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Published in: Rheumatology International 1/2013

01-01-2013 | Original Article

Changes in synovial fluid biochemical markers following arthroscopic surgery in patients with knee osteoarthritis

Authors: Arata Nakajima, Koichi Nakagawa, Yasuchika Aoki, Masato Sonobe, Yoshifumi Shibata, Masashi Yamazaki, Masazumi Murakami

Published in: Rheumatology International | Issue 1/2013

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Abstract

Although arthroscopic surgery (AS) for knee osteoarthritis has been widely employed, scientific evidence is lacking. The purpose of this study was to investigate temporal changes in synovial fluid levels of biochemical markers associated with cartilage metabolism following AS. Twenty-five knees of 24 patients with medial knee osteoarthritis (mean age 70.5 years) were included in this study. Synovial fluids were sampled immediately before surgery and 2, 4, 8, and 12 weeks after AS. Levels of the biochemical markers chondroitin 6-sulfate (C6S), chondroitin 4-sulfate (C4S), and keratan sulfate (KS) were measured and correlations among the biochemical markers were analyzed before and after surgery. C6S, C4S, and total CS levels were the same before and after surgery; however, the KS level decreased significantly at 2 weeks after AS. A strong, positive correlation was detected between C6S and KS levels at 12 weeks, differing from the weaker correlation seen before surgery. Seven of the patients required total or unicompartmental knee arthroplasties in the 2 years following AS. In this study, the significant reduction in KS levels and the strong correlation between C6S and KS levels were shown, which indicates suppressed cartilage turnover after AS. Exploring predictive factors indicating favorable or unfavorable outcomes from AS will be important future studies.
Literature
1.
go back to reference Poole AR, Kojima T, Yasuda T, Mwale F, Kobayashi M, Laverty S (2001) Composition and structure of articular cartilage: a template for tissue repair. Clin Orthop Relat Res 391(Suppl):S26–S33PubMedCrossRef Poole AR, Kojima T, Yasuda T, Mwale F, Kobayashi M, Laverty S (2001) Composition and structure of articular cartilage: a template for tissue repair. Clin Orthop Relat Res 391(Suppl):S26–S33PubMedCrossRef
2.
go back to reference Poole AR, Ionescu M, Swan A, Dieppe PA (1994) Changes in cartilage metabolism in arthritis are reflected by altered serum and synovial fluid levels of the cartilage proteoglycan aggrecan. Implications for pathogenesis. J Clin Invest 94:25–33PubMedCrossRef Poole AR, Ionescu M, Swan A, Dieppe PA (1994) Changes in cartilage metabolism in arthritis are reflected by altered serum and synovial fluid levels of the cartilage proteoglycan aggrecan. Implications for pathogenesis. J Clin Invest 94:25–33PubMedCrossRef
3.
go back to reference Petersson IF, Sandqvist L, Svensson B, Saxne T (1997) Cartilage markers in synovial fluid in symptomatic knee osteoarthritis. Ann Rheum Dis 56:64–67PubMedCrossRef Petersson IF, Sandqvist L, Svensson B, Saxne T (1997) Cartilage markers in synovial fluid in symptomatic knee osteoarthritis. Ann Rheum Dis 56:64–67PubMedCrossRef
4.
go back to reference Mourao PA (1988) Distribution of chondroitin 4-sulfate and chondroitin 6-sulfate in human articular and growth cartilage. Arthritis Rheum 31:1028–1033PubMedCrossRef Mourao PA (1988) Distribution of chondroitin 4-sulfate and chondroitin 6-sulfate in human articular and growth cartilage. Arthritis Rheum 31:1028–1033PubMedCrossRef
5.
go back to reference Yamada H, Miyauchi S, Hotta H, Morita M, Yoshihara Y, Kikuchi T et al (1999) Levels of chondroitin sulfate isomers in synovial fluid of patients with hip osteoarthritis. J Orthop Sci 4:250–254PubMedCrossRef Yamada H, Miyauchi S, Hotta H, Morita M, Yoshihara Y, Kikuchi T et al (1999) Levels of chondroitin sulfate isomers in synovial fluid of patients with hip osteoarthritis. J Orthop Sci 4:250–254PubMedCrossRef
6.
go back to reference Thonar EJ, Lenz ME, Klintworth GK, Caterson B, Pachman LM, Glickman P et al (1985) Quantification of keratan sulfate in blood as a marker of cartilage metabolism. Arthritis Rheum 28:1367–1376PubMedCrossRef Thonar EJ, Lenz ME, Klintworth GK, Caterson B, Pachman LM, Glickman P et al (1985) Quantification of keratan sulfate in blood as a marker of cartilage metabolism. Arthritis Rheum 28:1367–1376PubMedCrossRef
7.
