Differences in type II collagen turnover of osteoarthritic human knee and ankle joints



We analysed hyaline cartilage of human knee and ankle joints for collagen and proteoglycan turnover in order to find differences in the metabolism and biochemical content of the extracellular matrix that could explain the higher prevalence of osteoarthritis (OA) in the knee joint, compared to the ankle joint.


Cartilage tissue from ankle and knee joints of OA patients were assessed for total collagen and proteoglycan content. For turnover, the aggrecan 846-epitope (CS 846), the type II collagen C-propeptide (CP2) and the collagenase-generated intrahelical cleavage neoepitope (C2C) were quantified.


Molecular analyses showed that type II collagen turnover (CP2 and C2C) was significantly elevated in the ankle, whereas aggrecan turnover (CS 846), total proteoglycan and total collagen were comparable between both joints. Analysis of the inter-relationships in the components of cartilage matrix turnover showed a significant positive correlation of C2C vs CP2.


The data suggest an increased type II collagen turnover in ankle vs knee OA cartilage but a comparable aggrecan turnover and comparable contents of type II collagen and proteoglycan. These findings point towards a focused attempt in advanced OA cartilage to structurally repair the collagen network that was more pronounced in the ankle joint and may explain in part the higher prevalence of OA in the knee as compared to the ankle joint.

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We would like to thank Jana Schömburg und Christine Mollenhauer for their help in sample preparation and Dr. Juergen Mollenhauer for the useful discussions during this project. All experimental data were collected at the Orthopaedic Research Laboratories of the University of Jena. Special thank goes to the Deutsche Forschungsgemeinschaft (DFG), the Deutsche Arthrosehilfe e.V., and the Interdisciplinary Center for Clinical Research (IZKF) of the University of Jena for the financial support of this work.

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Correspondence to Matthias Aurich.

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This work was supported in part by a grant from the Deutsche Forschungsgemeinschaft DFG 156/6-1), Deutsche Arthrosehilfe e.V. and the Interdisciplinary Center for Clinical Research (IZKF) (M.A.). The funding sources had no involvement in study design, in the collection, analysis and interpretation of data, in the writing of the report or in the decision to submit the article for publication.

Ethical approval

The study has been approved by the local ethics committee (approval #0981-10/02 from the Ethics Committee of the Medical Faculty at the University of Jena, Jena, Germany) and was performed in concordance with the 1964 Declaration of Helsinki and according to the German Data Protection Act. Before the start of the investigation, written informed consent was obtained. The legal requirements concerning confidential medical communication were met. At any time, the patients had the right to withdraw consent without giving reasons and without disadvantages regarding further medical treatment. The medical therapy of the patients during hospitalization was performed independently of this research project. Patient data was stored exclusively in the Hospital according to current data protection laws. Third persons were not provided insight into source data. Any patient has the right to have his data deleted.

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Informed consent was obtained from all individual participants included in the study.

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Aurich, M., Hofmann, G.O. & Rolauffs, B. Differences in type II collagen turnover of osteoarthritic human knee and ankle joints. International Orthopaedics (SICOT) 41, 999–1005 (2017). https://doi.org/10.1007/s00264-017-3414-5

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  • Ankle
  • Cartilage
  • Human
  • Knee
  • Metabolism
  • Osteoarthritis