Knee Alignment Correction by High Tibial Osteotomy Reduces Symptoms and Synovial Inflammation in Knee Osteoarthritis Accompanied by Macrophage Phenotypic Change From M1 to M2
Authors' conclusion
Correction of lower limb alignment with HTO attenuated synovial inflammation and changed macrophage polarization from M1 to M2, suggesting an improved intraarticular environment in knee OA.
Study context
- Population
- Patients with knee osteoarthritic (OA) undergoing high tibial osteotomy (HTO)
- Participants
- 31 patients
- Comparison
- Synovial tissue and fluid at initial HTO vs at plate removal surgery
- Outcome
- Changes in the intraarticular microenvironment after HTO
Methodological detailspaired synovial samples before and after HTO, in vitro macrophage and fibroblast-like synoviocytes (FLS) experiments
- Paired synovial samples before and after HTO
- In vitro macrophage and FLS experiments
Main finding
As reported in the abstract
- Microarray: down-regulated inflammatory genes and pathways
- Real-time polymerase chain reaction (PCR): proinflammatory IL1B and IL6 down-regulated; M2 macrophage-related IL1RA, IL10, CCL18 and CD206 up-regulated
- Histology: attenuated synovitis scores and shift from M1 to M2 macrophages
- IL-1β concentrations in SF decreased after HTO
- Cartilage fragments drove M1 macrophage polarization and proinflammatory gene and protein expression in macrophages; in FLS they up-regulated only IL-6 protein
- Postoperative KOOS positively correlated with expression of M2-related genes CCL18 and CD206
Original publication
Knee Alignment Correction by High Tibial Osteotomy Reduces Symptoms and Synovial Inflammation in Knee Osteoarthritis Accompanied by Macrophage Phenotypic Change From M1 to M2. Arthritis Rheumatol. Published 9 March 2023. doi:10.
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