title: Correlation of intra-articular ankle pathology with cytokine biomarkers and matrix degradation products.
abstract: BACKGROUND
  Articular cartilage degeneration is mediated by inflammatory cytokines and fragments of structural matrix proteins. Few studies have examined the role of these biomarkers in intra-articular pathology of the ankle.
  
  
  METHODS
  Four groups of patients with increasing ankle pathology were enrolled. Group 1 included controls with no pain who underwent unrelated forefoot surgery. Group 2 included patients undergoing arthroscopy with intraoperative mild chondrosis. Group 3 included patients undergoing arthroscopy with moderate/severe chondrosis, osteochondral lesions, impingement, or loose bodies. Group 4 included positive controls with severe arthrosis undergoing ankle arthrodesis/arthroplasty. Ankle fluid was obtained by intra-articular aspiration and was assayed for IL-6, IFN-γ, MCP, MIP-1β, and fibronectin-aggrecan complex (FAC), a matrix-degradation marker. There were 36 patients total, 21 males and 15 females with a mean age 45 (±16; range 18 to 76) years and a mean VAS for pain of 4.7 (±3.5; range 0 to 9). In groups 1 through 4, there were 11, 6, 15 and 4 patients respectively.
  
  
  RESULTS
  The mean values of MCP-1 were 49.8 (±8.0) for minimal pathology and 133.9 (±33.0) for substantial pathology (pg/ml). The mean values of the FAC were 2.83 (±1.16) for minimal pathology and 9.62 (±2.23) for substantial pathology (optical density at 450 nm). The groups differed significantly in age, preoperative VAS, FAC, IL-6, and MCP-1 (p<0.05).
  
  
  CONCLUSIONS
  There are differences in FAC and MCP-1 with increasing grades of severity of intra-articular pathology.
  
  
  CONCLUSIONS
  These tests may play a role in determining the necessity for arthroscopy or intra-articular procedures in equivocal candidates.
authors.affiliation: UHZ Sports Medicine Institue, Coral Gables, FL, USA.
authors.forename: Thomas P
authors.initials: TP
authors.lastname: San Giovanni
authors.forename: S Raymond
authors.initials: SR
authors.lastname: Golish
authors.forename: Ariel
authors.initials: A
authors.lastname: Palanca
authors.forename: Lewis S
authors.initials: LS
authors.lastname: Hanna
authors.forename: Gaetano J
authors.initials: GJ
authors.lastname: Scuderi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D053674:Aggrecans / Q000378:metabolism*; D000704:Analysis of Variance; D000843:Ankle Joint / Q000378:metabolism* / Q000601:surgery; D001174:Arthrodesis; D001182:Arthroscopy; D015415:Biomarkers / Q000378:metabolism; D002357:Cartilage Diseases / Q000378:metabolism / Q000601:surgery; D002358:Cartilage, Articular / Q000378:metabolism / Q000601:surgery; D016022:Case-Control Studies; D016207:Cytokines / Q000378:metabolism*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005353:Fibronectins / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000378:metabolism / Q000601:surgery; D012720:Severity of Illness Index; D013582:Synovial Fluid / Q000378:metabolism*; D055815:Young Adult
chemical_list: D053674:Aggrecans; D015415:Biomarkers; D016207:Cytokines; D005353:Fibronectins