go back to reference Momohara S, Okada N, Ikari K, Mizuno S, Okamoto H (2007) Dermatan sulfate in the synovial fluid of patients with knee osteoarthritis. Mod Rheumatol 17:301–305PubMedCrossRef Momohara S, Okada N, Ikari K, Mizuno S, Okamoto H (2007) Dermatan sulfate in the synovial fluid of patients with knee osteoarthritis. Mod Rheumatol 17:301–305PubMedCrossRef
8.
go back to reference Manicourt DH, Poilvache P, Nzeusseu A, van Egeren A, Devogelaer JP, Lenz ME et al (1999) Serum levels of hyaluronan, antigenic keratan sulfate, matrix metalloproteinase 3, and tissue inhibitor of metalloproteinases 1 change predictably in rheumatoid arthritis patients who have begun activity after a night of bed rest. Arthritis Rheum 42:1861–1869PubMedCrossRef Manicourt DH, Poilvache P, Nzeusseu A, van Egeren A, Devogelaer JP, Lenz ME et al (1999) Serum levels of hyaluronan, antigenic keratan sulfate, matrix metalloproteinase 3, and tissue inhibitor of metalloproteinases 1 change predictably in rheumatoid arthritis patients who have begun activity after a night of bed rest. Arthritis Rheum 42:1861–1869PubMedCrossRef
9.
go back to reference Lohmander LS (1991) Markers of cartilage metabolism in arthrosis. A review. Acta Orthop Scand 62:623–632PubMedCrossRef Lohmander LS (1991) Markers of cartilage metabolism in arthrosis. A review. Acta Orthop Scand 62:623–632PubMedCrossRef
10.
go back to reference Nakayama Y, Narita T, Mori A, Uesaka S, Miyazaki K, Ito H (2002) The effects of age and sex on chondroitin sulfates in normal synovial fluid. Arthritis Rheum 46:2105–2108PubMedCrossRef Nakayama Y, Narita T, Mori A, Uesaka S, Miyazaki K, Ito H (2002) The effects of age and sex on chondroitin sulfates in normal synovial fluid. Arthritis Rheum 46:2105–2108PubMedCrossRef
11.
go back to reference Felson DT, Buckwalter J (2002) Debridement and lavage for osteoarthritis of the knee. N Engl J Med 347:132–133PubMedCrossRef Felson DT, Buckwalter J (2002) Debridement and lavage for osteoarthritis of the knee. N Engl J Med 347:132–133PubMedCrossRef
12.
go back to reference Moseley JB, O’Malley K, Petersen NJ, Menke TJ, Brody BA, Kuykendall DH et al (2002) A controlled trial of arthroscopic surgery for osteoarthritis of the knee. N Engl J Med 347:81–88PubMedCrossRef Moseley JB, O’Malley K, Petersen NJ, Menke TJ, Brody BA, Kuykendall DH et al (2002) A controlled trial of arthroscopic surgery for osteoarthritis of the knee. N Engl J Med 347:81–88PubMedCrossRef
13.
go back to reference Kirkley A, Birmingham TB, Litchfield RB, Giffin JR, Willits KR, Wong CJ et al (2008) A randomized trial of arthroscopic surgery for osteoarthritis of the knee. N Engl J Med 359:1097–1107PubMedCrossRef Kirkley A, Birmingham TB, Litchfield RB, Giffin JR, Willits KR, Wong CJ et al (2008) A randomized trial of arthroscopic surgery for osteoarthritis of the knee. N Engl J Med 359:1097–1107PubMedCrossRef
14.
go back to reference Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K et al (1986) Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Arthritis Rheum 29:1039–1049PubMedCrossRef Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K et al (1986) Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Arthritis Rheum 29:1039–1049PubMedCrossRef
15.
go back to reference Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Reum Dis 16:494–502CrossRef Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Reum Dis 16:494–502CrossRef
16.
go back to reference Yoshida K, Miyauchi S, Kikuchi H, Tawada A, Tokuyasu K (1989) Analysis of unsaturated disaccharides from glycosaminoglycuronan by high-performance liquid chromatography. Anal Biochem 177:327–332PubMedCrossRef Yoshida K, Miyauchi S, Kikuchi H, Tawada A, Tokuyasu K (1989) Analysis of unsaturated disaccharides from glycosaminoglycuronan by high-performance liquid chromatography. Anal Biochem 177:327–332PubMedCrossRef
17.
go back to reference Shinmei M, Miyauchi S, Machida A, Miyazaki K (1992) Quantification of chondroitin 4-sulfate and chondroitin 6-sulfate in pathologic joint fluid. Arthritis Rheum 35:1304–1308PubMed Shinmei M, Miyauchi S, Machida A, Miyazaki K (1992) Quantification of chondroitin 4-sulfate and chondroitin 6-sulfate in pathologic joint fluid. Arthritis Rheum 35:1304–1308PubMed
18.
go back to reference Yamada H, Miyauchi S, Morita M, Yoshida Y, Yoshihara Y, Kikuchi T et al (2000) Content and sulfation pattern of keratan sulfate in hip osteoarthritis using high performance liquid chromatography. J Rheumatol 27:1721–1724PubMed Yamada H, Miyauchi S, Morita M, Yoshida Y, Yoshihara Y, Kikuchi T et al (2000) Content and sulfation pattern of keratan sulfate in hip osteoarthritis using high performance liquid chromatography. J Rheumatol 27:1721–1724PubMed
