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Synovial cytokine expression in ankle osteoarthritis depends on age and stage

  • Experimental Study
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Aim of the study was the analysis of cytokine expression in ankle osteoarthritis (OA) hypothesizing age-dependent regulation patterns.

Methods

Forty-nine patients undergoing an arthroscopy of the ankle with different stages of chronic OA were prospectively included in a clinical trial comparing the group <18 years (n = 9, Ø15.1 ± 2.0 years) with the older patients (≥18 years, n = 40, Ø36.5 ± 11.9). Lavage fluids were analysed by ELISA for levels of aggrecan, BMP-2/7, IGF-1/R, bFGF, CD105, MMP-13, and IL-1β. Additionally, clinical parameters and scores (FFI, CFSS, AOFAS) were evaluated and supplemented by radiographic scores [Kellgren–Lawrence Score (KLS) for conventional X-rays, Ankle Osteoarthritis Scoring System (AOSS) for MRI].

Results

In contrast to distribution of gender and BMI (p < 0.005), parameters characterizing the cartilage defect as ICRS grading, size, and duration of symptoms were not dependent on age. The incidence of osteochondritis dissecans (OCD) was higher in the group <18 years (p < 0.006), but the average degree of OCD grading was not different. KLS and AOSS were significantly higher in the group ≥18 years (p < 0.02). Correlating with the higher degree of OA in the elderly, clinical function measured by FFI and AOFAS was statistically significantly worse (p < 0.05). Intra-articular concentrations of aggrecan (3.1-fold), bFGF (8.7-fold), BMP-7 (2.7-fold), and CD105 (1.5-fold) were statistically significantly higher in the group ≥18 years (p < 0.03).

Conclusions

Confirming the hypothesis, increased synovial levels of aggrecan, bFGF, BMP-7, and CD105 were found in patients over 18 years. This correlated with a higher stage of OA determined by radiographic changes or deteriorated function and may offer starting points for new diagnostics and interventional strategies.

Level of evidence

II.

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Acknowledgments

The study was funded by the AO Foundation Germany and the Department of Education and Research Germany (01EC1001D). We thank Prof. Christian Lohrmann, Department of Radiology, University of Freiburg Medical Center, for instructions and recommendations regarding the Ankle Osteoarthritis Scoring System.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Freiburg Medical Center, Hugstetter Str. 55, 79106, Freiburg i.Br., Germany

    Hagen Schmal, Ralf Henkelmann, Alexander T. Mehlhorn, Kilian Reising, Gerrit Bode, Norbert P. Südkamp & Philipp Niemeyer

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  1. Hagen Schmal
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  2. Ralf Henkelmann
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Correspondence to Hagen Schmal.

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Schmal, H., Henkelmann, R., Mehlhorn, A.T. et al. Synovial cytokine expression in ankle osteoarthritis depends on age and stage. Knee Surg Sports Traumatol Arthrosc 23, 1359–1367 (2015). https://doi.org/10.1007/s00167-013-2719-1

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