Molecular and structural biomarkers of inflammation at 2 years after acute anterior cruciate ligament injury do not predict structural knee osteoarthritis at 5 years. Roemer, F. W., Englund, M., Turkiewicz, A., Struglics, A., Guermazi, A., Lohmander, L. S., Larsson, S., & Frobell, R. Arthritis & Rheumatology, 71(2):238–243, February, 2019.
Molecular and structural biomarkers of inflammation at 2 years after acute anterior cruciate ligament injury do not predict structural knee osteoarthritis at 5 years [link]Paper  doi  abstract   bibtex   
Objective To determine the role of inflammatory biomarkers at 2 years after anterior cruciate ligament (ACL) injury for predicting radiographic and magnetic resonance imaging (MRI)-defined knee osteoarthritis (OA) 5 years post injury. Secondary aim was to estimate the concordance of inflammatory biomarkers assessed by MRI and synovial fluid. Methods We studied 113 patients with acute ACL injury. 1.5 Tesla knee MRIs were read for Hoffa- and effusion-synovitis. Biomarkers of inflammation included IL-6, IL-8, IL-10, TNF-α and IFN-ɣ in serum and synovial fluid, and IL-12p70 in serum. The outcome was radiographic knee OA (ROA) or MRI-defined OA (MROA) at 5 years. Area under receiver operating characteristic curve (AUC), sensitivity and specificity were evaluated in models including MRI features only (M1), inflammation biomarkers only (serum [M2a] – synovial [M2b]) or both MRI and serum [M3a] or synovial [M3b] markers. Linear regression was used for evaluating association between MRI and synovial biomarkers. Results At 5 years, ROA was present in 26% and MROA was present in 32% of patients’ injured knee. The AUCs (95% CI) for ROA were 0.44 (0.42-0.47;M1), 0.62 (0.59-0.65;M2a), 0.58 (0.55-0.61;M2b), 0.53 (0.50-0.56;M3a) and 0.50 (0.46-0.53;M3b) for each model. The corresponding AUCs for MROA were 0.67 (0.64-0.70), 0.49 (0.47-0.52), 0.65 (0.61-0.68), 0.56 (0.52-0.59) and 0.69 (0.66-0.72). The concordance between MRI and synovial biomarkers was statistically significant only for effusion–synovitis and IL-8. Conclusion Neither MRI-defined inflammation, nor selected synovial/serum inflammation biomarkers at 2 years predicted ROA or MROA at 5 years. Concordance between MRI and synovial inflammatory biomarkers was weak. This article is protected by copyright. All rights reserved.
@article{roemer_molecular_2019,
	title = {Molecular and structural biomarkers of inflammation at 2 years after acute anterior cruciate ligament injury do not predict structural knee osteoarthritis at 5 years},
	volume = {71},
	copyright = {This article is protected by copyright. All rights reserved.},
	issn = {2326-5205},
	shorttitle = {Brief {Report}},
	url = {https://onlinelibrary.wiley.com/doi/abs/10.1002/art.40687},
	doi = {10.1002/art.40687},
	abstract = {Objective To determine the role of inflammatory biomarkers at 2 years after anterior cruciate ligament (ACL) injury for predicting radiographic and magnetic resonance imaging (MRI)-defined knee osteoarthritis (OA) 5 years post injury. Secondary aim was to estimate the concordance of inflammatory biomarkers assessed by MRI and synovial fluid. Methods We studied 113 patients with acute ACL injury. 1.5 Tesla knee MRIs were read for Hoffa- and effusion-synovitis. Biomarkers of inflammation included IL-6, IL-8, IL-10, TNF-α and IFN-ɣ in serum and synovial fluid, and IL-12p70 in serum. The outcome was radiographic knee OA (ROA) or MRI-defined OA (MROA) at 5 years. Area under receiver operating characteristic curve (AUC), sensitivity and specificity were evaluated in models including MRI features only (M1), inflammation biomarkers only (serum [M2a] – synovial [M2b]) or both MRI and serum [M3a] or synovial [M3b] markers. Linear regression was used for evaluating association between MRI and synovial biomarkers. Results At 5 years, ROA was present in 26\% and MROA was present in 32\% of patients’ injured knee. The AUCs (95\% CI) for ROA were 0.44 (0.42-0.47;M1), 0.62 (0.59-0.65;M2a), 0.58 (0.55-0.61;M2b), 0.53 (0.50-0.56;M3a) and 0.50 (0.46-0.53;M3b) for each model. The corresponding AUCs for MROA were 0.67 (0.64-0.70), 0.49 (0.47-0.52), 0.65 (0.61-0.68), 0.56 (0.52-0.59) and 0.69 (0.66-0.72). The concordance between MRI and synovial biomarkers was statistically significant only for effusion–synovitis and IL-8. Conclusion Neither MRI-defined inflammation, nor selected synovial/serum inflammation biomarkers at 2 years predicted ROA or MROA at 5 years. Concordance between MRI and synovial inflammatory biomarkers was weak. This article is protected by copyright. All rights reserved.},
	language = {en},
	number = {2},
	urldate = {2018-10-04},
	journal = {Arthritis \& Rheumatology},
	author = {Roemer, Frank W. and Englund, Martin and Turkiewicz, Aleksandra and Struglics, André and Guermazi, Ali and Lohmander, L. Stefan and Larsson, Staffan and Frobell, Richard},
	month = feb,
	year = {2019},
	keywords = {anterior cruciate ligament injury, biomarkers, inflammation, magnetic resonance imaging, osteoarthritis},
	pages = {238--243},
}

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