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Abstract

Background: Postoperative arthrofibrosis is more common following surgical treatment of multi-ligament knee injury (MLKI) than isolated anterior cruciate ligament (ACL) injury. It has been proposed that the increased prevalence of postoperative arthrofibrosis after MLKIs may be due to increased inflammation secondary to greater trauma to the joint. The purpose of this study was to compare synovial concentrations of pro-inflammatory and anti-inflammatory cytokines between patients with MLKI and ACL injuries.

Methods: Synovial fluid was aspirated from the operative knee at the time of surgery from 14 patients with MLKI and 10 patients with isolated ACL injury. Structures injured, the time between injury and surgery, and demographic factors were recorded, and the concentrations of pro-inflammatory and anti-inflammatory markers in the synovial fluid were determined. Linear regressions were used to determine the association between injury pattern and synovial inflammatory markers when controlling for age, body mass index (BMI), and time between injury and surgery.

Results: When adjusting for group differences in age, BMI, and the time between injury and surgery, no group differences were detected (interferon gamma (P = 0.11), interleukin-1beta (IL-1b, P = 0.35), IL-2 (P = 0.28), IL-4 (P = 0.64), IL-6 (P = 0.37), IL-8 (P = 0.54), IL-10 (P = 0.25), IL-12p70 (P = 0.81), IL-13 (P = 0.31), and tumor necrosis factor-alpha (P = 0.90)).

Conclusion: Synovial fluid inflammatory markers did not differ between MLKI and isolated ACL injuries, although these pilot results should be used for hypothesis generation due to the small sample size. MLKIs have a greater prevalence of postoperative arthrofibrosis when compared to isolated ACL injuries; however, this may be due in part to factors other than the inflammatory status of the joint.

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