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Soft Tissue Knee Injury With Concomitant Osteochondral Fracture Is Associated With Higher Degree of Acute Joint Inflammation.

Swärd, Per LU ; Struglics, André LU ; Englund, Martin LU ; Roos, Harald LU and Frobell, Richard LU (2014) In American Journal of Sports Medicine 42(5). p.1096-1102
Abstract
BACKGROUND:Osteochondral fractures are often seen on magnetic resonance imaging (MRI) of acutely injured knees, but their existence has gained little interest because of a lack of knowledge of their relation to treatment options and outcome. It is not clear whether acute phase synovial fluid (SF) concentrations of cartilage and bone markers and proinflammatory cytokines are different between traumatically injured knees with or without osteochondral fracture. HYPOTHESIS:Acutely injured knees with an osteochondral fracture, particularly fractures with disrupted cortical bone, have higher concentrations of bone markers and cytokines than do knees without an osteochondral fracture. STUDY DESIGN:Cross-sectional study; Level of evidence, 3.... (More)
BACKGROUND:Osteochondral fractures are often seen on magnetic resonance imaging (MRI) of acutely injured knees, but their existence has gained little interest because of a lack of knowledge of their relation to treatment options and outcome. It is not clear whether acute phase synovial fluid (SF) concentrations of cartilage and bone markers and proinflammatory cytokines are different between traumatically injured knees with or without osteochondral fracture. HYPOTHESIS:Acutely injured knees with an osteochondral fracture, particularly fractures with disrupted cortical bone, have higher concentrations of bone markers and cytokines than do knees without an osteochondral fracture. STUDY DESIGN:Cross-sectional study; Level of evidence, 3. METHODS:Synovial fluid (hemarthrosis) was aspirated (median 1 day after injury) and 1.5-T MRI was performed (median 8 days after injury) in the acutely injured knee of 98 individuals (26% women; mean age, 23 years). As visualized on MRI, 39% knees had an osteochondral fracture with disrupted cortical bone, 30% had an osteochondral fracture with intact cortical bone, and 32% did not have an osteochondral fracture. Concentrations of sulfated glycosaminoglycan, ARGS aggrecan, cartilage oligomeric matrix protein, osteocalcin, secreted protein acidic and rich in cysteine (SPARC), osteopontin and proinflammatory cytokines (interleukin [IL]-1β, IL-6, IL-8, and tumor necrosis factor [TNF]-α) were analyzed. RESULTS:After adjusting for days between injury and SF aspiration, age at injury, and sex, knees with any osteochondral fracture (with or without disrupted cortical bone) had significantly higher SF concentrations of TNF-α (median [interquartile range (IQR)] = 9 [7-12] pg/mL vs 7 [5-14] pg/mL; P = .013), whereas knees with an osteochondral fracture with disrupted cortical bone had significantly higher SF concentrations (medians [IQRs]) of SPARC (492 [328-754] ng/mL vs 407 [140-685] ng/mL; P = .030), IL-8 (278 [148-628] pg/mL vs 138 [67-413] pg/mL; P = .028), and TNF-α (11 [7-15] pg/mL vs 7 [5-14] pg/mL; P = .004) compared with knees without an osteochondral fracture. CONCLUSION:In acutely injured knees with hemarthrosis, a concomitant osteochondral fracture with disrupted cortical bone is associated with a higher degree of joint inflammation. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
American Journal of Sports Medicine
volume
42
issue
5
pages
1096 - 1102
publisher
American Orthopaedic Society for Sports Medicine
external identifiers
  • pmid:24664137
  • wos:000335567700009
  • scopus:84900458461
ISSN
1552-3365
DOI
10.1177/0363546514524924
language
English
LU publication?
yes
id
3b75552f-fca9-4e2e-8a85-7a3aa207c31e (old id 4379786)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/24664137?dopt=Abstract
date added to LUP
2014-04-03 21:37:10
date last changed
2017-07-23 03:28:46
@article{3b75552f-fca9-4e2e-8a85-7a3aa207c31e,
  abstract     = {BACKGROUND:Osteochondral fractures are often seen on magnetic resonance imaging (MRI) of acutely injured knees, but their existence has gained little interest because of a lack of knowledge of their relation to treatment options and outcome. It is not clear whether acute phase synovial fluid (SF) concentrations of cartilage and bone markers and proinflammatory cytokines are different between traumatically injured knees with or without osteochondral fracture. HYPOTHESIS:Acutely injured knees with an osteochondral fracture, particularly fractures with disrupted cortical bone, have higher concentrations of bone markers and cytokines than do knees without an osteochondral fracture. STUDY DESIGN:Cross-sectional study; Level of evidence, 3. METHODS:Synovial fluid (hemarthrosis) was aspirated (median 1 day after injury) and 1.5-T MRI was performed (median 8 days after injury) in the acutely injured knee of 98 individuals (26% women; mean age, 23 years). As visualized on MRI, 39% knees had an osteochondral fracture with disrupted cortical bone, 30% had an osteochondral fracture with intact cortical bone, and 32% did not have an osteochondral fracture. Concentrations of sulfated glycosaminoglycan, ARGS aggrecan, cartilage oligomeric matrix protein, osteocalcin, secreted protein acidic and rich in cysteine (SPARC), osteopontin and proinflammatory cytokines (interleukin [IL]-1β, IL-6, IL-8, and tumor necrosis factor [TNF]-α) were analyzed. RESULTS:After adjusting for days between injury and SF aspiration, age at injury, and sex, knees with any osteochondral fracture (with or without disrupted cortical bone) had significantly higher SF concentrations of TNF-α (median [interquartile range (IQR)] = 9 [7-12] pg/mL vs 7 [5-14] pg/mL; P = .013), whereas knees with an osteochondral fracture with disrupted cortical bone had significantly higher SF concentrations (medians [IQRs]) of SPARC (492 [328-754] ng/mL vs 407 [140-685] ng/mL; P = .030), IL-8 (278 [148-628] pg/mL vs 138 [67-413] pg/mL; P = .028), and TNF-α (11 [7-15] pg/mL vs 7 [5-14] pg/mL; P = .004) compared with knees without an osteochondral fracture. CONCLUSION:In acutely injured knees with hemarthrosis, a concomitant osteochondral fracture with disrupted cortical bone is associated with a higher degree of joint inflammation.},
  author       = {Swärd, Per and Struglics, André and Englund, Martin and Roos, Harald and Frobell, Richard},
  issn         = {1552-3365},
  language     = {eng},
  number       = {5},
  pages        = {1096--1102},
  publisher    = {American Orthopaedic Society for Sports Medicine},
  series       = {American Journal of Sports Medicine},
  title        = {Soft Tissue Knee Injury With Concomitant Osteochondral Fracture Is Associated With Higher Degree of Acute Joint Inflammation.},
  url          = {http://dx.doi.org/10.1177/0363546514524924},
  volume       = {42},
  year         = {2014},
}