scholarly journals Association of acute inflammatory cytokines, fracture malreduction, and functional outcome 12 months after intra-articular ankle fracture—a prospective cohort study of 46 patients with ankle fractures

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
That Minh Pham ◽  
Emil Bjoertomt Kristiansen ◽  
Lars Henrik Frich ◽  
Kate Lykke Lambertsen ◽  
Søren Overgaard ◽  
...  
Keyword(s):  
Cohort Study ◽  
Functional Outcome ◽  
Inflammatory Cytokines ◽  
Functional Outcomes ◽  
Joint Space Narrowing ◽  
Joint Space ◽  
X Rays ◽  
Link Type ◽  
Ankle Surgery ◽  
Cytokine Levels

Abstract Background Several malreduction criteria have been proposed for ankle surgery, but the criteria of most importance for functional outcome remain undetermined. Furthermore, the acute inflammatory response in the ankle joint after fracture is hypothesized to result in osteoarthritis development, but no study has investigated the correlation between the levels of these inflammatory cytokines and post-surgical functional outcomes. We aimed to identify malreduction criteria and inflammatory cytokines associated with functional outcome after ankle surgery. Methods During surgery, synovial fluid from the fractured and healthy contralateral ankles of 46 patients was collected for chemiluminescence analysis of 22 inflammatory cytokines and metabolic proteins. The quality of fracture reduction was based on 9 criteria on plain X-rays and 5 criteria on weight-bearing computed tomography (WBCT) scans. After 3 and 12 months, we recorded scores on American Orthopedic Foot and Ankle Society (AOFAS) scale, the Danish version of Foot Function Index (FFI-DK), EQ-5D-5L index score, the Kellgren-Lawrence score, and joint space narrowing. Results Tibiofibular (TF) overlap (p = 0.02) and dime sign (p = 0.008) correlated with FFI-DK. Tibiotalar tilt correlated positively with joint space narrowing at 3 months (p = 0.01) and 12 months (p = 0.03). TF widening correlated with FFI-DK (p = 0.04), AOFAS (p = 0.02), and EQ-5D-5L (p = 0.02). No consistent correlations between synovial cytokine levels and functional outcomes were found at 12 months. Conclusions Malreduction of TF overlap, TF widening, and tibiotalar tilt were the most important criteria for functional outcome after ankle surgery. Increased inflammatory cytokine levels after fracture did not affect functional outcome at 12 months. Trial registration This cohort study is registered the 10th of December 2018 at ClinicalTrials.gov (NCT03769909), was approved by the local committee on health ethics (The Regional Committees on Health Research Ethics for Southern Denmark: J.No. S-20170139), and was reported to the National Danish Data Protection Agency (17/28505).

scholarly journals Association of Acute Inflammatory Cytokines, Fracture Malreduction, and Functional Outcome 12 Months After Intra-articular Ankle Fracture – A Prospective Cohort Study of 46 Patients with Ankle Fractures

2020 ◽  
Author(s):  
That Minh Pham
Keyword(s):  
Cohort Study ◽  
Functional Outcome ◽  
Inflammatory Cytokines ◽  
Functional Outcomes ◽  
Joint Space Narrowing ◽  
Weight Bearing ◽  
Joint Space ◽  
X Rays ◽  
Ankle Surgery ◽  
Cytokine Levels

Abstract Background Several malreduction criteria have been proposed for ankle surgery, but the criteria of most importance for functional outcome remain undetermined. Furthermore, the acute inflammatory response in the ankle joint after fracture is hypothesized to result in osteoarthritis development, but no study has investigated the correlation between the levels of these inflammatory cytokines and post-surgical functional outcomes. We aimed to identify malreduction criteria and inflammatory cytokines associated with functional outcome after ankle surgery.MethodsDuring surgery, synovial fluid from the fractured and healthy contralateral ankles of 46 patients was collected for chemiluminescence analysis of 22 inflammatory cytokines and metabolic proteins. The quality of fracture reduction was based on 9 criteria on plain X-rays and 5 criteria on weight-bearing computed tomography (WBCT) scans. After 3 and 12 months, we recorded scores on American Orthopedic Foot and Ankle Society (AOFAS) scale, the Danish version of Foot Function Index (FFI-DK), EQ-5D-5L index score, the Kellgren Lawrence score, and joint space narrowing. ResultsTibiofibular (TF) overlap (p=0.02) and dime sign (p=0.008) correlated with FFI-DK. Tibiotalar tilt correlated positively with joint space narrowing at 3 months (p=0.01) and 12 months (p=0.03). TF widening correlated with FFI-DK (p=0.04), AOFAS (p=0.02), and EQ-5D-5L (p=0.02). No consistent correlations between synovial cytokine levels and functional outcomes were found at 12 months.ConclusionsMalreduction of TF overlap, TF widening, and tibiotalar tilt were the most important criteria for functional outcome after ankle surgery. Increased inflammatory cytokine levels after fracture did not affect functional outcome at 12 months.Trial registration: This cohort study is registered the 10th of December 2018 at ClinicalTrials.gov (NCT03769909, https://clinicaltrials.gov/ct2/show/NCT03769909), was approved by the local committee on health ethics (The Regional Committees on Health Research Ethics for Southern Denmark: J.No. S-20170139), and was reported to the National Danish Data Protection Agency (17/28505).

