Identification of a Novel Fibronectin-Aggrecan Complex in the Synovial Fluid of Knees with Painful Meniscal Injury
Gaetano J. Scuderi, MD; S. Raymond Golish, MD, PhD; Frank F. Cook, MD; Jason M. Cuellar, MD, PhD; Robert P. Bowser, PhD; Lewis S. Hanna, PhD

Abstract

Background: Molecular biomarkers associated with knee pain may be useful as diagnostic modalities, prognostic indicators, and surrogate end points for therapeutic trials. The present study describes a novel complex of fibronectin and aggrecan that is present in the affected knee of patients with pain and meniscal abnormality.

Methods: The present prospective study included thirty patients with knee pain, mechanical symptoms, and magnetic resonance imaging findings that were positive for a meniscal tear who chose arthroscopic partial meniscectomy after unsuccessful nonoperative management. Synovial fluid was aspirated at the time of surgery and was assayed for the fibronectin-aggrecan complex with use of a heterogeneous enzyme-linked immunosorbent assay (ELISA). The results were compared with knee aspirates from ten asymptomatic volunteers with no pain who underwent magnetic resonance imaging of the knee.

Results: The mean optical density (and standard deviation) of the fibronectin-aggrecan complex was significantly greater in synovial fluid from knees undergoing arthroscopic surgery as compared with fluid from asymptomatic controls (13.29 ± 8.48 compared with 0.03 ± 0.09; p < 0.001). The mean age in the study group was significantly greater than in control group (46.0 ± 12.6 compared with 38.5 ± 6.0 years; p = 0.02), but controlling for age did not affect the results. Post hoc, an optical density cutoff value of 0.3 distinguished the study group from the control group with 100% accuracy.

Conclusions: A novel fibronectin-aggrecan complex is present in the synovial fluid of painful knees with meniscal abnormality. The fibronectin-aggrecan complex may prove to be useful as a clinical biomarker or therapeutic target. Further research is warranted to correlate functional outcome after surgery with the fibronectin-aggrecan complex and other cartilage biomarkers.

Level of Evidence: Diagnostic Level IV. See Instructions to Authors for a complete description of levels of evidence.

  • A commentary by Armando F. Vidal, MD, is available at www.jbjs.org/commentary and is linked to the online version of this article.

Footnotes

  • Investigation performed at Jupiter Outpatient Medical Center, Jupiter, Florida

  • Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. One or more of the authors, or a member of his or her immediate family, received, in any one year, payments or other benefits in excess of $10,000 or a commitment or agreement to provide such benefits from a commercial entity (Cytonics, Inc.).


Enter your JBJS login information below.
Please note that your username is the email address you provided when you registered.

List of OpenAthens registered sites, including contact details.