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Published in: Knee Surgery, Sports Traumatology, Arthroscopy 10/2023

Open Access 14-07-2023 | Osteoarthrosis | KNEE

Better post-operative outcomes at 1-year follow-up are associated with lower levels of pre-operative synovitis and higher levels of IL-6 and VEGFA in unicompartmental knee arthroplasty patients

Authors: Mei Lin Tay, Scott M. Bolam, A. Paul Monk, Sue R. McGlashan, Simon W. Young, Brya G. Matthews

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 10/2023

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Abstract

Purpose

Osteoarthritis (OA) is associated with inflammation, and residual inflammation may influence outcomes following knee arthroplasty. This may be more relevant for patients undergoing unicompartmental knee arthroplasty (UKA) due to larger remaining areas of native tissue. This study aimed to: (1) characterise inflammatory profiles for medial UKA patients and (2) investigate whether inflammation markers are associated with post-operative outcomes.

Methods

This prospective, observational study has national ethics approval. Bloods, synovial fluid, tibial plateaus and synovium were collected from medial UKA patients in between 1 January 2021 and 31 December 2021. Cytokine and chemokine concentrations in serum and synovial fluid (SF) were measured with multiplexed assays. Disease severity of cartilage and synovium was assessed using validated histological scores. Post-operative outcomes were measured with Oxford Knee Score (OKS), Forgotten Joint Score (FJS-12) and pain scores.

Results

The study included 35 patients. SF VEGFA was negatively correlated with pre-operative pain at rest (r − 0.5, p = 0.007), and FJS-12 at six-week (r 0.44, p = 0.02), six-month (r 0.61, p < 0.01) and one-year follow-up (r 0.63, p = 0.03). Serum and SF IL-6 were positively correlated with OKS at early follow-up (serum 6 weeks, r 0.39, p = 0.03; 6 months, r 0.48, p < 0.01; SF 6 weeks, r 0.35, p = 0.04). At six weeks, increased synovitis was negatively correlated with improvements in pain at rest (r − 0.41, p = 0.03) and with mobilisation (r − 0.37, p = 0.047).

Conclusion

Lower levels of synovitis and higher levels of IL-6 and VEGFA were associated with better post-operative outcomes after UKA, which could be helpful for identifying UKA patients in clinical practice.

Level of evidence

Level IV case series.
Appendix
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Metadata
Title
Better post-operative outcomes at 1-year follow-up are associated with lower levels of pre-operative synovitis and higher levels of IL-6 and VEGFA in unicompartmental knee arthroplasty patients
Authors
Mei Lin Tay
Scott M. Bolam
A. Paul Monk
Sue R. McGlashan
Simon W. Young
Brya G. Matthews
Publication date
14-07-2023
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 10/2023
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-023-07503-y

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