Bai Yuming, Zhang Haisen, Liu Chang, Jin Shengli, Su Ke, Liu Ying, Lü Zhichang
The Second Department of Orthopaedics, Central Hospital of Cangzhou, Cangzhou Hebei, 061001, P.R.China.
The Second Department of Orthopaedics, Central Hospital of Cangzhou, Cangzhou Hebei, 061001,
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2017 Apr 15;31(4):422-426. doi: 10.7507/1002-1892.201609123.
To investigate interleukin-1β (IL-1β), IL-6, and IL-17 levels in both synovial fluid and serum of patients with primary knee medial osteoarthritis (OA) after high tbial osteotomy (HTO).
Twenty-six patients with primary knee medial OA undergoing HTO between January 2011 and June 2014 (experimental group) and 30 healthy individuals (control group) were recruited into the study. There was no significant difference in gender, age, and body mass index between 2 groups ( >0.05). The X-ray film was taken to record healing time at osteotomy site, to measure the tibiofemoral angle, and to assess limb alignment after HTO. Visual analogue scale (VAS) pain score and knee society score (KSS) were used to evaluate pain level and function of the knee. The IL-1β, IL-6, and IL-17 concentrations in both plasma and synovial fluid were measured before operation and at 6, 12, and 18 months after operation in the experimental group using ELISA method; the levels in plasma were measured in control group.
Primary healing of incisions was achieved in patients. All patients were followed up 18-24 months (mean, 21 months). The X-ray film showed osseous healing at osteotomy site at 9-14 weeks (mean, 11.5 weeks). The average tibiofemoral angle was 167.5° (range, 165-170°) after bone healing. Satisfactory limb alignment was obtained in all patients. The postoperative VAS pain score was significantly decreased and KSS score was significantly improved when compared with preoperative scores ( <0.05), but no significant difference was found between different time points after operation ( >0.05). The preoperative plasma and synovial fluid IL-1β, IL-6, and IL-17 concentrations were significantly higher in patients than controls ( <0.05). The postoperative IL-1β, IL-6, and IL-17 concentrations in plasma and synovial fluid were significantly lower than preoperative ones in patients ( <0.05), but the concentrations were significantly higher than those in controls ( <0.05). The postoperative plasma and synovial fluid IL-1β, IL-6, and IL-17 concentrations were significantly declined in patients, but there was no significant difference between different time points after operation ( >0.05).
HTO can significantly improve the pain symptom and joint function and reduce IL-1β, IL-6, and IL-17 levels in both plasma and synovial fluid of patients with medial compartment knee OA, but these cytokines can not return to normal level.
探讨高位胫骨截骨术（HTO）治疗原发性膝内侧骨关节炎（OA）患者后，其滑液和血清中白细胞介素-1β（IL-1β）、IL-6及IL-17的水平。
选取2011年1月至2014年6月期间接受HTO治疗的26例原发性膝内侧OA患者作为实验组，另选30例健康个体作为对照组。两组在性别、年龄及体重指数方面无显著差异（P>0.05）。拍摄X线片记录截骨部位愈合时间，测量胫股角，并评估HTO术后肢体对线情况。采用视觉模拟评分法（VAS）疼痛评分和膝关节协会评分（KSS）评估膝关节疼痛程度及功能。实验组患者于术前及术后6、12、18个月采用酶联免疫吸附测定（ELISA）法检测血浆及滑液中IL-1β、IL-6及IL-17的浓度；对照组检测血浆中上述指标水平。
患者切口均一期愈合。所有患者均获随访18 - 24个月（平均21个月）。X线片显示截骨部位在9 - 14周（平均11.5周）达到骨性愈合。骨愈合后平均胫股角为167.5°（范围165 - 170°）。所有患者肢体对线良好。与术前评分相比，术后VAS疼痛评分显著降低，KSS评分显著改善（P<0.05），但术后不同时间点间差异无统计学意义（P>0.05）。患者术前血浆及滑液中IL-1β、IL-6及IL-17浓度显著高于对照组（P<0.05）。患者术后血浆及滑液中IL-1β、IL-6及IL-17浓度显著低于术前（P<0.05），但显著高于对照组（P<0.05）。患者术后血浆及滑液中IL-1β、IL-6及IL-17浓度显著下降，但术后不同时间点间差异无统计学意义（P>0.05）。
HTO可显著改善膝内侧间室OA患者的疼痛症状及关节功能，并降低其血浆及滑液中IL-1β、IL-6及IL-17水平，但这些细胞因子不能恢复至正常水平。
