In 38 traumatic knee joint effusions the
proteolytic enzyme PMN-elastase (PMN-E) and the repair marker
procollagen III aminoterminal
peptide (
PIIINP) were determined. According to the period between
trauma and first aspiration of the effusion, the patients were divided into 3 groups. Group I (17 patients; period between
trauma and first aspiration not longer than 72 hours) showed high concentrations of PMN-E (up to 5400 ng/ml) and low concentrations of
PIIINP (less than 13 U/ml). Group II (11 patients; aspiration within 4 to 14 days) had mean PMN-E and
PIIINP concentrations of 125.6 ng/ml and 52.1 U/ml, respectively. In group III (10 patients, aspiration after 14 days) mean PMN-E concentration was 123.8 ng/ml and mean
PIIINP concentration was 63.4 U/ml. Graphic depiction of PMN-E and
PIIINP levels in each individual sample as a function of time between
trauma and fluid collection revealed highly increasing PMN-E levels during the first 24 posttraumatic hours, followed by rapidly decreasing levels within 72 hours post
trauma, and no change after the 4th posttraumatic day. In contrast,
PIIINP increased continuously up to the first posttraumatic week and stayed at high levels up to 90 days (end of the observation period). The differential patterns of PMN-E and
PIIINP concentration in knee joint effusions may be useful in estimating the period between
trauma and first treatment (aspiration of effusion) and should, therefore, be helpful in detecting degenerative lesions, which seem to be characterized by low PMN-E concomitantly with high
PIIINP levels.