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Biomarker May Prove Useful for Diagnosing Knee Injury

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Researchers from Stanford University School of Medicine recently discovered a biomarker that may enable doctors to diagnose a common form of knee injury. The study, published in the Journal of Bone and Joint Surgery, has identified a specific protein complex in the knee fluid of patients with painful meniscal tears.

The menisci are cartilaginous tissues that provide structural integrity to the knee when it undergoes tension and torsion. Meniscal tears are painful and often accompanied by swelling and stiffness. Often, a torn meniscus can be treated with rest; some patients have to undergo arthroscopic surgery to trim away or repair the cartilage. However, sometimes it’s difficult for doctors to determine whether patient’s knee pain stems from a meniscal tear, joint arthritis or another type of leg injury.

A team of researchers led by Gaetano Scuderi, MD, clinical assistant professor of orthopaedic surgery at Stanford University School of Medicine and an orthopaedic surgeon at Stanford Hospital & Clinics, studied 30 patients with knee pain, mechanical symptoms and MRI findings that were positive for meniscal tear. All the patients chose arthroscopic partial meniscectomy after unsuccessful nonoperative management.

At the time of surgery, synovial fluid was aspirated and assayed by ELISA for a protein complex identified from an earlier study of patients with torn menisci and knee pain: a fibronectin-aggrecan complex. The results were compared with knee aspirates from ten asymptomatic volunteers with no pain who underwent magnetic resonance imaging of the knee. The researchers found an over 400-fold increase in fibronectin-aggrecan complex in the knee fluid of patients with a meniscal tear.

According to Raymond Golish, MD, PhD, co-author of the study:

The challenge is not identifying molecular markers of cartilage degeneration, dozens of which are now known. The difficulty is in finding markers that correlate with painful injuries, as opposed to age-related degeneration that is painless. This study is a big step in that direction.

The researchers are now running experiments to confirm that the fibronectin-aggrecan complex is not a biomarker for other types of knee injuries. They also are studying whether the protein complex, which is implicated in knee inflammation, could serve as a therapeutic target

Study: Identification of a Novel Fibronectin-Aggrecan Complex in the Synovial Fluid of Knees with Painful Meniscal Injury

Source: Stanford School of Medicine