title: Association between intraarticular cytokine levels and clinical parameters of osteochondritis dissecans in the ankle.
abstract: BACKGROUND
  Reliable data about in vivo regulation of cytokines in osteochondritis dissecans (OCD) of the ankle are still missing. Disease-specific regulation patterns were hypothesized.
  
  
  METHODS
  28 patients with a mean age of 30.7 ± 14.8 years undergoing an arthroscopy of the ankle because of OCD were prospectively included in a clinical trial. Lavage fluids were analyzed by ELISA for levels of aggrecan, BMP-2, BMP-7, IGF-1, IGF-1R, bFGF, endoglin, MMP-13, and IL-1β. Additionally, clinical parameters and scores (FFI, CFSS, AOFAS) were evaluated and supplemented by the Kellgren Lawrence Score (KLS) for conventional X-rays and the Ankle Osteoarthritis Scoring System (AOSS) for MRI.
  
  
  RESULTS
  Grading of OCD lesions statistically significant increased with age and was higher in case of previously performed operations (p<0.03). A worse clinical function reflected by low AOFAS and CFSS scores or high FFI was associated with high grading of cartilage damage or OCD (p<0.03). Similarly, high radiological scores (KLS and AOSS) indicating progress of OA positively correlated with grading of cartilage damage and OCD. The concordance between the MRI and arthroscopic classification was overall moderate (κ=0.52). Biochemically, only IGF/IGF-1R levels were consistently negatively associated with OCD grading, ICRS score, FFI and KLS (p<0.05). Correlation data is supported by post hoc statistics.
  
  
  CONCLUSIONS
  Radiological and clinical parameters in association with synovial IGF-1/IGF-1R levels indicated an increasing joint degeneration with rising OCD stage.
  
  
  BACKGROUND
  German Clinical Trials Register DRKS00000365, 11/03/2008.
authors.affiliation: Department of Orthopaedic Surgery, University of Freiburg Medical Center, Hugstetter Str, 55, D-79106, Freiburg, Germany. hagen.schmal@freenet.de.
authors.forename: Hagen
authors.initials: H
authors.lastname: Schmal
authors.forename: Ingo H
authors.initials: IH
authors.lastname: Pilz
authors.forename: Ralf
authors.initials: R
authors.lastname: Henkelmann
authors.forename: Gian M
authors.initials: GM
authors.lastname: Salzmann
authors.forename: Norbert P
authors.initials: NP
authors.lastname: Südkamp
authors.forename: Philipp
authors.initials: P
authors.lastname: Niemeyer
mesh_terms: D000328:Adult; D000843:Ankle Joint / Q000378:metabolism* / Q000473:pathology*; D015415:Biomarkers / Q000378:metabolism; D002358:Cartilage, Articular / Q000378:metabolism*; D016207:Cytokines / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010008:Osteochondritis Dissecans / Q000175:diagnosis* / Q000378:metabolism*; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; D016207:Cytokines