Kluzek Stefan, O'Sullivan Oliver
Centre for Sport, Exercise and Osteoarthritis Research, Versus Arthritis, Nottingham, England, UK.
Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, England, UK.
F1000Res. 2025 Jan 13;14:68. doi: 10.12688/f1000research.159920.1. eCollection 2025.
Biomarkers are essential tools in modern medicine, allowing stratification and monitoring of clinical care and treatment response. While systemic blood biomarkers, typically collected from the antecubital vein (AV), are widely used, their sensitivity for joint-specific pathologies such as osteoarthritis (OA) may be limited due to systemic dilution. At present, no serum biomarker reliably reflects the microenvironment of an affected joint in clinical practice. Although synovial fluid (SF) assessment can provide insights into localised pathology and are clinically used for diagnosis in crystal arthropathies and joint infections, their collection is invasive, painful, and carries risks, including infection, making repeated sampling impractical, limiting utility for monitoring treatment responses. This study introduces a novel ultrasound-guided venous sampling technique targeting the saphenous vein (SV) proximal to the knee joint as a less invasive alternative to SF aspiration, hypothesising that it may better reflect the joint-specific microenvironment.
A standardised gel model was used to train medically qualified researchers in ultrasound-guided venepuncture of vescles around 2-15 mm in diameter. Subsequently, 32 participants consented to blood sampling from the SV above the knee, with a proximally applied tourniquet to dilate vein diameter for easier venepuncture collection.
The technique achieved serum collection in over 80% of consented individuals with minimal adverse effects (including n=2 minor bruising and n=1 transient nerve irritation). Key procedural insights included optimal site selection, appropriate pressure application, and effective tourniquet use.
This method demonstrates feasibility, acceptability, and the potential for more localised sample collection, advancing biomarker research. Further validation, including paired SF comparisons, is required to confirm diagnostic utility and develop therapeutic strategies for joint-specific conditions.
生物标志物是现代医学的重要工具，可用于临床护理分层及治疗反应监测。虽然通常从前臂肘正中静脉（AV）采集的全身血液生物标志物被广泛应用，但由于全身稀释，它们对骨关节炎（OA）等关节特异性病变的敏感性可能有限。目前，在临床实践中，尚无血清生物标志物能可靠反映受影响关节的微环境。尽管滑膜液（SF）评估可为局部病变提供见解，且临床上用于晶体性关节炎和关节感染的诊断，但其采集具有侵入性、会引起疼痛且存在风险，包括感染，这使得重复采样不切实际，限制了其在监测治疗反应方面的应用。本研究引入了一种新型超声引导静脉采样技术，以膝关节近端的大隐静脉（SV）为目标，作为一种侵入性较小的SF抽吸替代方法，推测它可能能更好地反映关节特异性微环境。
使用标准化凝胶模型对具备医学资质的研究人员进行超声引导下直径2 - 15毫米水疱静脉穿刺培训。随后，32名参与者同意从膝关节上方的SV采集血液，近端应用止血带以扩张静脉直径便于静脉穿刺采集。
该技术在超过80%的同意参与者中成功采集到血清，不良反应极小（包括2例轻微瘀伤和1例短暂神经刺激）。关键操作要点包括最佳部位选择、适当压力施加和有效止血带使用。
该方法证明了可行性、可接受性以及更局部化样本采集的潜力，推动了生物标志物研究。需要进一步验证，包括配对SF比较，以确认诊断效用并制定针对关节特异性病症的治疗策略。
