Abstract
Circulating protein biomarkers have demonstrated utility as a diagnostic tool in predicting musculoskeletal disease severity, but their utility in the evaluation of shoulder lesions associated with shoulder instability is unknown. Thus, the purpose of this exploratory study was to determine whether preoperative biomarkers of cartilage turnover and inflammation are associated with specific shoulder lesions in shoulder instability. Thirty-three patients (29.9 ± 9.4 years of age, 4.5 ± 4.7 dislocations) undergoing surgical treatment for shoulder instability were assessed for the presence or absence of associated shoulder lesions. Biomarkers including cartilage oligomeric matrix protein (COMP), C-reactive protein (HS-CRP), interleukin-8 (IL-8), and macrophage inflammatory protein-1β (MIP-1b) were collected at the time of surgery. Patients with Hill-Sachs lesions had a 31% increase in COMP plasma levels (p=0.046). No other significant differences were observed for COMP, HS-CRP, IL-8, and MIP-1b with any shoulder lesion including Hill-Sachs lesions, capsular injuries, bony Bankart lesions, and SLAP lesions. In conclusion, inflammatory biomarkers including HS-CRP, IL-8, and MIP-1b were not associated with specific shoulder lesions, while biomarkers of cartilage turnover (COMP) were only elevated in Hill-Sachs lesions. These findings suggest that these biomarkers may have limited utility as prognostic indicators in patients with shoulder instability, though large-scale and longitudinal studies are still necessary.
Highlights
With an incidence rate of 24 per 100,000 people-years in North America, glenohumeral dislocations are commonly associated with intra-articular lesions such as Bankart lesions, Hill-Sachs lesions, capsular injuries, bony Bankart lesions, and superior labral tear from anterior to posterior (SLAP) lesions [1, 2]
Circulating biomarkers of cartilage turnover and general inflammation play a role in tracking osteoarthritis progression and have been studied in anterior cruciate ligament (ACL) tears and femoroacetabular impingement (FAI)
Previous research into serum cartilage biomarkers associated with shoulder instability revealed no significant differences in preinjury biomarkers in shoulder instability patients compared to controls [11]
Summary
Glenohumeral instability is a common injury among young and active populations. With an incidence rate of 24 per 100,000 people-years in North America, glenohumeral dislocations are commonly associated with intra-articular lesions such as Bankart lesions, Hill-Sachs lesions, capsular injuries, bony Bankart lesions, and superior labral tear from anterior to posterior (SLAP) lesions [1, 2]. Ese lesions do not always manifest clinically, and physical examination tests have varying levels of diagnostic accuracy. Regardless, these shoulder lesions can compromise the treatment of shoulder instability if not diagnosed [7]. Circulating biomarkers of cartilage turnover and general inflammation play a role in tracking osteoarthritis progression and have been studied in anterior cruciate ligament (ACL) tears and femoroacetabular impingement (FAI). We hypothesized that shoulder instability patients with associated lesions such as Hill-Sachs lesions or capsular injuries would have elevated biomarker levels of cartilage turnover and inflammation compared to shoulder instability patients without these corresponding lesions
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