Changes in the Immunomodulatory Properties of Adipose Stromal Cells Due to Hemarthrosis After Knee Injury

Radboud University Medical Center20 enrolled

Overview

The goal of this observational study is to gain insight in the natural course of pro-inflammatory factors and hemarthrosis in patients older than 18 with a recent knee trauma. The main question\[s\] it aims to answer are: * What is the natural course of pro-inflammatory factors and hemarthrosis in knee trauma? * What are the effects of inflammation and hemarthrosis on the anti-inflammatory potential of ASC's in order to better determine eligible patients and circumstances for ASC's therapy? Participants will: * undergo blood withdrawal * undergo knee arthrocentesis for synovial fluid sample collection * physical examination * fill out a questionnaire on knee complaints

Recent studies have found an amelioration of post-traumatic osteoarthritis by the use of adipose-derived stromal cells (ASC's) in an experimental animal model. This amelioration was only seen under inflammatory conditions. The presence of hemarthrosis has not been taken into account in the before mentioned animal model, and might have cytotoxic effects on ASC's and aggravate the inflammatory response. The objective of this study is to gain insight in the natural course of pro-inflammatory factors and hemarthrosis and its effects on the anti-inflammatory potential of ASC's in order to better determine eligible patients and circumstances for ASC's therapy. Therefore the investigators designed a pilot study with exploratory analyses in and with synovial fluid in a longitudinal cohort. Our study population will consist of 20 patients, older than 18 years, who sustained a recent knee trauma and are presented to the emergency department.The investigators will gather synovial fluid and blood samples for laboratory analysis perform and physical examination and provide questionnaires for clinical follow-up. The main study endpoint are the anti-inflammatory capacities of ASC's in synovial fluid that contains blood as a result of hemarthrosis after knee injury.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Post-Traumatic Osteoarthritis of Knee

Interventions

knee arthrocentesisPROCEDURE

arthrocentesis of the knee joint to gather a synovial fluid sample

venipuncturePROCEDURE

Peripheral venipuncture to gather a blood sample

MRI-scanDIAGNOSTIC_TEST

MRI-scan of the knee

Physical examinationDIAGNOSTIC_TEST

Physical examination of the injured knee

KOOS questionnaireOTHER

KOOS questionnaire of the injured knee

Eligibility

Sex: ALLMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Recently suffered an injury of the index knee (rotational or hyperextension) * A swollen joint * Inability to mobilise Exclusion Criteria: * Patients with an active inflammatory or infectious comorbid disease (including rheumatic diseases) * Patients using systemic immunosuppressant medication * Patients with a contra-indication for undergoing a MRI-scan (non-compatible implants or claustrophobia for example) * Patients with knee prosthesis * Patients with coagulation disorders * Patients with a history of a cruciate ligament or meniscal injury of the index knee * Patients with a tibiofemoral fracture of the index knee due to current distortion * In case the inclusion of the required amount of patient is reached in one the patient groups, additional patients belonging in the same patient group will not be included in the study

Outcomes

Primary Outcomes

Synovial fluid analysis

Analysis of changes in pro-inflammatory factors, erythrocytes (as measurement for hemarthrosis)

Time frame: Samples are taken at week 1, week 2, week 4, week 6 and week 8 after trauma

Secondary Outcomes

co-culture of synovial fluid with adipose stromal cells

Assessment of changes in cytotoxity of hemarthrosis in synovial fluid on adipose stromal cells

Time frame: samples are taken at week 1, week 2, week 4, week 6 and week 8 after trauma

MRI-imaging

MRI-images to determine post-traumatic changes in the articulate cartilage

Time frame: At inclusion and 1 year after trauma

Physical examination

Assessment of changes in swelling, warmth and appearance of the skin

Time frame: Physical examination at week 1, week 2, week 4, week 6 and week 8 after trauma

Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire

Assessment changes of knee complaints by using the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire, with minimum score of 0 and a maximum score of 100 and a higher score meaning a better outcome.

Time frame: Questionnaires are taken at week 1, week 2, week 4, week 6 and week 8 after trauma