Thank you very much. And thank you to everyone here at AOSSM for giving us the opportunity to present our research. All of our disclosures are available on the Academy website. So prior work from our group at NYU has evaluated the intraarticular inflammatory response to meniscus injury and described the changes in the synovial fluid cytokine profile relative to the patient's asymptomatic contralateral knee. As we all know, the outcomes following partial meniscectomy can be extremely variable, particularly in those with non-acute degenerative tears. It's possible that understanding the inflammatory process associated with meniscus pathology may help identify patients who are likely to respond favorably to surgical intervention in the form of an arthroscopic meniscectomy. So the purpose of the current study was to evaluate the association between the intraarticular inflammatory environment at the time of surgery and intermediate term outcomes after partial meniscectomy. The primary outcomes of interest were change in VAS pain score and Lysome knee score relative to the patient's preoperative baseline. This is a retrospective analysis of our prospectively collected synovial fluid database at NYU. Patients who underwent arthroscopic partial meniscectomy were included in the analysis. Synovial fluid was aspirated from the operative knee on the day of surgery immediately prior to the surgical incision. And the concentrations of select cytokines, chemokines, and growth factors were measured using ELISA. Patient reported outcome scores including VAS pain score and Lysome knee score were obtained both preoperatively and at a minimum of two years after surgery. The cohort included 50 patients with a mean age of 51 years. There was a relatively even split between patients who presented with an acute traumatic meniscus tear and those who had non-acute degenerative tears. The mean follow-up time for this study was just over five and a half years after surgery. We created two separate multivariable linear models, one for change in VAS pain score from preoperative baseline to intermediate term follow-up and the other for change in Lysome score. The models included several covariates to account for the effects of age, sex, BMI, smoking status, the duration of symptoms to the time of surgery, the underlying mechanism, and the amount of existing knee arthritis based on KL grade. We found that an increased level of the pro-inflammatory Rantes, also known as CCL5, in the synovial fluid at the time of surgery was associated with increased knee pain at the time of follow-up relative to the preoperative baseline. Similarly, a decreased level of interleukin-1 receptor antagonist and therefore increased levels of IL-1 activity were associated with worse improvement in Lysome score relative to baseline. And an increased level of matrix metalloproteinase-3 was associated with both with worse pain and worse function relative to baseline. These findings are consistent with our prior clinical studies and animal models that have shown that MMP3 and interleukin-1 are key players in post-traumatic cartilage degradation. So data from the current study provides early evidence that intra-articular cytokines measured at the time of surgery are associated with pain and knee function at an average of five years following an arthroscopic partial meniscectomy. These results suggest that synovial fluid biomarker analysis can potentially be used to predict patient response to surgical treatment, aiding in the selection of appropriate candidates for operative intervention. We continue to work at refining our models and validating their predicted performance in the sports medicine patients that we treat. Thank you all.

intraarticular inflammatory environment

synovial fluid

cytokines

pain and function

surgical treatment