scholarly journals Internet hand x-rays: A comparison of joint space narrowing and erosion scores (Sharp/Genant) of plain versus digitized x-rays in rheumatoid arthritis patients

2002 ◽  
Vol 3 (1) ◽  
Author(s):  
Hector O Arbillaga ◽  
Gregory P Montgomery ◽  
Luis P Cabarrus ◽  
Margaret M Watson ◽  
Liam Martin ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Joint Space Narrowing ◽  
Joint Space ◽  
X Rays

Clinical synovitis in a particular joint is associated with progression of erosions and joint space narrowing in that same joint, but not in patients initially treated with infliximab

2010 ◽  
Vol 69 (12) ◽  
pp. 2107-2113 ◽  
Author(s):  
N B Klarenbeek ◽  
M Güler-Yüksel ◽  
D M F M van der Heijde ◽  
H M J Hulsmans ◽  
P J S M Kerstens ◽  
...  
Keyword(s):  
Joint Space Narrowing ◽  
Clinical Signs ◽  
Joint Damage ◽  
Treatment Strategies ◽  
Joint Space ◽  
X Rays ◽  
Joint Level ◽  
Damage Progression ◽  
The Individual ◽  
Hands And Feet

ObjectivesTo assess the relationship between joint tenderness, swelling and joint damage progression in individual joints and to evaluate the influence of treatment on these relationships.MethodsFirst-year data of the Behandel Strategieën (BeSt) study were used, in which patients recently diagnosed as having rheumatoid arthritis (RA) were randomly assigned into four different treatment strategies. Baseline and 1-year x-rays of the hands and feet were assessed using the Sharp–van der Heijde score (SHS). With generalised estimating equations, 3-monthly assessments of tender and swollen joints of year 1 were related to erosion progression, joint space narrowing (JSN) progression and total SHS progression at the individual joint level (definition >0.5 SHS units) in year 1, corrected for potential confounders and within-patient correlation for multiple joints per patient.ResultsDuring year 1, 59% of all 13 959 joints analysed were ever tender and 45% ever swollen, 2.1% showed erosion progression, 1.9% JSN progression and 3.6% SHS progression. Swelling and tenderness were both independently associated with erosion and JSN progression with comparable OR, although with higher OR in the hands than in the feet. Local swelling and tenderness were not associated with local damage progression in patients initially treated with infliximab.ConclusionClinical signs of synovitis are associated with erosion and JSN progression in individual joints after 1 year in RA. A disconnect between synovitis and joint damage progression was observed at joint level in patients who were treated with methotrexate and infliximab as initial treatment, confirming the disconnect between synovitis and the development of joint damage in tumour necrosis factor blockers seen at patient level.

scholarly journals Fatigue in Patients with Multiple Sclerosis: Is It Related to Pro- and Anti-Inflammatory Cytokines?

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Arjan Malekzadeh ◽  
Wietske Van de Geer-Peeters ◽  
Vincent De Groot ◽  
Charlotte Elisabeth Teunissen ◽  
Heleen Beckerman ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Inflammatory Cytokines ◽  
Confounding Effect ◽  
Fatigue Score ◽  
Link Type ◽  
Cytokine Levels ◽  
Pathophysiological Role ◽  
Checklist Individual Strength ◽  
Anti Inflammatory ◽  
Effect Of Age

Objective. To investigate the pathophysiological role of pro- and anti-inflammatory cytokines in primary multiple sclerosis-related fatigue.Methods. Fatigued and non-fatigued patients with multiple sclerosis (MS) were recruited and their cytokine profiles compared. Patients with secondary fatigue were excluded. Fatigue was assessed with the self-reported Checklist Individual Strength (CIS20r), subscale fatigue. A CIS20r fatigue cut-off score of 35 was applied to differentiate between non-fatigued (CIS20r fatigue≤34) and fatigued (CIS20r fatigue≥35) patients with MS. Blood was collected to determine the serum concentrations of pro-inflammatory cytokines (IL-1β, IL-2, IL-6, IL-8, IL-12p70, IL-17, TNFα, and IFN-γ) and anti-inflammatory cytokines (IL-4, IL-5, IL-10, and IL-13). We controlled for the confounding effect of age, gender, duration of MS, disease severity, type of MS, and use of immunomodulatory drugs.Results. Similar cytokine levels were observed between MS patients with(n=21)and without fatigue(n=14). Adjusted multiple regression analyses showed a single significant positive relationship, that of IL-6 with CIS20r fatigue score. The explained variance of the IL-6 model was 21.1%, once adjusted for the confounding effect of age.Conclusion. The pro-inflammatory cytokine interleukin-6 (IL-6) may play a role in the pathophysiology of primary fatigue in patients with MS.Trial Registrations.ISRCTN69520623,ISRCTN58583714, andISRCTN82353628.

