title: Early intra-articular complement activation in ankle fractures.
abstract: Cytokine regulation possibly influences long term outcome following ankle fractures, but little is known about synovial fracture biochemistry. Eight patients with an ankle dislocation fracture were included in a prospective case series and matched with patients suffering from grade 2 osteochondritis dissecans (OCD) of the ankle. All fractures needed external fixation during which joint effusions were collected. Fluid analysis was done by ELISA measuring aggrecan, bFGF, IL-1 β, IGF-1, and the complement components C3a, C5a, and C5b-9. The time periods between occurrence of fracture and collection of effusion were only significantly associated with synovial aggrecan and C5b-9 levels (P < 0.001). Furthermore, synovial expressions of both proteins correlated with each other (P < 0.001). Although IL-1 β expression was relatively low, intra-articular levels correlated with C5a (P < 0.01) and serological C-reactive protein concentrations 2 days after surgery (P < 0.05). Joint effusions were initially dominated by neutrophils, but the portion of monocytes constantly increased reaching 50% at day 6 after fracture (P < 0.02). Whereas aggrecan and IL-1β concentrations were not different in fracture and OCD patients, bFGF, IGF-1, and all complement components were significantly higher concentrated in ankle joints with fractures (P < 0.01). Complement activation and inflammatory cell infiltration characterize the joint biology following acute ankle fractures.
authors: Department of Orthopedics and Trauma Surgery, Albert-Ludwigs University Medical Center Freiburg, 79106 Freiburg, Germany.
authors: Hagen
authors: 0000-0002-8801-2385
authors: H
authors: Schmal
authors: Department of Orthopedics and Trauma Surgery, Albert-Ludwigs University Medical Center Freiburg, 79106 Freiburg, Germany.
authors: Gian M
authors: GM
authors: Salzmann
authors: Department of Orthopedics and Trauma Surgery, Albert-Ludwigs University Medical Center Freiburg, 79106 Freiburg, Germany.
authors: Philipp
authors: P
authors: Niemeyer
authors: Department of Orthopedics and Trauma Surgery, Albert-Ludwigs University Medical Center Freiburg, 79106 Freiburg, Germany.
authors: Elia
authors: 0000-0002-2053-3643
authors: E
authors: Langenmair
authors: Inflarx, 07745 Jena, Germany.
authors: Renfeng
authors: R
authors: Guo
authors: Inflarx, 07745 Jena, Germany.
authors: Conny
authors: 0000-0002-2400-4685
authors: C
authors: Schneider
authors: Inflarx, 07745 Jena, Germany.
authors: Maria
authors: 0000-0002-8172-0688
authors: M
authors: Habel
authors: Inflarx, 07745 Jena, Germany.
authors: Niels
authors: 0000-0002-8915-3315
authors: N
authors: Riedemann
mesh_terms: D000328:Adult; D064386:Ankle Fractures / Q000378:metabolism* / Q000473:pathology / Q000628:therapy; D000843:Ankle Joint / Q000378:metabolism* / Q000473:pathology; D003167:Complement Activation; D003165:Complement System Proteins / Q000378:metabolism; D016222:Fibroblast Growth Factor 2 / Q000378:metabolism; D005786:Gene Expression Regulation; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D053583:Interleukin-1beta / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010008:Osteochondritis Dissecans / Q000378:metabolism / Q000473:pathology / Q000628:therapy; D013997:Time Factors
chemical_list: C583557:IGF1 protein, human; C508585:IL1B protein, human; D053583:Interleukin-1beta; D016222:Fibroblast Growth Factor 2; D007334:Insulin-Like Growth Factor I; D003165:Complement System Proteins