Abstract:

Objective To detect the expression levels of urokinase-type plasminogen activator(uPA)，matrix metalloproteinase-3 (MMP-3),MMP-9,MMP-13 and
MMP-14 in the patients with osteoarthritis(OA) before and after arthroscopic debridement,and to explore the influence of arthroscopic debridement in the expressions of uPA,MMP-3,MMP-9,MMP-13,and MMP-14.Methods 420 cases of synovial fluid from knee OA patients undergoing arthroscopic debridement  were obtained before operation.After six months follow-up,350 cases of synovial fluid samples were obtained and according to inclusion and exclusion criteria,228 synovial fluid were selected to analyze.The expression levels of uPA,MMP-3,MMP-9,MMP-13, and MMP-14 were measured by ELISA assay.Pain intensity of these patients before operation and  six months after operation were recorded using the Visual Analogue Scale/Score(VAS).The differences of the expression levels of uPA,MMP-3,MMP-9,MMP-13,and MMP-14 between before operation and after operation were compared.The relationship between the expression levels of uPA,and MMP-3,MMP-9,MMP-13,MMP-14 and VAS was analyzed with Spearman analysis.Results All the patients were followed up for 36.5 months.Compared with before operation,the expression levels of uPA and MMP-3  in the synovial fluid of the patients  after arthroscopic debridement  were significantly decreased(P<0.01),the expression levels of MMP-9  and  MMP-13 were also decreased (P<0.05）,but  the MMP-14 expression level showed no significant change. The expression levels of  uPA,MMP-3,MMP-9,MMP-13,MMP-14  were positively associated with VAS before arthroscopic debridement r=0.361,r=0.417,r=0.136,r=0.514,r=0.156,P<0.05);uPA and MMP-3 were positively correlated with VAS  after arthroscopic debridement（r=0.981，r=0.831，P<0.01），as well as the expression level of MMP-13 and VAS,but there were no significant differences between the expression levels of MMP-9,MMP-14 and VAS.Conclusion The decreased levels of uPA, MMP-3 and MMP-13 in synovial fluid may contribute to the pain-relief effects of arthroscopic debridement.
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Key words:  osteoarthritis, arthroscopic debridement, urokinase-type plasminogen activator, matrix metalloproteinase, pain