Current status of catabolic, anabolic and inflammatory biomarkers associated with structural and symptomatic changes in the chronic phase of post-traumatic knee osteoarthritis– a systematic review

Oliver O'Sullivan, Peter Ladlow, Kat Steiner, Charles Hillman, Joanne Stocks, Alexander N. Bennett, Ana M. Valdes, Stefan Kluzek

Research output: Contribution to journalReview articlepeer-review

1 Citation (SciVal)

Abstract

Post-traumatic OA (PTOA) can occur within 5 years after a significant injury and is a valuable paradigm for identifying biomarkers. This systematic review aims to summarise published literature in human studies on the associations of known serum and synovial fluid biomarkers at least a year from injury to structural, symptomatic changes and underlying PTOA processes. A systematic review was performed using PRISMA guidelines, prospectively registered on PROSPERO (CRD42022371838), for all ‘wet’ biomarkers a year or more post-injury in 18–45-year-old participants. Three independent reviewers screened search results, extracted data, and performed risk of bias assessments (Newcastle-Ottawa Scale). Study heterogeneity meant a narrative synthesis was undertaken, utilising SWiM guidelines. 952 studies were identified, 664 remaining after deduplication. Following first-round screening, 53 studies underwent second-round screening against pre-determined criteria. Eight studies, with 879 participants (49 ​% male), were included, measuring serum (n ​= ​7), synovial fluid (SF, n ​= ​6), or both (n ​= ​5). The pooled participant mean age was 29.1 (±4). 51 biomarkers were studied (serum ​= ​38, SF ​= ​13), with no correlation between paired serum and SF samples. One serum biomarker, cartilage oligomeric matrix protein (COMP), and four SF biomarkers, interleukin (IL)-1β, IL-6, tumour necrosis factor (TNF), and COMP, were measured in multiple studies. Associations were described between 11 biomarkers related to catabolism (n ​= ​4), anabolism (n ​= ​2), inflammation (n ​= ​4) and non-coding RNA (n ​= ​1), with OA imaging changes (X-ray and MRI), pain, quality of life and function. Widespread differences in study design and methodology prevented meta-analysis, and evidence was generally weak. A unified approach is required before widespread research and clinical biomarker use.

Original languageEnglish
Article number100412
Number of pages10
JournalOsteoarthritis and Cartilage Open
Volume5
Issue number4
Early online date5 Oct 2023
DOIs
Publication statusPublished - 31 Dec 2023

Bibliographical note

Funding Information:
This work was supported by a grant from Versus Arthritis (21076) and funding from the UK Ministry of Defence (2122.030). Funders were not involved in the preparation or publication of this work.

Keywords

  • Biomarkers
  • Pathophysiology
  • Post-traumatic osteoarthritis
  • Serum
  • Synovial fluid

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Rehabilitation
  • Biomedical Engineering

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