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Biomarker could make diagnosing knee injury easier, less costly
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A recently discovered fibronectic-aggrecan complex biomarker could assist in the diagnosis of meniscal injury, according to a study published in the Journal of Bone and Joint Surgery.
The marker is frequently present in the synovial fluid of knees with meniscal abnormality, study investigators found. The findings could be used to prevent needless surgery and significantly reduce costs related to medical imaging, the investigators noted in a press release.
“The challenge is not identifying molecular markers of cartilage degeneration, dozens of which are now known,” study co-author Raymond Golish, MD, PhD, stated in the release. “The difficulty is in finding markers that correlate with painful injuries, as opposed to age-related degeneration that is painless. This study is a big step in that direction.”
Comparison group
The investigators studied 30 patients with knee pain, mechanical symptoms and MRI findings that were positive for meniscal tear. All of the patients chose arthroscopic partial meniscectomy after undergoing unsuccessful nonoperative treatment.
At the time of surgery, the investigators sampled synovial fluid from each patient and assayed those samples for the fibronectin-aggrecan complex. Results of these tests were compared with knee aspirates from 10 asymptomatic volunteers with no pain. These volunteers also underwent MRI of the knee.
According to the study results, mean optical density and standard deviation the fibronectin-aggrecan complex was “significantly greater” in the synovial fluid samples from the knees that underwent arthroscopic surgery when compared to that from the asymptomatic control group.
Although the mean age of the symptomatic group in the study was noted as being significantly older than the control group, the authors added that controlling for age did not impact the final results.
According to the release, the presence of the fibronectin-aggrecan complex may potentially allow orthopedists to quickly and accurately diagnose whether the source of a patient’s discomfort is a meniscal tear, as opposed to joint arthritis or a different pathology.
More work needed
The authors added that further research should be performed to correlate the functional outcome of meniscal injury patients with the fibronectin-aggrecan complex and other cartilage biomarkers. They are running trials to confirm that the biomarker does not show up in other types of knee injuries. Work is also being done to investigate the therapeutic options inherent in the complex.
“We could envision several things, such as blocking the fibronectin and aggrecan protein fragments from coming together to form a complex, or interfering with the activation of white blood cells at the site,” lead author Gaetano Scuderi, MD, stated in the release.
Reference:
- Scuederi GJ, et al. Identification of a novel fibronectin-aggrecan complex in the synovial fluid of knees with painful meniscal injury. JBJS (Am). 2011;93:336-340. doi:10.2106/JBJS.J.00718
Disclosure: One or more of the authors, or a member of his or her immediate family, received, in any year, payments or other benefits in excess of $10,000 or a commitment or agreement to provide such benefits from Cytonics, Inc.
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