Inflammatory cytokine levels in synovial fluid 3, 4 days postoperatively and its correlation with early-phase functional recovery after anterior cruciate ligament reconstruction: a cohort study

Abstract

BackgroundSynovial fluid was collected prior to and at 3 to 4 days after ACL reconstruction to investigate the correlation between inflammatory cytokine levels in the acute phase after surgery and physical functional recovery at 3 months postoperatively.Methods For this purpose, 79 patients with ACL reconstruction using semitendinosus tendons were included in the study. Median days from injury to surgery were 80 days (13–291 days). Synovial fluid was obtained just before surgery and at 3 to 4 days after surgery. Physical activity of each patient was evaluated at 3 months postoperatively, and scored from 0 (hard to walk) to 5 (run). Patients able to jog (score 4) or run (score 5) were considered as the “quick recovery” group and others (scores 1–3) as the “delayed recovery” group.ResultsPhysical activity recovery scores in the early surgery group (preoperative period less than 60 days; Group I) were significantly better than those in the delayed surgery group (Group II). Among the cytokines tested, TNF-alpha and IL10 levels in synovial fluid were significantly higher in Group II at 3 to 4 days postoperatively, while levels of these cytokines were quite comparable preoperatively between the groups. Increased IL1-beta expression was noted in the delayed recovery group at 3 to 4 days postoperatively. In addition, levels of IL6, IL10 and IFN-gamma also tended to increase in patients with delayed recovery.ConclusionDelayed ACL reconstruction increases levels of inflammatory cytokines in synovial fluid after surgery and correlates with a prolonged recovery of short-period physical activity of the patients.

Bio-orthogonal Click Chemistry Methods to Evaluate the Metabolism of Inflammatory Challenged Cartilage after Traumatic Overloading

“…While the acute inflammation phase could be as short as a few days in young animals, 47,48 it can last for weeks in the human knee joint and then be sustained at a lower level for months to years after the initial injury. 4,37 In addition, the longitudinal GAG and collagen loss measured in this study represent the loss of the newly synthesized proteins labeled by click chemistry. Although the data showed the turnover of a subpopulation of total GAG or collagen in the tissue, it enabled the comparisons between different groups and yielded insights into how cytokines and injurious mechanical stresses affect cartilage degradation.…”

Impediments to Meniscal Repair: Factors at Play Beyond Vascularity

“…Since both inflammation post-injury and the reparative process occur on the order of weeks to months, these prolonging attributes are especially helpful. Delaying meniscal repair procedures after injury, similar to what is done with anterior cruciate ligament reconstruction ( Inoue et al, 2016 ), may help to delay repair until inflammation has subsided, improving the integrative nature, and thus long-term stability, of the repair.…”

Tackling the Challenges of Graft Healing After Anterior Cruciate Ligament Reconstruction—Thinking From the Endpoint

“…A significant negative correlation between the expressions of inflammatory cytokines and knee laxity function score was observed in the patient. The level of IL-1β in the synovial fluid at 3–4 days post-surgery predicted poor functional recovery at 3 months after ACLR ( Inoue et al, 2016 ). In another clinical trial, all patients with tibial tunnel enlargement had elevated synovial levels of TNF-α, IL-6, and NO at 7 days post-operation ( Zysk et al, 2004 ).…”