Diagnostic Utility of Cytokine Biomarkers in the Evaluation of Acute Knee Pain

Cuellar, Jason M.; Scuderi, Gaetano J.; Cuellar, Vanessa Gabrovsky; Golish, S. Raymond; Yeomans, David C.
October 2009
Journal of Bone & Joint Surgery, American Volume;Oct2009, Vol. 91-A Issue 10, p2313
Academic Journal
Background: The diagnosis of clinically important meniscal tears of the knee remains challenging, and it is unknown why only some injuries become painful. The role of inflammatory cytokines in generating pain following meniscal injury remains unclear. This study aimed to investigate the cytokine profile in patients with acute knee pain believed to be secondary to meniscal damage. Methods: This prospective cohort study included thirty-two patients without rheumatoid arthritis who had knee pain for less than six months, with either an acute or insidious onset, and elected to have arthroscopic treatment after nonoperative management had failed. Twenty-three of these patients elected to have the contralateral, nonoperatively treated knee lavaged at the time of arthroscopy. Fifteen asymptomatic control subjects also contributed samples of knee joint fluid, for a total of seventy samples from forty-seven subjects. Lavage of the operatively treated, contra lateral, and control knees was performed with the patient under regional anesthesia prior to arthroscopy, if applicable, by the infusion of sterile saline solution into the knee followed by the immediate withdrawal into a syringe. The concentrations of seventeen inflammatory cytokines and chemokines were measured with use of a multiplexed immunoassay panel. Preoperative magnetic resonance imaging findings and cytokine assay results were compared with intraoperative findings. Results: Multivariate analysis of variance detected significantly greater concentrations of interferon gamma (IFN-γ); interleukins 2, 4, 6, 10, and 13 (IL-2, IL-4, IL-6, IL-10, and IL-13); monocyte chemotactic protein-1 (MCP-1); and macrophage inflammatory protein-1 beta (MIP-1β) in fluid samples from painful knees than in samples from nonpainful knees. Correlation analysis demonstrated a significant positive correlation between patient-reported pain scores and concentrations of IL-6 (Spearman ρ = 0.7), MCP-1 (ρ = 0.8), MIP-1β (ρ = 0.6), and IFN-γ (ρ = 0.6). These four cytokines also demonstrated a positive correlation with each other (ρ = 0.5 to 0.7). The presence of IFN-γ, IL-6, MCP-1, or MIP-1β performed as well as magnetic resonance imaging in the prediction of intraoperative findings. Conclusions: Intra-articular concentrations of four inflammatory cytokines IFN-γ, IL-6, MCP-1, and MIP-1β correlated to pain in patients with symptomatic meniscal tears in the knee but were markedly lower in asymptomatic normal knees and in asymptomatic knees with meniscal tears. These cytokines may be involved in the generation of pain following meniscal injury.


Related Articles

  • Arthroscopic surgery of the knee. Gallannaugh, S.C. // British Medical Journal (Clinical Research Edition);9/20/1986, Vol. 293 Issue 6549, p710 

    Investigates the arthroscopic surgery of the knee. Need for a skilled technique and a degree of perseverance and patience; Advantages of arthroscopic surgery; Complications of the procedure.

  • Inferiorly based thigh flap for reconstruction of defects around the knee joint. Akhtar, Md. Sohaib; Khan, Arshad Hafeez; Khurram, Mohammed Fahud; Ahmad, Imran // Indian Journal of Plastic Surgery;May-Aug2014, Vol. 47 Issue 2, p221 

    Background: Soft-tissue defects around the knees are common in injured limbs and in the same injury the leg is often involved and the thigh is spared. Furthermore due to pliable and relatively lax skin, we have used inferiorly based thigh flap to reconstruct defects around knee joint. Aims and...

  • Treatment of Posterolateral Knee Injuries: Complex Considerations for Complex Injuries. Harner, Christopher D. // Journal of Bone & Joint Surgery, American Volume;9/21/2011, Vol. 93-A Issue 18, pe108-1 

    In this article the author discusses aspects of a report titled ‘‘Outcomes of Treatment of Acute Grade-III Isolated and Combined Posterolateral Knee Injuries. A Prospective Case Series and Surgical Technique," by Andrew G. Geeslin and Robert F. LaPrade. Topics discussed include...

  • Manual Khalifa Therapy in Patients with Completely Ruptured Anterior Cruciate Ligament in the Knee: First Preliminary Results from Thermal Imaging. LITSCHER, GERHARD; OFNER, MICHAEL; LITSCHER, DANIELA // North American Journal of Medical Sciences;Aug2013, Vol. 5 Issue 8, p473 

    Background: This preliminary publication describes acute temperature effects after manual Khalifa therapy. Aims: The goal of this study was to describe temperature distribution and the effects on surface temperature of the knees and feet in patients with completely ruptured anterior cruciate...

  • Non-operative treatment of ACL rupture with mild instability. Jin Hwan Ahn; Moon Jong Chang; Yong Seuk Lee; Kyung Hwan Koh; Yong Serk Park; Sang Soo Eun // Archives of Orthopaedic & Trauma Surgery;Aug2010, Vol. 130 Issue 8, p1001 

    This study examined whether or not conservative treatment of an acutely injured anterior cruciate ligament (ACL) could be successful in a select group of patients. Routine ACL reconstruction surgery in all acute ACL-injured patients should be avoided. We hypothesize that acutely injured ACL with...

  • 5 QUESTIONS WITH Dr. Michael Lee.  // Business People;Dec2014, Vol. 27 Issue 12, p42 

    An interview with Doctor Michael Lee, an orthopaedic surgeon who performs a newer knee replacement alignment technique in Fort Wayne, Indiana, is presented. When asked about the factors behind the growing need for knee replacement surgeries, Lee refers to injuries and genetics. He reveals that...

  • Clinical digest. Exercise therapy is more beneficial than arthroscopic surgery in older knee patients.  // Nursing Standard;6/24/2015, Vol. 29 Issue 43, p15 

    The article discusses results of a study which reveal that arthroscopic surgery for knee pain in middle-aged or older patients has an inconsequential benefit and exercise therapy is more beneficial than arthroscopic surgery in older knee patients.

  • Comparación del uso intraarticular postoperatorio de RV023 y hialuronato G-F20 en artroscopía de rodilla. Experiencia en el Hospital Español de México. Valles-Figueroa, J. F. J.; Ambrosio-Salgado, J.; Suárez-Ahedo, C. E.; Rueda-Villarón, O. // Acta Ortopedica Mexicana;mar/apr2011, Vol. 25 Issue 2, p119 

    For the past two decades arthroscopic surgery has revolutionized the treatment of acute traumatic knee injuries with patients returning sooner to activities of daily living. However, there are factors that delay this goal, such as postoperative intraarticular bleeding, and the swelling and pain...

  • Implantation of a collagen matrix for an AMIC repair during dry arthroscopy. Sadlik, Boguslaw; Wiewiorski, Martin // Knee Surgery, Sports Traumatology, Arthroscopy;Aug2015, Vol. 23 Issue 8, p2349 

    Several arthroscopic cartilage repair techniques in the knee joint require the insertion of a cut-to-shape matrix. Depending on the location and accessibility of the cartilage lesion, this procedure can be challenging. To overcome the limitations of currently used techniques, a novel matrix...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics