Abstract | BACKGROUND: METHODS: Twenty-one patients with an intra-articular ankle fracture were included in this study. All patients had a contralateral ankle joint that was pain free, had no radiographic evidence of arthritis, and no history of trauma. The uninjured ankle served as a matched control. SF was obtained from bilateral ankles at the time of surgery which occurred at a mean of 17 days post-fracture (range 8-40). The SF was analyzed for granulocyte macrophage colony-stimulating factor ( GM-CSF), interferon-gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), interleukin (IL)-1β, IL-2, IL-6, IL-8, IL-10, IL-12p70, MMP-1, MMP-2, MMP-3, MMP-9, MMP-10, CTXII, sGAG, and bilirubin/ biliverdin (markers of hemearthrosis) using either multiplex assay or ELISA using commercially available kits. Mean concentrations of each factor were compared between SF from fractured and control ankles, and correlation analysis was done to determine potential relationships between levels of cytokines and time from fracture and age at fracture. RESULTS: Twelve of 18 measured factors including GM-CSF, IL-10, IL-1β, IL-6, IL-8, TNF-α, MMP-1, MMP-2, MMP-3, MMP-9, MMP-10, and bilirubin/ biliverdin were found to be significantly higher in the fractured ankles. Mean concentrations of ECM degradation markers (sGAG and CTXII) were not found to be significatnly different between groups. CONCLUSION: These data indicate that after intra-articular ankle fracture the SF exhibits a largely pro-inflammatory and extra-cellular matrix degrading environment similar to that described in idiopathic osteoarthritis. IL-6, IL-8, MMP-1, MMP-2, MMP-3, MMP-9, and MMP-10 were significantly elevated and may play a role in the development of PTOA. CLINICAL RELEVANCE: In addition to anatomic fracture reduction, these data lend credence to reducing acute intra-articular inflammation through the development of antagonists to these pro-inflammatory and degrading mediators. Likewise, intra-articular lavage might reduce this inflammatory burden.
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Authors | Samuel B Adams, Lori A Setton, Richard D Bell, Mark E Easley, Janet L Huebner, Thomas Stabler, Virginia B Kraus, Elizabeth M Leimer, Steven A Olson, Dana L Nettles |
Journal | Foot & ankle international
(Foot Ankle Int)
Vol. 36
Issue 11
Pg. 1264-71
(Nov 2015)
ISSN: 1944-7876 [Electronic] United States |
PMID | 26449389
(Publication Type: Journal Article, Research Support, N.I.H., Extramural)
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Copyright | © The Author(s) 2015. |
Chemical References |
- Cytokines
- Inflammation Mediators
- Matrix Metalloproteinases
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Topics |
- Adult
- Ankle Injuries
(metabolism, surgery)
- Cytokines
(metabolism)
- Extracellular Matrix
(metabolism)
- Female
- Humans
- Inflammation Mediators
(metabolism)
- Intra-Articular Fractures
(metabolism, surgery)
- Male
- Matrix Metalloproteinases
(metabolism)
- Middle Aged
- Osteoarthritis
(metabolism)
- Synovial Fluid
(chemistry)
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