Surgical reconstruction of ruptured anterior cruciate ligament prolongs trauma-induced increase of inflammatory cytokines in synovial fluid : An exploratory analysis in the KANON trial
Larsson, S. LU
; Struglics, A.
LU
; Lohmander, L. S.
LU
and Frobell, R.
LU
(2017)
In Osteoarthritis and Cartilage
25(9).
p.1443-1451
- Abstract
Objective: Prospectively monitor how treatment of acutely ruptured anterior cruciate ligament (ACL) affects biomarkers of inflammation and proteolytic degradation over 5 years. Design: We studied 119 subjects with acute ACL injury from the randomized controlled knee anterior cruciate ligament, non-surgical versus surgical treatment (KANON)-trial (Clinical trial ISRCTN 84752559) who had synovial fluid, serum and urine samples available from at least two out of six visits over 5 years after acute ACL rupture. All subjects followed a similar rehabilitation protocol where, according to randomization, 60 also had early ACL reconstruction and 59 had the option to undergo a delayed ACL reconstruction if needed. Interleukin (IL)-6, IL-8, IL-10,... (More)
Objective: Prospectively monitor how treatment of acutely ruptured anterior cruciate ligament (ACL) affects biomarkers of inflammation and proteolytic degradation over 5 years. Design: We studied 119 subjects with acute ACL injury from the randomized controlled knee anterior cruciate ligament, non-surgical versus surgical treatment (KANON)-trial (Clinical trial ISRCTN 84752559) who had synovial fluid, serum and urine samples available from at least two out of six visits over 5 years after acute ACL rupture. All subjects followed a similar rehabilitation protocol where, according to randomization, 60 also had early ACL reconstruction and 59 had the option to undergo a delayed ACL reconstruction if needed. Interleukin (IL)-6, IL-8, IL-10, interferon-gamma (IFNγ), tumor necrosis factor (TNF), amino acids alanine, arginine, glycine, serine (ARGS)-aggrecan, C-terminal crosslinking telopeptide type II collagen (CTX-II) and N-terminal crosslinking telopeptide type I collagen (NTX-I) were quantified by enzyme-linked immunosorbent assays (ELISA). Results: Subjects randomized to early ACL reconstruction had higher cytokine concentrations in index knee synovial fluid at 4 months (IL-6, IL-8, IL-10, TNF), 8 months (IL-6 and TNF) and at 5 years (IFNγ) compared to those randomized to optional delayed reconstruction. Those that underwent delayed ACL reconstruction within 5 years (30 subjects), had higher synovial fluid concentrations of IL-6 at 5 years compared to those treated with rehabilitation alone. No differences between groups were noted for ARGS-aggrecan in synovial fluid and serum or CTX-II and NTX-I in urine over 5 years, neither as randomized nor as treated. Conclusions: Surgical ACL reconstruction constitutes a second trauma to the acutely injured joint resulting in a prolonged elevation of already high synovial fluid levels of inflammatory cytokines.
(Less)
- author
- Larsson, S.
LU
; Struglics, A.
LU
; Lohmander, L. S.
LU
and Frobell, R.
LU
- organization
- publishing date
- 2017-09
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Anterior cruciate ligament reconstruction, Biomarkers, Cytokines, Orthopedic surgery, Osteoarthritis, Synovial fluid
- in
- Osteoarthritis and Cartilage
- volume
- 25
- issue
- 9
- pages
- 1443 - 1451
- publisher
- W.B. Saunders
- external identifiers
-
- scopus:85020044776
- wos:000407934000009
- pmid:28522220
- ISSN
- 1063-4584
- DOI
- 10.1016/j.joca.2017.05.009
- language
- English
- LU publication?
- yes
- id
- 259f2a19-05b3-4e24-987f-a08340a82a06
- date added to LUP
- 2017-06-27 08:11:03
- date last changed
- 2025-10-15 03:24:31
@article{259f2a19-05b3-4e24-987f-a08340a82a06,
abstract = {{<p>Objective: Prospectively monitor how treatment of acutely ruptured anterior cruciate ligament (ACL) affects biomarkers of inflammation and proteolytic degradation over 5 years. Design: We studied 119 subjects with acute ACL injury from the randomized controlled knee anterior cruciate ligament, non-surgical versus surgical treatment (KANON)-trial (Clinical trial ISRCTN 84752559) who had synovial fluid, serum and urine samples available from at least two out of six visits over 5 years after acute ACL rupture. All subjects followed a similar rehabilitation protocol where, according to randomization, 60 also had early ACL reconstruction and 59 had the option to undergo a delayed ACL reconstruction if needed. Interleukin (IL)-6, IL-8, IL-10, interferon-gamma (IFNγ), tumor necrosis factor (TNF), amino acids alanine, arginine, glycine, serine (ARGS)-aggrecan, C-terminal crosslinking telopeptide type II collagen (CTX-II) and N-terminal crosslinking telopeptide type I collagen (NTX-I) were quantified by enzyme-linked immunosorbent assays (ELISA). Results: Subjects randomized to early ACL reconstruction had higher cytokine concentrations in index knee synovial fluid at 4 months (IL-6, IL-8, IL-10, TNF), 8 months (IL-6 and TNF) and at 5 years (IFNγ) compared to those randomized to optional delayed reconstruction. Those that underwent delayed ACL reconstruction within 5 years (30 subjects), had higher synovial fluid concentrations of IL-6 at 5 years compared to those treated with rehabilitation alone. No differences between groups were noted for ARGS-aggrecan in synovial fluid and serum or CTX-II and NTX-I in urine over 5 years, neither as randomized nor as treated. Conclusions: Surgical ACL reconstruction constitutes a second trauma to the acutely injured joint resulting in a prolonged elevation of already high synovial fluid levels of inflammatory cytokines.</p>}},
author = {{Larsson, S. and Struglics, A. and Lohmander, L. S. and Frobell, R.}},
issn = {{1063-4584}},
keywords = {{Anterior cruciate ligament reconstruction; Biomarkers; Cytokines; Orthopedic surgery; Osteoarthritis; Synovial fluid}},
language = {{eng}},
number = {{9}},
pages = {{1443--1451}},
publisher = {{W.B. Saunders}},
series = {{Osteoarthritis and Cartilage}},
title = {{Surgical reconstruction of ruptured anterior cruciate ligament prolongs trauma-induced increase of inflammatory cytokines in synovial fluid : An exploratory analysis in the KANON trial}},
url = {{http://dx.doi.org/10.1016/j.joca.2017.05.009}},
doi = {{10.1016/j.joca.2017.05.009}},
volume = {{25}},
year = {{2017}},
}