دورية أكاديمية
أعرض في EDS

The Relationship Between Intra-articular Fracture Energy and a Patient's Inflammatory Response.

التفاصيل البيبلوغرافية
العنوان: The Relationship Between Intra-articular Fracture Energy and a Patient's Inflammatory Response.
المؤلفون: Haller JM; Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT., Fink D; Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA., Smith H; Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA., Olsen Z; Arkansas College of Osteopathic Medicine, Fort Smith, AR; and., Jacobs C; Massachusetts General Brigham Sports Medicine, Foxborough, MA., Anderson D; Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA.
المصدر: Journal of orthopaedic trauma [J Orthop Trauma] 2024 Jun 01; Vol. 38 (6), pp. e225-e229.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 8807705 Publication Model: Print Cited Medium: Internet ISSN: 1531-2291 (Electronic) Linking ISSN: 08905339 NLM ISO Abbreviation: J Orthop Trauma Subsets: MEDLINE
أسماء مطبوعة: Publication: Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: [New York, N.Y.] : Raven Press, [c1987-
مواضيع طبية MeSH: Intra-Articular Fractures*/complications , Intra-Articular Fractures*/metabolism , Synovial Fluid*/metabolism, Humans ; Male ; Female ; Adult ; Middle Aged ; Prospective Studies ; Cytokines/metabolism ; Tibial Fractures/complications ; Injury Severity Score ; Ankle Fractures/complications ; Inflammation/metabolism ; Aged ; Young Adult
مستخلص: Objectives: Prior studies have demonstrated elevated inflammatory cytokine concentrations in the synovial fluid of articular fracture patients postinjury. Similarly, CT-based fracture energy measurements have been correlated with posttraumatic osteoarthritis risk after pilon fracture. The purpose of this study was to determine the associations between synovial fluid cytokine levels, fracture energy, and overall trauma to the body in articular fracture patients.
Methods: Acute tibial plateau, tibial plafond, and rotational ankle fracture patients were prospectively enrolled from December 2011 through January 1, 2019. Synovial fluid concentrations of interleukin-1 beta, interleukin-1 receptor antagonist, IL-6, IL-8, IL-10, matrix metallopeptidase-1, MMP-3, and MMP-13 were quantified. Patient CT scans were used to calculate fracture energy. The Injury Severity Score (ISS) was used to relate cytokine levels to whole-body injury severity. Spearman rho correlation coefficients were calculated to assess the relationship between injury severity metrics and synovial fluid cytokine, chemokine, and matrix metallopeptidase concentrations.
Results: Eighty-seven patients were enrolled with 42 had a tibial plateau fractures (OTA/AO 41B1-2, 41B2-14, 41B3-3, 41C1-3, 41C2-4, 41C3-16), 24 patients had a tibial plafond fracture (OTA/AO 43B1-2, 43B2-4, 43B3-5, 43C1-2, 43C2-3, 43C3-8), and 21 had a rotational ankle fracture (OTA/AO 44B1-3, 44B2-3, 44B3-6, 44C1-4, 44C2-5). Fracture energy significantly differed between fracture patterns, with ankle fractures involving substantially less fracture energy (median = 2.92 J) than plafond (10.85 J, P < 0.001) and plateau fractures (13.05 J, P < 0.001). After adjustment for multiple comparisons, MMP-3 was significantly correlated with transformed fracture energy (r = 0.41, 95% confidence interval [CI], 0.22-0.58, P < 0.001), while IL-1β was significantly correlated with the Injury Severity Score (Spearman ρ = 0.31, 95% CI, 0.08-0.49, P = 0.004).
Conclusions: Synovial fluid MMP-3 concentration was significantly correlated with CT-quantified fracture energy in intra-articular fracture patients. Given that in clinical practice fracture energy tends to correlate with posttraumatic osteoarthritis risk, MMP-3 may warrant further investigation for its role in posttraumatic osteoarthritis development after articular fracture.
Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Competing Interests: The authors report no conflict of interest.
(Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
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معلومات مُعتمدة: Orthopedic Trauma Association
تواريخ الأحداث: Date Created: 20240313 Date Completed: 20240515 Latest Revision: 20240515
رمز التحديث: 20240516
DOI: 10.1097/BOT.0000000000002800
PMID: 38478361
قاعدة البيانات: MEDLINE
الوصف
تدمد:1531-2291
DOI:10.1097/BOT.0000000000002800