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Select Biomarkers on the Day of Anterior Cruciate Ligament Reconstruction Predict Poor Patient-Reported Outcomes at 2-Year Follow-Up: A Pilot Study.

dc.contributor.author Kraus, Virginia
dc.contributor.author Reinke, Emily
dc.contributor.author Lattermann, Christian
dc.contributor.author Conley, Caitlin E-W
dc.contributor.author Johnson, Darren L
dc.contributor.author Huston, Laura J
dc.contributor.author Huebner, Janet L
dc.contributor.author Chou, Ching-Heng
dc.contributor.author Spindler, Kurt P
dc.contributor.author Jacobs, Cale A
dc.date.accessioned 2019-02-02T15:29:33Z
dc.date.available 2019-02-02T15:29:33Z
dc.date.issued 2018-01
dc.identifier.issn 2314-6141
dc.identifier.issn 2314-6141
dc.identifier.uri https://hdl.handle.net/10161/18045
dc.description.abstract Background:The majority of patients develop posttraumatic osteoarthritis within 15 years of anterior cruciate ligament (ACL) injury. Inflammatory and chondrodegenerative biomarkers have been associated with both pain and the progression of osteoarthritis; however, it remains unclear if preoperative biomarkers differ for patients with inferior postoperative outcomes. Hypothesis/Purpose:The purpose of this pilot study was to compare biomarkers collected on the day of ACL reconstruction between patients with "good" or "poor" 2-year postoperative outcomes. We hypothesized that inflammatory cytokines and chondrodegenerative biomarker concentrations would be significantly greater in patients with poorer outcomes. Study Design:Prospective cohort design. Methods:22 patients (9 females, 13 males; age = 19.5 ± 4.1 years; BMI = 24.1 ± 3.6 kg/m2) previously enrolled in a randomized trial evaluating early anti-inflammatory treatment after ACL injury. Biomarkers of chondrodegeneration and inflammation were assessed from synovial fluid (sf) samples collected on the day of ACL reconstruction. Participants completed Knee Injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentation Committee (IKDC) questionnaires two years following surgery. Patients were then categorized based on whether their KOOS Quality of Life (QOL) score surpassed the Patient Acceptable Symptom State (PASS) threshold of 62.5 points or the IKDC PASS threshold of 75.9 points. Results:Patients that failed to reach the QOL PASS threshold after surgery (n = 6, 27%) had significantly greater sf interleukin-1 alpha (IL-1α; p = 0.004), IL-1 receptor antagonist (IL-1ra; p = 0.03), and matrix metalloproteinase-9 (MMP-9; p = 0.01) concentrations on the day of surgery. Patients that failed to reach the IKDC PASS threshold (n = 9, 41%) had significantly greater sf IL-1α (p = 0.02). Conclusion:These pilot data suggest that initial biochemical changes after injury may be an indicator of poor outcomes that are not mitigated by surgical stabilization alone. Biological adjuvant treatment in addition to ACL reconstruction may be beneficial; however, these data should be used for hypothesis generation and more definitive randomized clinical trials are necessary.
dc.language eng
dc.publisher Hindawi Limited
dc.relation.ispartof BioMed research international
dc.relation.isversionof 10.1155/2018/9387809
dc.subject Humans
dc.subject Knee Injuries
dc.subject Prognosis
dc.subject Treatment Outcome
dc.subject Follow-Up Studies
dc.subject Prospective Studies
dc.subject Pilot Projects
dc.subject Quality of Life
dc.subject Adolescent
dc.subject Adult
dc.subject Female
dc.subject Male
dc.subject Young Adult
dc.subject Anterior Cruciate Ligament Reconstruction
dc.subject Biomarkers
dc.subject Anterior Cruciate Ligament Injuries
dc.subject Patient Reported Outcome Measures
dc.title Select Biomarkers on the Day of Anterior Cruciate Ligament Reconstruction Predict Poor Patient-Reported Outcomes at 2-Year Follow-Up: A Pilot Study.
dc.type Journal article
dc.date.updated 2019-02-02T15:29:32Z
pubs.begin-page 9387809
pubs.organisational-group School of Medicine
pubs.organisational-group Duke
pubs.organisational-group Duke Molecular Physiology Institute
pubs.organisational-group Institutes and Centers
pubs.organisational-group Orthopaedics
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Pathology
pubs.organisational-group Medicine, Rheumatology and Immunology
pubs.organisational-group Medicine
pubs.organisational-group Staff
pubs.publication-status Published
pubs.volume 2018
duke.contributor.orcid Reinke, Emily|0000-0001-7629-8067


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