Serum and knee synovial fluid matrix metalloproteinase-13 and tumor necrosis factor-alpha levels in patients with late-stage osteoarthritis

Acta Orthop Traumatol Turc. 2016;50(3):356-61. doi: 10.3944/AOTT.2015.15.0115.

Abstract

Objective: The aim of this study was to compare serum and synovial fluid levels of matrix metalloproteinase-13 (MMP-13) and tumor necrosis factor-alpha (TNF-α) in 2 stages of osteoarthritis, and investigate their correlation with Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores.

Methods: Forty-two patients (mean age: 64±8.8 years) with grade 3 and grade 4 knee osteoarthritis according to Kellgren-Lawrence criteria were enrolled in the study and underwent total knee arthroplasty. TNF-α and MMP-13 levels were measured preoperatively from venous blood samples and intraoperatively from knee synovial fluid via enzyme-linked immunosorbent assay. Preoperative and 1-month postoperative knee functions were assessed by WOMAC.

Results: Grade 4 synovial fluid MMP-13 (4.76±5.82 pg/ml) was elevated compared to grade 3 (3.95±4.45), whereas grade 3 serum MMP-13 (1.128±0.308 pg/ml) was found elevated compared to grade 4 (1.038±0.204) (p=0.438, p=0.430, respectively). Grade 4 serum TNF-α (0.253±0.277) was elevated compared to grade 3 (0.206±0.219), whereas grade 3 synovial fluid TNF-α (0.129±0.052) was elevated compared to grade 4 (0.118±0.014). Positive correlation was observed between synovial fluid MMP-13 levels and postoperative WOMAC scores. Mean serum TNF-α (0.226±0.246 pg/ml) was elevated compared to synovial levels (0.124±1.59), and synovial MMP-13 (4.31±1.24) was elevated compared to serum levels (1.089±1.519).

Conclusion: Despite the systemic increase in TNF-α levels concordant with osteoarthritis grade, MMP-13 levels are elevated via local manner, with a significant correlation with WOMAC scores.

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Knee*
  • Female
  • Humans
  • Male
  • Matrix Metalloproteinase 13 / blood
  • Matrix Metalloproteinase 13 / chemistry*
  • Middle Aged
  • Osteoarthritis, Knee / metabolism*
  • Serology
  • Synovial Fluid / chemistry*
  • Tumor Necrosis Factor-alpha / blood
  • Tumor Necrosis Factor-alpha / chemistry*

Substances

  • Tumor Necrosis Factor-alpha
  • MMP13 protein, human
  • Matrix Metalloproteinase 13