Increased intraarticular synovial fluid cytokines may predict pain in partial meniscectomy
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Key takeaways:
- Increased concentrations of chemokine ligand 5 and matrix metalloproteinase-3 predicted increased VAS knee pain.
- Decreased levels of interleukin-1 receptor antagonist yielded worse improvements in Lysholm score.
WASHINGTON – Intraarticular levels of synovial fluid cytokines at surgery may be predictive of intermediate-term postoperative function and pain in patients undergoing arthroscopic partial meniscectomy, according to presented data.
“These results suggest that synovial fluid biomarker analysis can technically be used to predict patient response to surgical treatment, aiding in the selection of appropriate candidates for operative intervention,” Eric Strauss, MD, said during a presentation at the American Orthopaedic Society for Sports Medicine Annual Meeting.
In the retrospective analysis of prospectively collected data from a synovial fluid database, researchers studied 50 patients who had synovial fluid aspirated from the operative knee immediately before undergoing arthroscopic partial meniscectomy. Strauss and colleagues collected preoperative and postoperative outcome scores at a minimum of 2 years. With the preoperative and postoperative patient-reported outcome scores, researchers used generalized linear models to determine the relationship between biomarkers and improvement in Lysholm knee score, improvement in VAS pain score and postoperative KOOS-Physical Function relative to the patient’s preoperative baseline.
Overall, 34 patients met the minimal clinically important difference for the Lysholm score and 16 patients did not. Mean patient age was approximately 51 years with 48% of patients having traumatic tears and 52% degenerative tears. Mean follow-up time was approximately 5.6 years postoperatively.
Researchers found increased concentrations of chemokine ligand 5 and matrix metalloproteinase-3 (MMP-3) were predictive of increased VAS knee pain. Higher levels of MMP-3 were predictive of worse function relative to baseline. Decreased synovial fluid levels of interleukin-1 receptor antagonist (IL-1 Ra) were associated with worse improvements in Lysholm score relative to baseline. At the time of surgery, higher levels of IL-1 Ra were associated with greater improvements in midterm Lysholm scores.
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Shankar D, et al. Paper 36. Presented at: American Orthopaedic Society for Sports Medicine; July 13-16, 2023; Washington, D.C.
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