Changes and associations between synovial fluid and magnetic resonance imaging markers of osteoarthritis after high tibial osteotomy
Authors' conclusion
Decreased aberrant knee mechanical loading in patients with OA is associated with decreased biological and imaging measures of inflammation (measured in synovial fluid and on MRI) and increased anabolic processes.
Study context
- Population
- Patients with symptomatic knee osteoarthritis (OA) and varus alignment undergoing medial opening wedge high tibial osteotomy
- Participants
- 26 patients
- Exposure
- One year after medial opening wedge high tibial osteotomy (HTO) vs before HTO
- Outcome
- Changes in a large panel of synovial fluid biomarkers (cytokines, growth factors) and their association with changes in MRI effusion-synovitis and cartilage T2 relaxation time
- Follow-up
- One year
Methodological detailsexploratory, before-after (baseline and one year after HTO), linear mixed effects models, gene set enrichment analysis (GSEA)
- Exploratory
- Before-after (baseline and one year after HTO)
- Linear mixed effects models
- GSEA
Main finding
As reported in the abstract
Synovial fluid biomarker pathway enrichment · one year after HTO
- Decreased enrichment in Toll-like receptor and TNF-α signalling
- Leading contributors to reduction: IL-6, TNF-α and IL-1β
- Highest contributors to positive enrichment: EGF, PDGF-BB and FGF-2
Observational data: associations, not effects.
Further findings
| Outcome | Estimate |
|---|---|
| Change in MRI effusion-synovitis volume, mean (95% CI) · one year after HTO | mean −2811.58 mm³ (95% CI −5094.40 to −528.76) |
| Change in medial tibiofemoral cartilage T2 relaxation time, mean (95% CI) · one year after HTO | mean −0.33 ms (95% CI −2.69 to 2.05) |
Correlation (r) of effusion-synovitis volume change with biomarker changes · one year after HTO
- Decreased MMP-1, r
- 0.44 (95% CI 0.05; 0.71)
- Decreased IL-7, r
- 0.41 (95% CI 0.00; 0.69)
- Decreased IL-1β, r
- 0.59 (95% CI 0.25; 0.80)
- Increased MIP-1β, r
- 0.47 (95% CI 0.10; 0.73)
- Moderately correlated
Correlation (r) of T2 relaxation time decrease with biomarker changes · one year after HTO
- Decreased Flt-3L, r
- 0.61 (95% CI 0.28; 0.81)
- Decreased IL-10, r
- 0.47 (95% CI 0.09; 0.73)
- Decreased IP-10, r
- 0.42 (95% CI 0.03-0.70)
- Increased MMP-9, r
- −0.41 (95% CI −0.7; −0.03)
- Increased IL-18, r
- −0.48 (95% CI −0.73; −0.10)
- Moderately correlated
Original publication
Changes and associations between synovial fluid and magnetic resonance imaging markers of osteoarthritis after high tibial osteotomy. Arthritis Res Ther. Published 10 October 2024. doi:10.
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