Investigation of biomarker for intra-articular fibrosis after anterior cruciate reconstruction

2021 Fiscal Year Final Research Report

• Project/Area Number: 19K18454
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 56020:Orthopedics-related
• Research Institution: Tokyo Medical and Dental University
• Principal Investigator: Nakagawa Yusuke 東京医科歯科大学, 大学院医歯学総合研究科, 准教授 (60822666)
• Project Period (FY): 2019-04-01 – 2022-03-31
• Keywords: 線維化 / 前十字靭帯損傷 / 炎症性サイトカイン / 関節液

Outline of Final Research Achievements

omplications after anterior cruciate ligament reconstruction (ACLR) includes intra-articular fibrosis leading to residual pain and delayed functional recovery. This study aimed to evaluate clinical outcomes and inflammatory cytokine levels in the synovial fluid of ACLR patients with or without severe IFP fibrosis. Patients were divided into two groups based on IFP fibrosis scoring. Synovial fluid was aspirated on the third or fourth postoperative day to measure inflammatory cytokines levels. Of the 36 patients included, 7 were allocated to the severe fibrosis group and 29 to the mild fibrosis group. Pain in the severe fibrosis group was greater and lower extension muscle strength than that in the mild fibrosis group. The severe fibrosis group demonstrated higher interleukin-1β, interleukin-6, and interferon-γ levels. Severe IFP fibrosis was associated with higher inflammatory cytokines in the synovial fluid and led to unfavorable clinical outcomes.

Free Research Field

整形外科

Academic Significance and Societal Importance of the Research Achievements

関節液中の炎症性サイトカインが高い患者でIFP線維化のリスクが高いことから、そのような患者に対して、MRIによるIFP線維化の評価。IFP線維化があればリハビリ、抗炎症薬の内服、ヒアルロン酸注射など早期に介入を行い、治療成績の改善につなげる。
炎症性サイトカインがIFP線維化の発生に関わる機序の一端が明らかとなった。今後さらに詳細なメカニズムを明らかにすることでIFP線維化を抑制する治療法の開発につながると考える。