Biomarkers after ACL surgery may signal severity of osteoarthritis later in life

A majority of Anterior Cruciate Ligament (ACL) reconstruction patients develop a condition known as post-traumatic osteoarthritis (PTOA) within 15 years of surgery, which can be debilitating and limit activity.

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Lisa Weisenberger, American Orthopaedic Society for Sports Medicine, AOSSM March 18, 2017

Researchers presenting their work at the American Orthopaedic Society for Sports Medicine’s (AOSSM) Specialty Day in San Diego are highlighting how a set of biomarkers on the day of surgery may explain why some individuals have worse PTOA than others after two years.

“Previous studies demonstrated how ACL injury triggers a biochemical process that worsens after the first 4-6 weeks of injury. Our research notes that higher levels of collagen breakdown at the time of surgery, may correlate to worse outcomes at two years,” said lead author of the study, Christian Lattermann MD of the University of Kentucky.

Lattermann and his colleagues studied 18 patients (9 females and 9 males ranging in age from 14 – 32 years) with an ACL injury. These individuals were previously enrolled in a prospective randomized trial evaluating early anti-inflammatory treatment after ACL injury. As part of the initial trial, synovial, serum, and urinary biomarkers of chondro-degeneration and inflammation were collected on the day of the surgery. The researchers utilized a variety of outcomes measures, including the KOOS-QOL scores to analyze results.

Figure 1: MR images (sagittal view) of the ACL originate (big arrow) and terminate (small arrow). The big arrow indicates the ligament directed originate from the epiphyseal plate, and the small arrow indicates the ligament terminated the bone which it attachment. The Original Compared with Terminal in Anterior or Posterior Cruciate Ligament Tear, Denglu Yan, Yancheng Song, Zhaojie Wang, and Zhi Zhang. Int J Sports Exerc Med 2015, 1:4 ISSN: 2469-5718. DOI: 10.23937/2469-5718/1510023

“Our data strongly suggests that initial biochemical changes after injury may have powerful consequences that cannot be mitigated by surgical stabilization alone,” notes Lattermann. “These results also create an opportunity to learn more about how early interventions with anti-inflammatory medications, may help lessen osteoarthritis risks in ACL patients, especially those patients with high levels of a particular biomarker.”

Source American Orthopaedic Society for Sports Medicine, AOSSM
Via EurekAlert! American Association for the Advancement of Science AAAS

The American Orthopaedic Society for Sports Medicine (AOSSM) is a world leader in sports medicine education, research, communication and fellowship, and includes national and international orthopaedic sports medicine leaders. The Society works closely with many other sports medicine specialists, including athletic trainers, physical therapists, family physicians, and others to improve the identification, prevention, treatment, and rehabilitation of sports injuries. AOSSM is also a founding partner of the STOP Sports Injuries campaign to prevent overuse and traumatic injuries in kids.

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