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前交叉韧带损伤后滑液中基质金属蛋白酶-3 和白细胞介素-6 的浓度与重建后 6 个月的步态生物力学相关。

Synovial fluid concentrations of matrix Metalloproteinase-3 and Interluekin-6 following anterior cruciate ligament injury associate with gait biomechanics 6 months following reconstruction.

机构信息

MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 27599, USA.

出版信息

Osteoarthritis Cartilage. 2021 Jul;29(7):1006-1019. doi: 10.1016/j.joca.2021.03.014. Epub 2021 Mar 27.

Abstract

OBJECTIVE

To compare gait biomechanics 6 months following anterior cruciate ligament (ACL) reconstruction (ACLR) between patients with the highest and lowest concentrations of synovial fluid (SF) interleukin-6 (IL-6) and matrix metalloproteinase-3 (MMP-3), as well as compared to uninjured controls.

DESIGN

SF concentrations of IL-6 and MMP-3 were collected 7 ± 4 days post injury in 38 ACL injured patients (55% female, 21±4yrs, 25.3 ± 5.2BMI). ACL injured individuals were stratified into the lowest and highest quartiles based on IL-6 (IL-6 and IL-6) and MMP-3 (MMP-3 and MMP-3) concentrations. Gait biomechanics were collected on the injured limb 6 months post-ACLR and in 38 uninjured controls (50% female, 21±3yrs, 23.8 ± 2.8BMI). Functional analyses of variance were used to compare vertical ground reaction force (vGRF), knee flexion angle (KFA), and internal knee extension moment (KEM) waveforms throughout stance phase of gait to determine the proportions of stance differing between limbs and groups.

RESULTS

Compared to uninjured controls, IL-6 and MMP-3 ACL subgroups demonstrated lesser vGRF (largest differences: IL-6, 7.88%BW; MMP-3, 11.05%BW) during early-stance and greater vGRF (largest differences: IL-6, 6.21%BW; MMP-3, 5.85%BW) in mid-stance, lesser KFA (largest differences: IL-6, 3.11°; MMP-3, 3.72°) and lesser KEM (largest differences: IL-6, 0.96%BW•m; MMP-3, 1.07%BW•m) in early-stance, as well as greater KFA in mid-stance (largest differences: IL-6, 1.5°; MMP-3, 2.95°).

CONCLUSIONS

High SF concentrations of a proinflammatory cytokine and a degradative enzyme early post-ACL injury are associated with aberrant gait biomechanics in the injured limb at 6 months post-ACLR (i.e., lesser vGRF, KFA and KEM) linked to posttraumatic osteoarthritis development.

摘要

目的

比较前交叉韧带(ACL)重建(ACLR)后 6 个月时滑液(SF)中白细胞介素 6(IL-6)和基质金属蛋白酶 3(MMP-3)浓度最高和最低的患者的步态生物力学,以及与未受伤的对照组相比。

设计

在 38 名 ACL 受伤患者(55%为女性,21±4 岁,25.3±5.2 BMI)受伤后 7±4 天采集 SF 中 IL-6 和 MMP-3 的浓度。根据 IL-6(IL-6 和 IL-6)和 MMP-3(MMP-3 和 MMP-3)浓度,将 ACL 受伤个体分为最低和最高四分位。在 ACLR 后 6 个月和 38 名未受伤的对照组(50%为女性,21±3 岁,23.8±2.8 BMI)采集受伤肢体的步态生物力学。使用功能方差分析比较步态站立相期间的垂直地面反作用力(vGRF)、膝关节屈曲角度(KFA)和膝关节内伸肌力矩(KEM)波形,以确定肢体和组之间站立相的差异比例。

结果

与未受伤的对照组相比,IL-6 和 MMP-3 ACL 亚组在早期站立时 vGRF 较小(最大差异:IL-6,7.88%BW;MMP-3,11.05%BW),在中期站立时 vGRF 较大(最大差异:IL-6,6.21%BW;MMP-3,5.85%BW),早期站立时 KFA 较小(最大差异:IL-6,3.11°;MMP-3,3.72°)和 KEM 较小(最大差异:IL-6,0.96%BW•m;MMP-3,1.07%BW•m),以及中期站立时 KFA 较大(最大差异:IL-6,1.5°;MMP-3,2.95°)。

结论

ACL 损伤后早期 SF 中促炎细胞因子和降解酶的高浓度与 ACLR 后 6 个月受伤肢体的异常步态生物力学有关(即 vGRF、KFA 和 KEM 较小),与创伤后骨关节炎的发展有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b613/8658576/b10860177b78/nihms-1694717-f0001.jpg

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