L. Dahlberg et al., CARTILAGE METABOLISM IN THE INJURED AND UNINJURED KNEE OF THE SAME PATIENT, Annals of the Rheumatic Diseases, 53(12), 1994, pp. 823-827
Objective-To examine if unilateral knee injury affects the synovial fl
uid concentrations of aggrecan fragments, cartilage oligomeric matrix
protein (COMP) fragments, stromelysin-1, and tissue inhibitor of metal
loproteinases-1 (TIMP-1) in the contralateral uninjured knee. Methods-
Synovial fluids from the injured and uninjured knees were obtained at
different times in a group of patients after unilateral knee trauma. S
erum samples were obtained on the same occasion. Concentrations of agg
recan fragments were determined by precipitation with Alcian Blue; tho
se of COMP fragments, stromelysin-1, and TLMP-1 were measured by immun
oassay. Concentrations were compared with those in a reference group o
f 10 healthy volunteers. Results-Immediately after knee injury, concen
trations of aggrecan fragments, COMP fragments, stromelysin-1 and TIMP
-1 were increased in the synovial fluid of the injured knee. However,
concentrations of aggrecan and COMP fragments, and stromelysin-1 incre
ased also in the contralateral uninjured knee immediately after injury
, but less than in the injured knee. Subsequently, the concentrations
of all markers decreased in the synovial fluid of the injured knee, bu
t remained unchanged in the uninjured knee. The concentration of aggre
can fragments in the injured knee decreased to less than that in the u
ninjured knee in the chronic phase. Serum concentrations of COMP were
much smaller than those in synovial fluid. Conclusions-The increased c
oncentrations of aggrecan and COMP fragments and stromelysin-1 in the
joint fluid of the contralateral, uninjured knee following unilateral
knee injury, compared with concentrations in healthy reference knees,
suggest changes in joint metabolism in both unilateral knee injury. me
chanisms for these changes are unclear. The low serum concentration of
COMP makes it less likely that there is any significant 'exchange' of
molecular markers between the knees. A further consequence of these f
indings is that the contralateral knee cannot be recommended as the on
ly control joint in studies of matrix metabolism in patients with unil
ateral knee injury.