Department of Orthopaedic Surgery, Musculoskeletal Research Center.
Department of Cell Biology and Physiology, Washington University School of Medicine at Barnes Jewish Hospital.
Curr Opin Rheumatol. 2019 Jan;31(1):70-79. doi: 10.1097/BOR.0000000000000566.
The interaction between joint injuries and posttraumatic osteoarthritis (PTOA) is generally thought to be mechanical in nature, however, surgical intervention has little effect on the development of PTOA. Little is known about the biological underpinning of how meniscus and anterior cruciate ligament (ACL) tears lead to cartilage degeneration. This review summarizes the latest findings regarding biological factors that influence how the knee responds to meniscus and ligament injuries, how meniscus and/or ACL tears turn the joint in the direction of PTOA and whether patient risk for PTOA after meniscus/ACL injury can be predicted.
Literature indicates that numerous intrinsic and extrinsic factors are associated with the biological response of the knee to injuries associated with PTOA. Gene/protein biomarkers provide insight into the biologic response of the knee to meniscus/ACL tears and the relationship to osteoarthritis in at-risk patients. Animal studies detail the time-course of disease pathogenesis and inform about the molecules that potentially alter the course of disease.
The molecular metabolic state of the meniscus/ACL after injury is associated with several biological factors. The limited studies to date provide initial evidence on the early molecular manifestations of injury, suggesting possible mechanisms for further study.
关节损伤与创伤后骨关节炎(PTOA)之间的相互作用通常被认为是机械性质的,然而,手术干预对 PTOA 的发展几乎没有影响。关于半月板和前交叉韧带(ACL)撕裂如何导致软骨退化的生物学基础知之甚少。本文综述了最新的研究结果,这些结果涉及影响膝关节对半月板和韧带损伤反应的生物学因素、半月板和/或 ACL 撕裂如何使关节朝着 PTOA 的方向发展,以及半月板/ACL 损伤后患者是否存在 PTOA 风险。
文献表明,许多内在和外在因素与 PTOA 相关的膝关节对损伤的生物学反应有关。基因/蛋白质生物标志物提供了对膝关节对半月板/ACL 撕裂的生物学反应的深入了解,以及与高危患者骨关节炎的关系。动物研究详细描述了疾病发病机制的时间过程,并提供了可能改变疾病进程的分子信息。
损伤后半月板/ACL 的分子代谢状态与多种生物学因素有关。目前有限的研究提供了损伤早期分子表现的初步证据,为进一步研究提供了可能的机制。