Department of Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden.
Department of Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; Clinical Epidemiology Research & Training Unit, Boston University School of Medicine, Boston, MA, USA.
Osteoarthritis Cartilage. 2012 May;20(5):388-395. doi: 10.1016/j.joca.2012.02.001. Epub 2012 Feb 10.
To investigate whether change in concentrations over time of aggrecanase generated ARGS-aggrecan in synovial fluid (SF ARGS) associates with progression of radiographic knee osteoarthritis (OA) and patient-reported outcome in subjects with previous meniscectomy.
We studied 141 subjects at two time points after meniscectomy. Time point A was on average 18 years after meniscectomy, time point B was on average 7.5 years later; 74 subjects had SF available from both examinations. We measured SF ARGS by an electrochemiluminescence immunoassay, graded radiographic features of tibiofemoral or patellofemoral OA according to the Osteoarthritis Research Society International (OARSI) atlas, and scored patient-reported outcomes using the Knee Injury and Osteoarthritis Outcome Score (KOOS). Using logistic regression (adjusted for age, gender, body mass index, time between examinations, and SF ARGS at first examination) we assessed associations between change in SF ARGS between first and second examinations and progression of radiographic OA and KOOS.
In subjects with decreasing SF ARGS between examinations, the likelihood of loss of joint space and worsening of KOOS pain between examinations was increased 6- and 4-fold respectively compared to those increasing in SF ARGS (odds ratio (OR) 5.72; 95% confidence interval (CI) 1.53-21.4 and 3.66; 1.01-13.2, respectively). No significant associations were seen between decreasing SF ARGS and progression of osteophytes (OR 0.88; 0.28-2.78), or for patient-reported outcomes other than KOOS pain.
Having decreasing levels of SF ARGS over time was associated with an increased risk of loss of joint space and pain worsening, but showed no association with other patient-reported outcomes or osteophyte progression.
研究滑液中软骨寡聚基质蛋白（ARGS）-聚集蛋白聚糖（aggrecan）浓度随时间的变化与半月板切除术后膝关节骨关节炎（OA）放射学进展和患者报告结局的关系。
我们对半月板切除术后 141 例患者进行了两次研究。时间点 A 平均为半月板切除术后 18 年，时间点 B 平均为 7.5 年后；74 例患者在两次检查中均有滑液样本。我们通过电化学发光免疫测定法测量滑液中的 SF ARGS，根据国际骨关节炎研究协会（OARSI）图谱对胫股或髌股 OA 的放射学特征进行分级，并使用膝关节损伤和骨关节炎结果评分（KOOS）对患者报告的结果进行评分。我们使用逻辑回归（调整年龄、性别、体重指数、两次检查之间的时间以及第一次检查时的 SF ARGS）来评估两次检查之间 SF ARGS 的变化与放射学 OA 进展和 KOOS 之间的关系。
与 SF ARGS 检查中增加的患者相比，SF ARGS 检查中减少的患者在两次检查之间失去关节间隙和 KOOS 疼痛恶化的可能性分别增加了 6 倍和 4 倍（比值比（OR）5.72；95%置信区间（CI）1.53-21.4 和 3.66；1.01-13.2）。SF ARGS 减少与骨赘进展（OR 0.88；0.28-2.78）或除 KOOS 疼痛外的其他患者报告结局之间无显著相关性。
SF ARGS 水平随时间的降低与关节间隙丧失和疼痛恶化的风险增加相关，但与其他患者报告结局或骨赘进展无关。
