Schmal Hagen, Salzmann Gian M, Langenmair Elia R, Henkelmann Ralf, Südkamp Norbert P, Niemeyer Philipp
Department of Orthopaedic and Trauma Surgery, University of Freiburg Medical Center, Hugstetter Street. 55, 79106 Freiburg, Germany.
ScientificWorldJournal. 2014 Feb 13;2014:434802. doi: 10.1155/2014/434802. eCollection 2014.
Reliable data about in vivo regulation of cytokines in early ankle osteoarthritis (OA) are still missing.
49 patients with a mean age of 33 ± 14 years undergoing an arthroscopy of the ankle with different stages of chronic OA were prospectively included in a clinical trial. Lavage fluids were analyzed by ELISA. Additionally, clinical parameters and scores (FFI, CFSS, and AOFAS) were evaluated and supplemented by the Kellgren Lawrence Score (KLS) and the ankle osteoarthritis scoring system (AOSS).
ICRS grading of cartilage damage, previous operations, and duration of complains were strong indicators for OA progress and showed correlations to age, clinical scores, validated KLS, and AOSS (P < 0.04). Systemic and intraarticular inflammatory parameters were low in all patients. Biochemically, aggrecan and BMP-7 positively indicated OA with statistically significant associations with duration of symptoms, FFI, AOFAS, and KLS (P < 0.04). In contrast, BMP-2 levels showed statistically significant negative correlations to aggrecan or BMP-7 concentrations, which is in line with the negative association with ICRS score and KLS and the positive correlation with FFI (P < 0.03).
We were able to identify different key markers of OA in the ankle as aggrecan, BMP-7, and BMP-2, offering starting points for new ways in diagnostics and interventional strategies.
早期踝关节骨关节炎（OA）中细胞因子体内调节的可靠数据仍然缺失。
49例平均年龄为33±14岁、接受不同慢性OA阶段踝关节镜检查的患者被前瞻性纳入一项临床试验。通过酶联免疫吸附测定（ELISA）分析灌洗液。此外，评估临床参数和评分（功能障碍指数[FFI]、慢性疼痛严重程度评分[CFSS]和美国足踝外科协会评分[AOFAS]），并补充凯尔格伦·劳伦斯评分（KLS）和踝关节骨关节炎评分系统（AOSS）。
软骨损伤的国际软骨修复协会（ICRS）分级、既往手术和主诉持续时间是OA进展的有力指标，并与年龄、临床评分、验证后的KLS和AOSS相关（P<0.04）。所有患者的全身和关节内炎症参数均较低。生化方面，聚集蛋白聚糖和骨形态发生蛋白-7（BMP-7）呈阳性表明OA，与症状持续时间、FFI、AOFAS和KLS有统计学显著关联（P<0.04）。相比之下，BMP-2水平与聚集蛋白聚糖或BMP-7浓度呈统计学显著负相关，这与与ICRS评分和KLS的负相关以及与FFI的正相关一致（P<0.03）。
我们能够确定踝关节OA的不同关键标志物为聚集蛋白聚糖、BMP-7和BMP-2，为诊断和干预策略的新方法提供了切入点。
