BALTIMORE — In a study recently presented at the American Orthopaedic Society for Sports Medicine Annual Meeting 2012, researchers found that pre-injury levels of key cartilage biomarkers were associated with a risk of future ACL injuries.
“We expected to see post-injury differences in biomarkers, but were astonished that the biomarkers showed measurable differences months or years prior to injury,” U.S. Army Lt. Col. Steven J. Svoboda, MD, stated in a press release. “If we can identify people predisposed to ACL tears, one day we may be able to prevent injuries before they occur.”
The study won the O’Donaghue Sports Injury Research Award at this year’s meeting.
Svoboda and the researchers wanted to find out whether four key biomarkers found pre-injury would signal a tendency toward ACL injury. The biomarkers were C2C, C12C, CPII and CSA46. They conducted a case control study of 45 patients. They obtained informed consent from patients to use their data. They then pulled data from West Point’s Cadet Injury and Illness Tracking System to analyze for previous ACL injuries. They assessed for differences in biomarker levels and conducted univariate and multivariate models to assess for the association between biomarker levels preinjury and later ACL injuries.
The researchers found significant differences in three of the biomarker levels, C2C, C12C and CPII. When conducting the univariate conditional logistical regression model, they found an odds ratio of more than nine for C12C, more than four for C2C, 19 for CPII and less than one for CS846. After multivariate modeling, they found an odds ratio of more than 3 for C2C and 28 for CPII.
One nanogram per milliliter increase in CPII at baseline means a 19 times increased chance of sustaining an ACL injury, Svoboda said. A one nanogram per milliliter increase in C2C at baseline increases the odds of ACL injury 9.1 times. According to the univariate analysis, a one nanogram per milliliter increase in C12C increases the patient odds of ACL injury 4.3 times.
“Pre-injury serum biomarker concentrations for cartilage turnover appear to be associated with subsequent anterior cruciate ligament injury,” Svoboda said during his presentation. – by Renee Blisard Buddle
Svoboda SJ, Owens BD, Harvey T, et al. The association between serum biomarkers of cartilage turnover and subsequent anterior cruciate ligament rupture. Presented at the American Orthopaedic Society for Sports Medicine Annual Meeting 2012. July 12-15. Baltimore.
Disclosure: Svoboda has no relevant financial disclosures.