Authors:
Facilities:
Elson S. Floyd College of Medicine, Spokane, WA, USA; 2University of Minnesota Medical School, Minneapolis, MN, USA; 3Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA; 4Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA, USA; 5Twin Cities Orthopedics, Edina, MN, USA; 6Orthopedics Northwest, Yakima, WA, USA
Contributions:
(I) Conception and design: MI Kennedy, CP Olson, RF LaPrade, NI Kennedy; (II) Administrative support: MI Kennedy, AJ Tagliero, NN DePhillipo; (III) Provision of study materials or patients: MI Kennedy; (IV) Collection and assembly of data: MI Kennedy, CP Olson; (V) Data analysis and interpretation: MI Kennedy, CP Olson, AJ Tagliero; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.
Abstract:
Background: The healing process is initiated by injurious stimuli in response to cellular damage. Upon recruiting proinflammatory biomarkers to the tissue site of injury, the release of additional biomarkers occurs, including the likes of cytokines, matrix molecules, macrophages, neutrophils, and others. This influx of immune system mediators can occur for chronic periods, and though its intention is for healing the original injurious stimuli, it is also suspected of causing long term cartilage impairment following internal structure damage. The objective of this narrative review is to identify which inflammatory factors have the leading roles in the progression of osteoarthritis (OA) following knee injuries and how they fluctuate throughout the healing process, both acutely and chronically.
Methods: This narrative review was performed following a computerized search of the electronic database on PubMed in May 2023. Abstracts related to the inflammatory biomarkers of the post-traumatic knee were included for review.
Key Content and Findings: The chronic low-level inflammation that leads to OA leads to the destruction of the cartilage extracellular matrix, which new and developing orthopedic research is still attempting to find resolve for. Some of this damage is attributed to the biomechanical alterations that occurs following injury, though with most procedures capable of joint biomechanical restoration, focus has rather been shifted toward the environment of inflammatory biomarkers.
Conclusions: Future studies will be aiming to improve the diagnostics of OA, focusing on a consistent correlation of inflammatory biomarkers with imaging. Additionally, biochemical treatments will need to focus on validating reproducible modulation of signaling molecules, in attempts to lessen the chronic elevations of destructive biomarkers.
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