synovial fluid 
      ADAMTS9 and ADAMTS4 levels were measured by enzyme linked immunosorbent assay 
      (ELISA). ''Total WOMAC score regression of 18% and above'' was taken as a minimal 
      clinically important difference (MCID) to indicate improvement. Determining the 
      best predictors of intraarticular steroid injection success in both groups was 
      evaluated by multiple logistic regression analyses. RESULTS: Synovial fluid 
      ADAMTS9 levels were significantly lower in the stage 4 OA group when compared 
      with the stage 3 group. The level of synovial fluid ADAMTS9 was statistically 
      significantly lower in the WOMAC score percent change >/=18% than the WOMAC score 
      percent change <18% group in Stage 3 OA group (P = 0.026). Decreasing synovial 
      fluid ADAMTS9 levels (odds ratio (OR): 0.625, 95% confidence interval (CI): 
      0.437-0.893) were found to be predictive for the WOMAC score percent change >/=18 
      in all OA patients (P = 0.010). Decreasing ADAMTS9 levels in synovial fluid (OR: 
      0.602; 95% CI = 0.372-0.974) were predictive for MCID in stage 3 OA patients (P = 
      0.039). CONCLUSION: The lower levels of ADAMTS9 in synovial fluid may be used in 
      conjunction with high WOMAC scores in the prediction of intraarticular steroid 
      injection success and advanced stage knee OA patients.
CI  - This work is licensed under a Creative Commons Attribution 4.0 International 
      License.
FAU - Ozler, Kenan
AU  - Ozler K
AUID- ORCID: 0000-0002-4992-5245
AD  - Department of Orthopedics, Konya Beysehir State Hospital, Konya, Turkey
LA  - eng
PT  - Journal Article
DEP - 20200826
PL  - Turkey
TA  - Turk J Med Sci
JT  - Turkish journal of medical sciences
JID - 9441758
RN  - 0 (Steroids)
RN  - EC 3.4.24.- (ADAMTS9 Protein)
RN  - EC 3.4.24.- (ADAMTS9 protein, human)
RN  - EC 3.4.24.82 (ADAMTS4 Protein)
RN  - EC 3.4.24.82 (ADAMTS4 protein, human)
SB  - IM
MH  - ADAMTS4 Protein/*analysis
MH  - ADAMTS9 Protein/*analysis
MH  - Aged
MH  - Female
MH  - Humans
MH  - Injections, Intra-Articular
MH  - Middle Aged
MH  - *Osteoarthritis, Knee/drug therapy/physiopathology
MH  - Severity of Illness Index
MH  - *Steroids/administration & dosage/therapeutic use
MH  - Synovial Fluid/*chemistry
PMC - PMC7491267
OTO - NOTNLM
OT  - ADAMTS4
OT  - ADAMTS9
OT  - WOMAC score
OT  - synovial fluid
OT  - knee osteoarthritis
COIS- The authors declare that they have no conflict of interest and this study has 
      received no financial support.
EDAT- 2020/06/04 06:00
MHDA- 2021/07/13 06:00
PMCR- 2020/08/26
CRDT- 2020/06/04 06:00
PHST- 2018/09/16 00:00 [received]
PHST- 2020/05/19 00:00 [accepted]
PHST- 2020/06/04 06:00 [entrez]
PHST- 2020/06/04 06:00 [pubmed]
PHST- 2021/07/13 06:00 [medline]
PHST- 2020/08/26 00:00 [pmc-release]
AID - 10.3906/sag-1809-108 [doi]
PST - epublish
SO  - Turk J Med Sci. 2020 Aug 26;50(5):1330-1336. doi: 10.3906/sag-1809-108.