Serum and knee synovialfluid matrixmetalloproteinase-13 and tumor necrosis factor-alpha levels in patients with late stage osteoarthritis

Objective: To compare the levels of MMP-13 and TNF-ain late stage osteoarthritis, deŞne their predominant pathways and investigate their correlation with McMaster Universities Arthritis Index scores.Patients and methods: A total of 42 patients (mean age 64± 8.8) with grade 3 and grade 4 knee osteoarthritis according to Kellegren- Lawrence criteria and who were scheduled for total knee arthroplastywere enrolled in the study. TNF-alpha and MMP-13 levels were measured preoperatively from venousblood samples and intraoperatively from knee synovialfluid via ELISA. Preoperative and 1 monthpostoperative knee functions were assessed by McMaster Universities Arthritis Index.Results: Grade 4 synovialfluid MMP-13 (4.76 ± 5.82) was elevated compared to grade 3 (3.95 ± 4.45)(p¼ 0.438), whereas grade 3 serum MMP-13 (1.128 ± 0.308) was found elevated compared to grade 4(1.038± 0.204) (p ¼ 0.430). Grade 4 serum TNF-a(0.253± 0.277) was elevated compared to grade 3(0.206± 0.219) whereas grade 3 synovial fluid TNF-a(0.129± 0.052) was elevated compared to grade 4(0.118± 0.014). Positive correlation was observed between synovial fluid MMP-13 levels and postoperative WOMAC scores. Mean serum TNF-alevel (0.226± 0.246 pg/ml) was found higher compared tosynovial level (0.124± 1.59), synovial MMP-13 level (4.31 ± 1.24) was found higher compared to serumlevel (1.089± 1.519).Conclusion: Despite the systemic increase in TNF-alevels concordant with osteoarthritis grade, MMP-13levels are elevated via local manner with a signiŞcant correlation with WOMAC scores.Level of evidence: Level IV, Diagnostic study

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