Abstract
BackgroundLubrication function is impaired and the lubricant content of synovial fluid (SF) changes immediately after plateau tibia fractures. Here, we aimed to analyze the lubricant content of SF at chronic term following plateau tibia fracture.MethodsForty-eight surgically treated patients without joint incongruency (<2 mm displacement) were included in the study. Joint aspiration had been possible in 16 of the participants. However, sampling could be made from healthy knees in only ten of these patients. Twenty-six SF samples (16 injured knees, 10 healthy knees) were analyzed for concentrations of hyaluronic acid (HA), proteoglycan-4 (PRG4), TNF-α, IL-1β, and IL-6.ResultsThe group of experimental samples were obtained at a mean of 31 (12–66) months after injury from patients with a mean age of 45.1 (32–57) years. There were no relationships detected between biochemical analysis results and patient ages, sexes, postoperative time, and fracture type. After excluding six patients for whom we could not sample from their healthy knee, ten patients’ values were compared with paired Wilcoxon signed rank test and no significant differences detected between the healthy and injured knee in terms of the SF concentrations of HA and PRG4 (p = 0.225 and 0.893, respectively). Similarly, there were no statistically significant differences in SF sample concentrations of TNF-α, IL-1β, and IL-6 between healthy and injured knees.ConclusionsDespite acute changes, the long-term concentrations of HA and PRG4 were similar after plateau tibial fracture. We could not detect any concentration level differences between healthy knees and injured knees regarding HA and PRG4 in the long-term follow-up.
Highlights
Lubrication function is impaired and the lubricant content of synovial fluid (SF) changes immediately after plateau tibia fractures
In preoperative examinations of digital recordings, three patients were found to have had: type 2, four patients; type 3, two patients; type 4, three patients; type 5, four patients; and type 6 tibia plateau fracture according to the Schatzker classification
In the analysis of Spearman’s nonparametric test, there was no significant correlation between the results of the biochemical analysis, fracture type, and displacement of articular surface (p > 0.05)
Summary
Lubrication function is impaired and the lubricant content of synovial fluid (SF) changes immediately after plateau tibia fractures. We aimed to analyze the lubricant content of SF at chronic term following plateau tibia fracture. Intra-articular fractures are disabling injuries that deteriorate the articular surface [1, 2]. Deterioration and insufficient restoration of articular surfaces may cause arthrosis and secondary labor loss [2]. Apart from the articular surface integrity, an ideal lubrication provides reduction of friction and wear of the cartilage surface. This mechanism is directly related to lubricant content of synovial fluid (SF) with hyaluronic acid (HA) and proteoglycan-4 (PRG4) [3]. HA and PRG4 are the primary lubricant macromolecules in SF [5], with HA being the quantitatively major component
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