INTRODUCTION: The prevalence of unrelieved pain following total knee arthroplasty (TKA) is substantial. OBJECTIVE: We asked if cytokine markers of inflammation in preoperative serum or knee synovial fluid (SF) would predict pain 2 years following TKA. METHODS: Demographic data and functional outcomes were recorded at baseline and 2 years with the WOMAC index. Serum and SF tissue samples were collected at the time of surgery. Linear regression modeling was used to determine the relationship between SF/serum inflammatory markers and a lesser improvement in self reported pain at two years follow-up. RESULTS: Of our 28 patient cohort, significant correlations between serum and SF levels were found for IL-1β (p<0.002), MIP-1β (p<0.001), adiponectin (p<0.001) and leptin (p<0.001). Adjusted analysis showed that greater SF concentrations of TNF-α, MMP-13 and IL-6 were independent predictors of less pain improvement at two years follow-up (p<0.05). CONCLUSIONS: Those patients, having ongoing pain despite no clinical or radiological cause, may have an inflammatory profile characterizing a predisposition to ongoing pain after TKA. LEVEL OF EVIDENCE: Prognosis study, Level 2.
INTRODUCTION: The prevalence of unrelieved pain following total knee arthroplasty (TKA) is substantial. OBJECTIVE: We asked if cytokine markers of inflammation in preoperative serum or knee synovial fluid (SF) would predict pain 2 years following TKA. METHODS: Demographic data and functional outcomes were recorded at baseline and 2 years with the WOMAC index. Serum and SF tissue samples were collected at the time of surgery. Linear regression modeling was used to determine the relationship between SF/serum inflammatory markers and a lesser improvement in self reported pain at two years follow-up. RESULTS: Of our 28 patient cohort, significant correlations between serum and SF levels were found for IL-1β (p<0.002), MIP-1β (p<0.001), adiponectin (p<0.001) and leptin (p<0.001). Adjusted analysis showed that greater SF concentrations of TNF-α, MMP-13 and IL-6 were independent predictors of less pain improvement at two years follow-up (p<0.05). CONCLUSIONS: Those patients, having ongoing pain despite no clinical or radiological cause, may have an inflammatory profile characterizing a predisposition to ongoing pain after TKA. LEVEL OF EVIDENCE: Prognosis study, Level 2.
Authors: Javad Parvizi; Ryan M Nunley; Keith R Berend; Adolph V Lombardi; Erin L Ruh; John C Clohisy; William G Hamilton; Craig J Della Valle; Robert L Barrack Journal: Clin Orthop Relat Res Date: 2014-01 Impact factor: 4.176
Authors: Paolo Adravanti; Stefano Nicoletti; Stefania Setti; Aldo Ampollini; Laura de Girolamo Journal: Int Orthop Date: 2013-12-20 Impact factor: 3.075
Authors: Hannah L Paish; Thomas Edward Baldock; Colin S Gillespie; Alicia Del Carpio Pons; Derek A Mann; David J Deehan; Lee A Borthwick; Nicholas S Kalson Journal: J Orthop Res Date: 2019-07-23 Impact factor: 3.494