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Open Access Research article

Association between intraarticular cytokine levels and clinical parameters of osteochondritis dissecans in the ankle

Hagen Schmal*, Ingo H Pilz, Ralf Henkelmann, Gian M Salzmann, Norbert P Südkamp and Philipp Niemeyer

Author Affiliations

Department of Orthopaedic Surgery, University of Freiburg Medical Center, Hugstetter Str. 55, D-79106, Freiburg, Germany

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BMC Musculoskeletal Disorders 2014, 15:169  doi:10.1186/1471-2474-15-169

Published: 22 May 2014

Abstract

Background

Reliable data about in vivo regulation of cytokines in osteochondritis dissecans (OCD) of the ankle are still missing. Disease-specific regulation patterns were hypothesized.

Methods

28 patients with a mean age of 30.7 ± 14.8 years undergoing an arthroscopy of the ankle because of OCD were prospectively included in a clinical trial. Lavage fluids were analyzed by ELISA for levels of aggrecan, BMP-2, BMP-7, IGF-1, IGF-1R, bFGF, endoglin, MMP-13, and IL-1β. Additionally, clinical parameters and scores (FFI, CFSS, AOFAS) were evaluated and supplemented by the Kellgren Lawrence Score (KLS) for conventional X-rays and the Ankle Osteoarthritis Scoring System (AOSS) for MRI.

Results

Grading of OCD lesions statistically significant increased with age and was higher in case of previously performed operations (p < 0.03). A worse clinical function reflected by low AOFAS and CFSS scores or high FFI was associated with high grading of cartilage damage or OCD (p < 0.03). Similarly, high radiological scores (KLS and AOSS) indicating progress of OA positively correlated with grading of cartilage damage and OCD. The concordance between the MRI and arthroscopic classification was overall moderate (κ = 0.52). Biochemically, only IGF/IGF-1R levels were consistently negatively associated with OCD grading, ICRS score, FFI and KLS (p < 0.05). Correlation data is supported by post hoc statistics.

Conclusions

Radiological and clinical parameters in association with synovial IGF-1/IGF-1R levels indicated an increasing joint degeneration with rising OCD stage.

Trial registration

German Clinical Trials Register DRKS00000365, 11/03/2008.

Keywords:
Ankle; Osteoarthritis; Ankle Osteoarthritis Scoring System; Biomarker; Clinical trial; IGF-1