Ab0029 disbalance of Synovial Fluid Cytokines in Chronic Knee Synovitis

Abstract

BackgroundOne of the most important issues of orthopedics remain long-standing synovitis despite the treatment after traumas and arthroscopy even after removal of mechanical irritating factor (meniscal resection, chondroplasty). In the long term prolonged treatment of arthritis may lead to irreversible joint damage progression. Current generally accepted strategy is to start the treatment as early as possible which affects the following disease course. Due to this, the study of pathogenetic features of posttraumatic synovitis is of interest as based on them, the choice of the most specific and effective treatment may be made.ObjectivesTo study the features of cytokine level changes in synovial fluid in knee synovitis.MethodsThe prospective study of patients with long-standing knee synovitis included knee arthroscopy and outcome registration, measurement of cytokines in aspirated prior to surgery synovial fluid using flow fluorometry.ResultsThe study included 41 patients (31.7% males and 68.3% females) with an average age 51.3±12.5 years. Trauma was present in 48.8% of patients. The duration of synovitis below 1 years was observed in 68.3% of patients, 56.1% of them had it for less than 6 months. Osteoarthritis stage 1 was observed in 24.4% of patients, stage 2 – in 22%, stage 3 – in 39%, stage 4 – in 14.6% of patients. The average VAS score on inclusion prior to arthroscopy was 3.56±0.72. Improvement immediately after the surgery was observed in 28 patients (68.3%). Other patients (31.7%) had long-standing synovitis (for over 2 weeks after the intervention), and 7 of them (17%) – for over 2 months. In the synovial fluid the level of IL-10 and TNFα decreased with increasing age (rs=-0,637, p=0,014 и rs=-0,481, p=0,044, respectively). The level of IL-10 positively correlated with synovitis duration (rs=0,830, p=0,011). Besides, in patients with synovitis duration more than a year, the level of IL-4 (r=0,578, p=0,024) and IL-10 (r=0,769, p=0,022) was higher. IL-4 was also higher with higher intensity of pain according to VAS score (rs=0,799, p=0,041). Also, there was a correlation of IL-6 level and presence of trauma in past medical history (p=0.05).ConclusionProinflammatory TNFα and anti-inflammatory IL-10 positively correlated with the age. If synovitis was present for over a year, patients had higher levels of IL-4 and IL-10, which could be explained by proliferation processes in osteoarthritis. High pain intensity was associated with higher levels of IL-4. Trauma was associated with increased levels of IL-6 in synovial fluid, which may probably be the trigger factor of inflammation.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsNone Declared.