Marks Paul H, Donaldson Michelle L Cameron
Department of Orthopaedic Surgery, University of Toronto, Orthopaedic and Arthritic Institute, Toronto, Ontario, Canada.
Arthroscopy. 2005 Nov;21(11):1342-7. doi: 10.1016/j.arthro.2005.08.034.
Patients with chronic anterior cruciate ligament (ACL) deficiency are at high risk of articular cartilage damage and the development of osteoarthritis (OA). It has been hypothesized that biochemical factors, such as cytokines, contribute to the process. The purpose of our study was to determine the concentrations of potentially chondrodestructive and chondroprotective cytokines in the chronic ACL-deficient knee, and to determine if the cytokine profile or other factors correlated with the amount of chondral damage present in the knee.
A consecutive series of patients who consented to the Institutional Review Board-approved study.
Synovial fluid lavages were obtained from 31 patients with ACL-deficient knees. Four patients had lavages aspirated from their contralateral normal knee. These lavages were analyzed for interleukin (IL)-1alpha, IL-1beta, IL-1ra, and tumor necrosis factor (TNF)-alpha. At arthroscopy, the amount of chondral damage was graded based on the Outerbridge classification.
Concentrations of chondrodestructive IL-1beta and TNF-alpha were significantly higher in patients with ACL ruptures than in the contralateral normal knees. The more severe the chondral damage, the higher the concentration of IL-1beta and TNF-alpha. Chondroprotective cytokine concentrations decreased with increasing grades of chondral damage. We found a linear correlation between the severity of chondral damage and the time from injury (r2 = .954).
A difference was seen in the cytokine profiles between the normal and injured knees. This difference varied based on the severity of chondral damage, which was associated with time from injury.
Cytokine levels are associated with chondral damage.
慢性前交叉韧带（ACL）损伤患者存在关节软骨损伤和骨关节炎（OA）发展的高风险。据推测，细胞因子等生化因素参与了这一过程。本研究的目的是测定慢性ACL损伤膝关节中潜在的软骨破坏和软骨保护细胞因子的浓度，并确定细胞因子谱或其他因素是否与膝关节中软骨损伤的程度相关。
一系列连续的患者同意参与经机构审查委员会批准的研究。
从31例ACL损伤膝关节患者中获取滑膜液灌洗样本。4例患者还从对侧正常膝关节获取灌洗样本。对这些灌洗样本分析白细胞介素（IL）-1α、IL-1β、IL-1受体拮抗剂（IL-1ra）和肿瘤坏死因子（TNF）-α。在关节镜检查时，根据Outerbridge分类法对软骨损伤程度进行分级。
ACL断裂患者中软骨破坏因子IL-1β和TNF-α的浓度显著高于对侧正常膝关节。软骨损伤越严重，IL-1β和TNF-α的浓度越高。软骨保护细胞因子的浓度随着软骨损伤程度的增加而降低。我们发现软骨损伤的严重程度与受伤时间之间存在线性相关性（r2 = 0.954）。
正常膝关节和损伤膝关节的细胞因子谱存在差异。这种差异因软骨损伤的严重程度而异，而软骨损伤的严重程度与受伤时间相关。
细胞因子水平与软骨损伤相关。
