By Jordana Bieze Foster
Patients with acute intra-articular ankle fractures demonstrate elevated levels of biomarkers that are commonly associated with osteoarthritis (OA), suggesting that the degenerative process that leads to OA in the majority of ankle trauma patients begins in the acute phase, according to research from Duke University Medical Center in Durham, NC.
In 21 patients with unilateral acute intra-articular ankle fracture and no history of trauma or pain in either ankle, the investigators analyzed synovial fluid samples from both ankles at the time of open reduction and internal fixation, which on average was 17 days postinjury. They found that the affected ankle had significantly higher concentrations of three proinflammatory cytokines and four matrix metalloproteinases than the unaffected ankle. Similar biomarkers have previously been associated with degenerative OA, particularly in the knee.
“All healing is inflammatory, but not all of those biomarkers are part of the normal inflammatory response,” said Samuel B. Adams Jr, MD, an orthopedic surgeon at Duke Regional Hospital, who presented the findings in late March at the annual meeting of the American Academy of Orthopaedic Surgeons.
Adams SB Jr, Bell R, Nettles DL, et al. Elevated synovial fluid inflammatory cytokines and matrix metalloproteinases after ankle fracture. Presented at the American Academy of Orthopaedic Surgeons annual meeting, Las Vegas, NV, March 2015.