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Clinical Trial
. 2010 Jul 29:11:170.
doi: 10.1186/1471-2474-11-170.

Association between expression of the bone morphogenetic proteins 2 and 7 in the repair of circumscribed cartilage lesions with clinical outcome

Hagen Schmal  1 , Philipp Niemeyer, Jörn Zwingmann, Fabian Stoffel, Norbert P Südkamp, Alexander T Mehlhorn
Affiliations
Clinical Trial

Association between expression of the bone morphogenetic proteins 2 and 7 in the repair of circumscribed cartilage lesions with clinical outcome

Hagen Schmal et al. BMC Musculoskelet Disord. .

Abstract

Background: Although there is much known about the role of BMPs in cartilage metabolism reliable data about the in vivo regulation in natural and surgically induced cartilage repair are still missing.

Methods: Lavage fluids of knee joints of 47 patients were collected during surgical therapy. 5 patients had no cartilage lesion and served as a control group, the other 42 patients with circumscribed cartilage defects were treated by microfracturing (19) or by an Autologous Chondrocyte Implantation (23). The concentrations of BMP-2 and BMP-7 were determined by ELISA. The clinical status was evaluated using the IKDC Score prior to and 1 year following the operation.

Results: High level expression in the control group was found for BMP-2, concentrations of BMP-7 remained below detection levels. No statistical differences could be detected in concentrations of BMP-2 or BMP-7 in the lavage fluids of knees with cartilage lesions compared to the control group. Levels of BMP-7 did not change after surgical cartilage repair, whereas concentrations of BMP-2 statistically significant increased after the intervention (p < 0.001). The clinical outcome following cartilage regenerating surgery increased after 1 year by 29% (p < 0.001). The difference of the IKDC score after 1 year and prior to the operation was used to quantify the degree of improvement following surgery. This difference statistically significant correlated with initial BMP-2 (R = 0.554, p < 0.001) but not BMP-7 (R = 0.031, n.s.) levels in the knee joints.

Conclusions: BMP-2 seems to play an important role in surgically induced cartilage repair; synovial expression correlates with the clinical outcome.

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Figures

Figure 1
Figure 1
BMP-2 Course. BMP-2 content in lavage fluids of knee joints without cartilage lesions (control, n = 5), with cartilage damage (n = 42), following cartilage surgery at day 1 (n = 28) post operation (po), and following cartilage surgery at day 2 (n = 6) post operation. Groups were compared as indicated by the connecting lines, significance levels are specified.
Figure 2
Figure 2
BMP-7 Course. BMP-7 content in lavage fluids of knee joints without cartilage lesions (control, n = 5), with cartilage damage (n = 42), following cartilage surgery at day 1 (n = 28) post operation (po), and following cartilage surgery at day 2 (n = 6) post operation. Groups were compared as indicated by the connecting lines, significance levels are specified.
Figure 3
Figure 3
Association BMP-2 and IKDC Score. Significant positive correlation between differences of the IKDC Score evaluated initially and after 1 year and initial intraarticular BMP-2 concentrations in all patients undergoing ACI or microfracturing (R = 0.554, p < 0.001)
See this image and copyright information in PMC

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