A possible issue of articular cartilage degeneration in acute phase after anterior cruciate ligament reconstruction

• Published in: Orthopaedic journal of sports medicine 2021-07, Vol.9 (7_suppl4)
• Main Authors: Tajima, Takuya, Yamaguchi, Nami, Yokoe, Takuji, Chosa, Etsuo, Morita, Yudai
• Format: Article
• Language: English
• Subjects: Arthritis; Cartilage; Hematoma; Knee; Ligaments; Orthopedics; Osteoarthritis; Proteins; Sports medicine; Surgery
• ISSN: 2325-9671; 2325-9671
• DOI: 10.1177/2325967121S00218

Objectives: Intra-articular hematoma are caused by articular injury such as ligament rupture or intra-articular fracture and following knee surgery. It has been reported that intra-articular hematoma leads to cartilage degeneration. Exposure of articular cartilage to low concentrations of blood for a period as short as 2 days has been confirmed to induce the irreversible cartilage damage. Anterior cruciate ligament (ACL) injury is increased risk for developing posttraumatic osteoarthritis (OA). Despite improvement in ACL reconstruction (ACLR), the incidence of posttraumatic OA has remained relatively unchanged over the several decades later. One of cause in OA may be thought to intra-articular hematoma after ACLR. A primary feature in OA is cartilage degeneration, it involves the loss of extracellular matrix components including aggrecan and Type Ⅱ collagen. A distintegrin and metalloprotease with thrombospondin motifs (ADAMTS)-4, -5, -9 and matrix metalloprotease (MMP)-2, -9 are reported primary proteases responsible for aggrecan cleavage in OA. The present study was designed to the hypothesis described as above by evaluating the influence of intra-articular hematoma on ADAMTS-4, -5, -9, MMP-2 and -9 activities in acute phase after ACLR. Methods: Patient sample Intra-articular hematoma was collected from patients, who were underwent primary ACLR with consent to participate in this study, on day1, 4 and 7 after surgery. Day1 samples were collected from drainage tube for approximately 10 ml. Day4 and day7 samples were collected by inserted needle and aspiration under sterile condition. For control sample, it was selected and adopted SF without intra-articular hematoma. To obtain enough amount of SF for control sample on the ipsilateral knee, 20ml of 0.9% saline was injected into the joint cavity prior to arthroscopic surgery. In the laboratory, intra-articular hematoma and SF were centrifuged for 15 min at 3000g and the supernatant were stored at -80℃ until assay. From March 2017 to March 2020, 98 patients who were undergone knee arthroscopic surgery took part in this study. The study protocol was reviewed and approved (accession no.: O-0149) by the local ethics committees at our institutions. The procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Written informed consent was obtained from the patie