关键词:

膝骨关节炎, 关节置换术, 血清软骨寡聚基质蛋白, Ⅱ型胶原C-端肽, 可溶性血管细胞黏附分子-1, 预后

Abstract:

Objective　To investigate the value of serum levels of cartilage oligomeric matrix protein (COMP), C-terminal telopeptide of type Ⅱ collagen (CTX-Ⅱ), and soluble vascular cell adhesion molecule-1 (sVCAM-1) in the prediction of prognosis of patients with knee osteoarthritis (KOA) after joint arthroplasty. Methods　The clinical data of 120 patients with KOA undergoing joint arthroplasty at Xi'an International Medical Center Hospital from January 2023 to August 2024 were retrospectively analyzed. Among them, there were 71 males and 49 females, with an age of (62.55 ± 5.67) years. All the patients were assessed using the Lysholm Knee Score (LKS). Based on the assessment scores 6 months after the surgery, the patients were divided into a good prognosis group (LKS≥70; 92 cases) and a poor prognosis group (LKS <70; 28 cases). The data were collected and compared between the two groups. Receiver operating characteristic (ROC) curves were plotted, and the areas under the curves (AUC) were calculated to evaluate the predictive values of serum COMP, CTX-Ⅱ, and sVCAM-1 levels for postoperative prognosis. Statistical comparisons were conducted using t and χ² tests. Results　There were no statistical differences between the two groups in the terms of gender, age, body mass index, surgical test, American Society of Anesthesiologists (ASA) grade, Association Research Circulation Osseous (ARCO) stage, history of alcohol consumption, history of smoking, diabetes, and hypertension (all P>0.05). The levels of COMP, CTX-Ⅱ, and sVCAM-1 in the good prognosis group were lower than those in the poor prognosis group [(475.81±74.52) ng/L vs. (523.96±74.14) ng/L, (1 005.21±105.99) ng/L vs. (1 070.12±115.67) ng/L, and (43.17±6.59) nmol/L vs. (72.21±6.96) nmol/L], with statistical differences (all P<0.05). The results of logistic regression analysis showed that COMP≥492.51 ng/L, CTX-Ⅱ≥1 040.02 ng/L, and sVCAM-1≥58.41 nmol/L were the independent risk factors affecting the patients' poor prognosis (all P<0.05). The ROC analysis showed that the AUC's of COMP≥492.51 ng/L, CTX-Ⅱ≥1 040.02 ng/L, and sVCAM-1≥58.41 nmol/L in the prediction the patients' prognosis were 0.825, 0.795, and 0.833,  respectively; the AUC of the combination of the three was 0.924, with a sensitivity of 85.84% and a specificity of 86.48%. Conclusions　The serum levels of COMP, CTX-Ⅱ, and sVCAM-1 are valuable for dynamically assessing prognosis of patients with KOA after joint arthroplasty. Their combination may more effectively predict the poor prognosis.

Key words:

Knee osteoarthritis, Joint arthroplasty, Cartilage oligomeric matrix protein, Type Ⅱ , collagen C-terminal telopeptide, Soluble vascular cell adhesion molecule-1, Prognosis