2025 ISAKOS Biennial Congress ePoster
Day of Surgery Serum MMP-3 Concentration is Independently Associated with Achieving a KOOS4 and IKDC Patient Acceptable Symptom State 6 Years After Anterior Cruciate Ligament Reconstruction.
Lachlan Batty, FRACS, Melbourne, VIC AUSTRALIA
Kate E. Webster, PhD, Bundoora, Victoria AUSTRALIA
Natasha Vasileff, PhD, Canberra, ACT AUSTRALIA
Jereme Spiers, PhD, Canberra AUSTRALIA
Minh Huynh, PhD, Melbourne, Victoria AUSTRALIA
Brian M. Devitt, MD, PhD, FRCS, FRACS, Dublin, Leinster IRELAND
Timothy S. Whitehead, MBBS, FRACS, Richmond, VIC AUSTRALIA
Haydn Klemm, BFSc&Nutr (Hons), Richmond, VIC AUSTRALIA
Julian A. Feller, FRACS, FAOrthA, Melbourne, VIC AUSTRALIA
OrthoSport Victoria, Melbourne, VIC, AUSTRALIA
FDA Status Not Applicable
Summary
Day of surgery serum MMP-3 is independently associated with 6 year PROMS after ACL reconstruction
ePosters will be available shortly before Congress
Abstract
Background
Patient reported outcome measures (PROMs) are an important metric following anterior cruciate ligament (ACL) reconstruction. There is conflicting evidence as to whether select biomarkers may correlate with PROMs after ACL reconstruction. Biomarkers of chondral metabolism correlating with PROMs reflective of post traumatic arthritis symptoms would be of clinical importance.
Hypothesis/Purpose: To assess for an association between three systemic biomarkers of chondral metabolism measured at the time of surgery and achieving a patient acceptable symptom state (PASS) PROM threshold at 6-year post primary ACL reconstruction.
Methods
From a prospective longitudinal study, urine and serum samples were taken immediately prior to primary ACL. 666 patients provided samples (mean age 24.9 years, 60.5% male, mean pre-operative Marx score 12.3). Concentrations of three biomarkers of chondral metabolism, urinary C-terminal cross-linked telopeptide of type II collagen (u-CTX-II), serum N-propeptide of collagen IIA (s-PIIANP) and serum Matrix Metalloproteinase 3 (s-MMP-3) were measured using immunoassays. The International Knee Documentation Committee Subjective Knee Form (IKDC) and Knee Osteoarthritis and Outcome Score 4 (KOOS4) PROM scores were recorded 6 years post operatively. Scores dichotomised based on PASS thresholds. Multivariate logistic regression models were developed with IKDC and KOOS4 PASS as the dependent variable and baseline biomarker concentrations along with 11 other clinical and demographic parameters as predictive variables.
Results
Factors independently associated with not achieving a KOOS4 PASS at the 6-year mark were higher baseline s-MMP-3 (OR 0.98, p=0.006), a worse articular cartilage score at surgery (OR 0.87, p=0.034), higher pre-operative body mass index (BMI) (OR 0.91, p=0.027) and ACL graft rupture (OR 0.35, p=0.007). Factors independently associated with not achieving a IKDC PASS at the 6-year mark were higher baseline s-MMP-3 (OR 0.98, p=0.013), a worse articular cartilage scores at surgery (OR 0.85, p=0.016), higher preoperative BMI (OR 0.90, p=0.012) and an ACL graft rupture (OR 0.27, p=0.001). There was no association between baseline u-CTX-II or baseline s-PIIANP and achieving either the KOOS4 or IKDS PASS threshold at 6 years.
Conclusion
s-MMP-3 as measured on the day of surgery was an independent predictor of failing to achieve the PASS threshold for both the KOOS4 and IKDC PROMs at the 6-year timepoint following ACL reconstruction.