19.
go back to reference Kobayashi K, Matsuzaka S, Yoshida Y, Miyauchi S, Wada Y, Moriya H (2004) The effects of intra-articularly injected sodium hyaluronate on levels of intact aggrecan and nitric oxide in the joint fluid of patients with knee osteoarthritis. Osteoarthritis Cartilage 12:536–542PubMedCrossRef Kobayashi K, Matsuzaka S, Yoshida Y, Miyauchi S, Wada Y, Moriya H (2004) The effects of intra-articularly injected sodium hyaluronate on levels of intact aggrecan and nitric oxide in the joint fluid of patients with knee osteoarthritis. Osteoarthritis Cartilage 12:536–542PubMedCrossRef
20.
go back to reference Hasegawa M, Nakoshi Y, Tsujii M, Sudo A, Masuda H, Yoshida T et al (2008) Changes in biochemical markers and prediction of effectiveness of intra-articular hyaluronan in patients with knee osteoarthritis. Osteoarthritis Cartilage 16:526–529PubMedCrossRef Hasegawa M, Nakoshi Y, Tsujii M, Sudo A, Masuda H, Yoshida T et al (2008) Changes in biochemical markers and prediction of effectiveness of intra-articular hyaluronan in patients with knee osteoarthritis. Osteoarthritis Cartilage 16:526–529PubMedCrossRef
21.
go back to reference Sugimoto H, Yamada H, Terada N, Kanaji A, Kato S, Date H et al (2006) Intra-articular injection of high molecular weight hyaluronan for osteoarthritis of the knee-prediction of effectiveness with biological markers. J Rheumatol 33:2527–2531PubMed Sugimoto H, Yamada H, Terada N, Kanaji A, Kato S, Date H et al (2006) Intra-articular injection of high molecular weight hyaluronan for osteoarthritis of the knee-prediction of effectiveness with biological markers. J Rheumatol 33:2527–2531PubMed
22.
go back to reference Smith GN Jr, Myers SL, Brandt KD, Mickler EA (1998) Effect of intra-articular hyaluronan injection in experimental canine osteoarthritis. Arthritis Rheum 41:976–985PubMedCrossRef Smith GN Jr, Myers SL, Brandt KD, Mickler EA (1998) Effect of intra-articular hyaluronan injection in experimental canine osteoarthritis. Arthritis Rheum 41:976–985PubMedCrossRef
23.
go back to reference Uesaka S, Nakayama Y, Yoshihara K, Ito H (2002) Significance of chondroitin sulfate isomers in the synovial fluid of osteoarthritis patients. J Orthop Sci 7:232–237PubMedCrossRef Uesaka S, Nakayama Y, Yoshihara K, Ito H (2002) Significance of chondroitin sulfate isomers in the synovial fluid of osteoarthritis patients. J Orthop Sci 7:232–237PubMedCrossRef
24.
go back to reference Sharif M, Osborne DJ, Meadows K, Woodhouse SM, Colvin EM, Shepstone L et al (1996) The relevance of chondroitin and keratan sulfate markers in normal and arthritic synovial fluid. Br J Rheumatol 35:951–957PubMedCrossRef Sharif M, Osborne DJ, Meadows K, Woodhouse SM, Colvin EM, Shepstone L et al (1996) The relevance of chondroitin and keratan sulfate markers in normal and arthritic synovial fluid. Br J Rheumatol 35:951–957PubMedCrossRef
25.
go back to reference Campion GV, McCrae F, Schnitzer TJ, Lenz ME, Dieppe PA, Thonar EJ (1991) Levels of keratan sulfate in the serum and synovial fluid of patients with osteoarthritis of the knee. Arthritis Rheum 34:1254–1259PubMedCrossRef Campion GV, McCrae F, Schnitzer TJ, Lenz ME, Dieppe PA, Thonar EJ (1991) Levels of keratan sulfate in the serum and synovial fluid of patients with osteoarthritis of the knee. Arthritis Rheum 34:1254–1259PubMedCrossRef
26.
go back to reference Ishiguro N, Ito T, Ito H, Iwata H, Jugessur H, Ionescu M et al (1999) Relationship of matrix metalloproteinases and their inhibitors to cartilage proteoglycan and collagen turnover: analyses of synovial fluid from patients with osteoarthritis. Arthritis Rheum 42:129–136PubMedCrossRef Ishiguro N, Ito T, Ito H, Iwata H, Jugessur H, Ionescu M et al (1999) Relationship of matrix metalloproteinases and their inhibitors to cartilage proteoglycan and collagen turnover: analyses of synovial fluid from patients with osteoarthritis. Arthritis Rheum 42:129–136PubMedCrossRef
Metadata
Title
Changes in synovial fluid biochemical markers following arthroscopic surgery in patients with knee osteoarthritis
Authors
Arata Nakajima
Koichi Nakagawa
Yasuchika Aoki
Masato Sonobe
Yoshifumi Shibata
Masashi Yamazaki
Masazumi Murakami
Publication date
01-01-2013
Publisher
Springer-Verlag
Published in
Rheumatology International / Issue 1/2013
Print ISSN: 0172-8172
Electronic ISSN: 1437-160X
DOI
https://doi.org/10.1007/s00296-012-2374-8

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