Synovial fluid concentrations of matrix Metalloproteinase-3 and Interluekin-6 following anterior cruciate ligament injury associate with gait biomechanics 6 months following reconstruction

Objective: To compare gait biomechanics 6 months following anterior cruciate ligament (ACL) reconstruction (ACLR) between patients with the highest and lowest concentrations of synovial fluid (SF) interleukin-6 (IL-6) and matrix metalloproteinase-3 (MMP-3), as well as compared to uninjured controls. Design: SF concentrations of IL-6 and MMP-3 were collected 7 +/- 4 days post injury in 38 ACL injured patients (55% female, 21 +/- 4yrs, 25.3 +/- 5.2BMI). ACL injured individuals were stratified into the lowest and highest quartiles based on IL-6 (IL-6(Lowest) and IL-6(Highest)) and MMP-3 (MMP-3(Lowest) and MMP-3(Highest)) concentrations. Gait biomechanics were collected on the injured limb 6 months post-ACLR and in 38 uninjured controls (50% female, 21 +/- 3yrs, 23.8 +/- 2.8BMI). Functional analyses of variance were used to compare vertical ground reaction force (vGRF), knee flexion angle (KFA), and internal knee extension moment (KEM) waveforms throughout stance phase of gait to determine the proportions of stance differing between limbs and groups. Results: Compared to uninjured controls, IL-6(High) and MMP-3(High) ACL subgroups demonstrated lesser vGRF (largest differences: IL-6, 7.88%BW; MMP-3, 11.05%BW) during early-stance and greater vGRF (largest differences: IL-6, 6.21%BW; MMP-3, 5.85%BW) in mid-stance, lesser KFA (largest differences: IL-6, 3.11 degrees; MMP-3, 3.72 degrees) and lesser KEM (largest differences: IL-6, 0.96%BW.m; MMP-3, 1.07%BW.m) in early-stance, as well as greater KFA in mid-stance (largest differences: IL-6, 1.5 degrees; MMP-3, 2.95 degrees). Conclusions: High SF concentrations of a proinflammatory cytokine and a degradative enzyme early post-ACL injury are associated with aberrant gait biomechanics in the injured limb at 6 months post-ACLR (i.e., lesser vGRF, KFA and KEM) linked to posttraumatic osteoarthritis development. (C) 2021 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Automated summary

The study compared gait biomechanics 6 months post-ACL reconstruction between patients with different concentrations of SF IL-6 and MMP-3, as well as compared to uninjured controls. Patients with higher IL-6 and MMP-3 concentrations post-ACL injury demonstrated aberrant gait biomechanics at 6 months, potentially linked to the development of posttraumatic osteoarthritis.