PMID- 36349932
OWN - NLM
STAT- MEDLINE
DCOM- 20221215
LR  - 20221221
IS  - 1552-3365 (Electronic)
IS  - 0363-5465 (Linking)
VI  - 50
IP  - 14
DP  - 2022 Dec
TI  - RANTES Concentration at the Time of Surgery Is Associated With Postoperative 
      Stiffness in Patients Undergoing ACL Reconstruction.
PG  - 3838-3843
LID - 10.1177/03635465221131805 [doi]
AB  - BACKGROUND: Patients undergoing anterior cruciate ligament (ACL) reconstruction 
      have been shown to be at risk for postoperative arthrofibrosis. Diagnostic 
      biomarkers associated with the development of postoperative stiffness are 
      unknown. HYPOTHESIS: Biomarkers found in the synovial fluid at the time of 
      surgery are associated with the development of postoperative arthrofibrosis in a 
      cohort of patients undergoing ACL reconstruction. STUDY DESIGN: Case-control 
      study; Level of evidence, 3. METHODS: Patients undergoing ACL reconstruction were 
      prospectively enrolled. Synovial fluid was collected before surgical incision. A 
      cohort of patients with postoperative stiffness requiring manipulation under 
      anesthesia (MUA) and/or lysis of adhesions (LOA) was retrospectively identified. 
      Matching of cases to controls was performed using a 1:2 pair matching algorithm. 
      Risk factor-adjusted single-biomarker and multivariable models were used to 
      assess the association of synovial fluid biomarkers with postoperative stiffness 
      requiring MUA/LOA. Stepwise logistic regression controlling for clinical risk 
      factors was used to identify biomarkers that are possible predictors of 
      postoperative stiffness. RESULTS: A total of 11 cases (3 male, 8 female) were 
      identified and matched with 21 controls (6 male, 15 female) with no significant 
      differences in age, sex, smoking history, or days from injury to surgery. 
      Concentrations of the biomarker regulated upon activation, normal T-cell 
      expressed and presumably secreted (RANTES) were significantly higher in patients 
      requiring MUA/LOA versus controls (694.20 pg/mL [interquartile range, 
      214.75-3428.79] vs 113.04 pg/mL [interquartile range, 32.81-517.91], 
      respectively; P = .034). On single-biomarker models, RANTES (odds ratio, 2.28; 
      95% CI, 1.29-5.37; P = .019) and basic fibroblast growth factor (bFGF) (odds 
      ratio, 1.91; 95% CI, 1.07-3.99; P = .047) were associated with increased risk of 
      postoperative stiffness requiring MUA/LOA after ACL reconstruction. Stepwise 
      logistic regression identified 3 biomarkers that are possible predictors of 
      postoperative stiffness, which were included in the final model: Interleukin 1 
      receptor antagonist (IL-1RA) (P = .198), bFGF (P = .157), and RANTES (P = .046). 
      CONCLUSION: Higher concentrations of synovial fluid biomarkers bFGF and RANTES 
      were associated with increased risk for stiffness requiring intervention after 
      ACL reconstruction. Interleukin 6 (IL-6), vascular endothelial growth factor A 
      (VEGF-A), tissue inhibitor of metalloproteinases 1 (TIMP-1), interleukin 1 
      receptor antagonist (IL-1RA), matrix metalloproteinase 3 (MMP-3), monocyte 
      chemotactic protein 1 (MCP-1), and macrophage inflammatory protein 1B (MIP-1B) 
      were not associated with the development of postoperative arthrofibrosis.
FAU - Avila, Amanda
AU  - Avila A
AD  - NYU Langone Medical Center, Orthopaedic Surgery Department, Division of Sports 
      Medicine, New York, New York, USA.
FAU - Petrera, Massimo
AU  - Petrera M
AD  - NYU Langone Medical Center, Orthopaedic Surgery Department, Division of Sports 
      Medicine, New York, New York, USA.
FAU - Duenes, Matthew
AU  - Duenes M
AD  - NYU Langone Medical Center, Orthopaedic Surgery Department, Division of Sports 
      Medicine, New York, New York, USA.
FAU - Kingery, Matthew T
AU  - Kingery MT
AD  - NYU Langone Medical Center, Orthopaedic Surgery Department, Division of Sports 
      Medicine, New York, New York, USA.
FAU - Song, Melissa
AU  - Song M
AD  - NYU Langone Medical Center, Orthopaedic Surgery Department, Division of Sports 
      Medicine, New York, New York, USA.
FAU - Jazrawi, Laith M
AU  - Jazrawi LM
AD  - NYU Langone Medical Center, Orthopaedic Surgery Department, Division of Sports 
      Medicine, New York, New York, USA.
FAU - Strauss, Eric J
AU  - Strauss EJ
AD  - NYU Langone Medical Center, Orthopaedic Surgery Department, Division of Sports 
      Medicine, New York, New York, USA.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20221109
PL  - United States
TA  - Am J Sports Med
JT  - The American journal of sports medicine
JID - 7609541
RN  - 0 (Vascular Endothelial Growth Factor A)
RN  - 0 (Interleukin 1 Receptor Antagonist Protein)
RN  - 0 (Receptors, Interleukin-1)
SB  - IM
MH  - Humans
MH  - Female
MH  - Male
MH  - *Vascular Endothelial Growth Factor A
MH  - Case-Control Studies
MH  - *Interleukin 1 Receptor Antagonist Protein
MH  - Retrospective Studies
MH  - Receptors, Interleukin-1
OTO - NOTNLM
OT  - anterior cruciate ligament
OT  - arthrofibrosis
OT  - biomarkers
OT  - stiffness
OT  - synovial fluid
EDAT- 2022/11/10 06:00
MHDA- 2022/12/15 06:00
CRDT- 2022/11/09 06:22
PHST- 2022/11/10 06:00 [pubmed]
PHST- 2022/12/15 06:00 [medline]
PHST- 2022/11/09 06:22 [entrez]
AID - 10.1177/03635465221131805 [doi]
PST - ppublish
SO  - Am J Sports Med. 2022 Dec;50(14):3838-3843. doi: 10.1177/03635465221131805. Epub 
      2022 Nov 9.