Osteophytes and joint space narrowing are independently associated with pain in finger joints in hand osteoarthritis

2011 ◽  
Vol 70 (10) ◽  
pp. 1835-1837 ◽  
Author(s):  
Marion C Kortekaas ◽  
Wing-Yee Kwok ◽  
Monique Reijnierse ◽  
Tom W J Huizinga ◽  
Margreet Kloppenburg
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Joint Space Narrowing ◽  
Joint Space ◽  
Hand Osteoarthritis ◽  
X Rays ◽  
Finger Joints ◽  
Hand Joints ◽  
American College Of Rheumatology ◽  
Structural Abnormalities

ObjectiveTo study the associations between structural abnormalities on ultrasound (US) or conventional x-rays (CR) and pain in hand osteoarthritis (HOA).MethodsIn 55 consecutive patients with HOA (mean age 61 years, 86% women) fulfilling the American College of Rheumatology criteria, pain in 30 separate hand joints was assessed upon palpation; osteophytes were assessed by US and CR and joint space narrowing (JSN) by CR. Associations between structural abnormalities and pain per joint were analysed using generalised estimated equations to account for patient effects and adjusted for age, sex, body mass index, US inflammatory features and other remaining structural abnormalities.ResultsIn 1649 joints, 69% and 46% had osteophytes on US and CR, respectively and 47% had JSN. Osteophytes and JSN showed independent associations with pain per joint adjusted: OR for osteophytes: 4.8 (95% CI 3.1 to 7.5) for US and 4.1 (95% CI 2.4 to 7.1) for CR; for JSN: 4.2 (95% CI 2.0 to 9.0).ConclusionsOsteophytes and JSN are independently associated with pain in individual HOA joints, taking into account patient effects.

The Influence of Articular Morphology on Non-Traumatic Degenerative Changes of the Distal Radioulnar Joint. A Radiographic Study

2006 ◽  
Vol 31 (2) ◽  
pp. 221-225 ◽  
Author(s):  
N. HOLLEVOET ◽  
R. VERDONK ◽  
G. VAN MAELE
Keyword(s):  
Joint Space Narrowing ◽  
Joint Space ◽  
Distal Radioulnar Joint ◽  
Ulnar Variance ◽  
Degenerative Changes ◽  
X Rays ◽  
Radioulnar Joint ◽  
Ulnar Head ◽  
Sigmoid Notch ◽  
Inferior Edge

We examined 248 wrist X-rays of patients over 50 years of age to find out if ulnar variance, orientation of the sigmoid notch and ulnar head inclination play a role in the development of non-traumatic osteoarthritis of the distal radioulnar joint. Minor degenerative changes, viz. focal joint space narrowing and/or lipping, or small osteophytes at the inferior edge of the ulnar head, were present in 13% of the X-rays of these wrists. They were significantly more frequent in wrists with a more inclined ulnar head and significantly less present in wrists with an oblique, distally orientated sigmoid notch. There was no significant association with ulnar variance or age. This study suggests that articular morphology may play a role in the development of degenerative changes of the distal radioulnar joint.

scholarly journals Varus alignment of the proximal tibia is associated with structural progression in early to moderate varus osteoarthritis of the knee

2020 ◽  
Vol 28 (10) ◽  
pp. 3279-3286 ◽  
Author(s):  
Jonathan S. Palmer ◽  
Luke D. Jones ◽  
A. Paul Monk ◽  
Michael Nevitt ◽  
John Lynch ◽  
...  
Keyword(s):  
Cohort Study ◽  
Lower Limb ◽  
Joint Space Narrowing ◽  
Proximal Tibia ◽  
Joint Space ◽  
Medial Compartment ◽  
Osteoarthritis Of The Knee ◽  
Varus Alignment ◽  
Medial Proximal Tibial Angle ◽  
Structural Progression

Abstract Purpose Lower limb malalignment is a strong predictor of progression in knee osteoarthritis. The purpose of this study is to identify the individual alignment variables that predict progression in early to moderate osteoarthritis of the knee. Method A longitudinal cohort study using data from the Osteoarthritis Initiative. In total, 955 individuals (1329 knees) with early to moderate osteoarthritis (Kellgren-Lawrence grade 1, 2 or 3) were identified. All subjects had full-limb radiographs analysed using the Osteotomy module within Medicad® Classic (Hectec GMBH) to give a series of individual alignment variables relevant to the coronal alignment of the lower limb. Logistic regression models, with generalised estimating equations were used to identify which of these individual alignment variables predict symptom worsening (WOMAC score > 9 points) and or structural progression (joint space narrowing progression in the medial compartment > 0.7mm) over 24 months. Results Individual alignment variable were associated with both valgus and varus alignment (mechanical Lateral Distal Femoral Angle, Medial Proximal Tibial Angle and mechanical Lateral Distal Tibial Angle). Only the Medial Proximal Tibial Angle was significantly associated with structural progression and none of the variables was associated with symptom progression. The odds of joint space narrowing progression in the medial compartment occurring at 24 months increased by 21% for every one degree decrease (more varus) in Medial Proximal Tibial Angle (p < 0.001) Conclusions Our results suggest that the risk of structural progression in the medial compartment is associated with greater varus alignment of the proximal tibia. Level of evidence Level III, retrospective cohort study.

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