Tollefson Luke V, Kennedy Mitchell I, Tagliero Adam J, Malinowski Konrad, Chahla Jorge, Moatshe Gilbert, Kennedy Nicholas I, LaPrade Robert F, DePhillipo Nicholas N
Twin Cities Orthopedics, Edina, MN, USA.
Elson S. Floyd College of Medicine, Spokane, WA, USA.
Ann Jt. 2024 Jan 15;9:6. doi: 10.21037/aoj-23-56. eCollection 2024.
Knee surgery attempts to restore the native biomechanics of the knee, improve stability, and decrease the progression of osteoarthritis (OA). However, despite improvements in surgical techniques, tissue degradation and OA are common after knee surgery, occurring in higher rates in surgical knees compared to non-surgical knees. The aim of this study is to analyze previous literature to determine which synovial fluid biomarkers contribute to knee tissue degradation and decrease patient outcomes in the post-surgical setting of the knee.
A narrative review of relevant literature was performed in July 2023. Studies reporting on synovial biomarkers associated with the post-surgical knee were included.
The literature reported that proinflammatory synovial biomarkers cause cartilage degradation and turnover which eventually leads to OA. The associated biomarkers are typically present prior to physical symptoms so understanding which one's correlate to OA is important for potential therapeutic treatments in the future. Studying the preoperative, early postoperative, and late postoperative synovial biomarkers will allow physicians to develop an improved understanding of how these biomarkers progress and correlate to knee tissue degradation and OA. This understanding could lead to further developments into potential treatment options. Research into inhibiting or reversing these inflammatory biomarkers to slow the progression of knee tissue degradation has already begun and has reported some promising results but is currently limited in scope.
Synovial fluid biomarkers in the post-surgical knee setting may contribute to decreased patient outcomes and the progression of knee tissue degradation. There is no current consensus on which of these biomarkers are the most detrimental or associated with decreased patient outcomes. With an improved understanding of the individual biomarkers, potential personalized therapeutic treatment could be used by physicians in the future to improve patient outcomes after surgery.
膝关节手术旨在恢复膝关节的自然生物力学，提高稳定性，并减缓骨关节炎（OA）的进展。然而，尽管手术技术有所改进，但膝关节手术后组织退化和OA仍很常见，手术膝关节的发生率高于非手术膝关节。本研究的目的是分析既往文献，以确定哪些滑液生物标志物会导致膝关节组织退化，并降低膝关节手术后患者的预后。
2023年7月对相关文献进行了叙述性综述。纳入了报告与膝关节手术后相关的滑液生物标志物的研究。
文献报道促炎性滑液生物标志物会导致软骨降解和更新，最终导致OA。相关生物标志物通常在出现身体症状之前就已存在，因此了解哪些与OA相关对于未来的潜在治疗很重要。研究术前、术后早期和晚期的滑液生物标志物将使医生更好地了解这些生物标志物如何进展以及与膝关节组织退化和OA的相关性。这种理解可能会带来潜在治疗选择的进一步发展。抑制或逆转这些炎症生物标志物以减缓膝关节组织退化进展的研究已经开始，并报告了一些有前景的结果，但目前范围有限。
膝关节手术后的滑液生物标志物可能会导致患者预后下降和膝关节组织退化的进展。目前对于哪些生物标志物最具危害性或与患者预后下降相关尚无共识。随着对个体生物标志物的进一步了解，医生未来可能会使用潜在的个性化治疗方法来改善患者术后的预后。
