目的:探讨血清生物标志物[软骨寡聚基质蛋白(COMP)和基质金属蛋白酶-3(MMP-3)]水平与临床,磁共振成像(MRI),和关节镜下发现的前交叉韧带(ACL)不足的膝盖,在X光片上没有骨关节炎的变化。
方法:纳入Kellgren-Lawrence0级或1级ACL损伤患者。术前测定血清COMP和MMP-3水平。血清生物标志物水平与年龄的相关性,体重指数(BMI),从受伤时间开始的持续时间,Tegner活动度量表(TAS)评分,Lysholm膝盖得分,国际膝关节文献委员会得分,KT-1000关节测量仪测量,全器官MRI评分(WORMS),MRIT2弛豫时间,通过计算Spearman相关系数来评估国际软骨研究协会(ICRS)和关节镜等级。术中发现之间的关联(软骨,半月板)和血清生物标志物水平使用Mann-WhitneyU检验确定。进行多元回归分析以研究血清生物标志物水平与MRI和关节镜检查结果之间的相关性。
结果:纳入98例患者,平均年龄23.7岁。较高的血清COMP水平与年龄和较高的BMI相关。TAS评分,血清MMP-3水平,WORMS,和T2弛豫时间(股骨内侧,胫骨内侧)。多因素分析显示血清COMP水平与WORMS、ICRS分级独立相关。
结论:血清COMP水平与年龄相关,BMI,TAS评分,和MMP-3水平在ACL缺陷型膝关节中,与WORMS和ICRS分级独立相关。因此,血清COMP水平可以帮助检测软骨退变,即使在没有影像学改变的患者中也是如此。关键点•血清COMP与ACL缺陷性膝关节的WORM和ICRS等级相关。•血清COMP水平有助于检测软骨退变,即使在没有影像学改变的骨关节炎患者中。
OBJECTIVE: To investigate the association between serum biomarker [cartilage oligomeric matrix protein (COMP) and matrix metalloproteinase-3 (MMP-3)] levels and clinical, magnetic resonance imaging (MRI), and arthroscopic findings in anterior cruciate ligament (ACL)-deficient knees without osteoarthritic changes on radiographs.
METHODS: Patients with ACL injury of Kellgren-Lawrence grade 0 or 1 were enrolled. Serum COMP and MMP-3 levels were measured preoperatively. Correlations of serum biomarker levels with age, body mass index (BMI), duration from time of injury, Tegner activity scale (TAS) score, Lysholm knee score, International Knee Documentation Committee score, KT-1000 arthrometer measurements, whole-organ MRI score (WORMS), MRI T2 relaxation time, and arthroscopic International Cartilage Research Society (ICRS) grade were assessed by calculating Spearman correlation coefficients. Associations between intraoperative findings (cartilage, meniscus) and serum biomarker levels were determined using the Mann-Whitney U test. Multiple regression analysis was performed to investigate the correlations between serum biomarker levels and MRI and arthroscopic findings.
RESULTS: Ninety-eight patients with a mean age of 23.7 years were enrolled. Higher serum COMP level was correlated with older age and higher BMI, TAS score, serum MMP-3 level, WORMS, and T2 relaxation times (medial femur, medial tibia). Multivariate analysis showed that the serum COMP level was independently associated with WORMS and ICRS grade.
CONCLUSIONS: The serum COMP level was correlated with age, BMI, TAS score, and MMP-3 level in ACL-deficient knees and was independently correlated with WORMS and ICRS grade. Thus, the serum COMP level can help detect cartilage degeneration even in patients without radiographic osteoarthritic changes. Key Points • Serum COMP correlated with WORMS and ICRS grade in ACL deficient knee. • The serum COMP level could help in detecting cartilage degeneration, even in patients with no radiographic osteoarthritic changes.