| Objective: To analyze the clinical significance of the expression of TNF-? and MMP-2 in the joint fluid through the investigation of the correlation between VAS scores of bone contusion around the knee joint,the content of TNF-?,MMP-2 in the joint fluid and the BME.Methods:(1)30 patients(30 knees)were admitted to the fifth affiliated(Zhuhai)hospital of Zunyi Medical University from January 2015 to Aguest 2016,and enrolled as experimental group in this study.10 patients with knee soft tissue contusion were selected as the control group and took symptomatic treatment with long-legged plaster external fixation,medicating swelling and pain,physical therapy.(2)According to Lynch bone marrow edema classification criteria,the experimental group was divided into three minor groups: 10 cases of type I,10 cases of type II and 10 cases of type III,and measure the ROIA by siemens MRI software.For the experimental group,the content of TNF-? and MMP-2 were measured through the puncture of the ipsilateral knee and the pain scores are measured by visual analogue scale(VAS)separately at the time of admission,the first month and the third month after the injury respectively.The comparison of the content of TNF-??MMP-2 and VAS scores between the experimental group and the control group was carried out by independent sample t test.(3)The pairwise comparison of TNF-?,MMP-2,VAS scores and ROIA between type I,type II and type ? of bone contusion was analyzed by one-way ANOVA.(4)The changes of TNF-?,MMP-2 and VAS scores in different phases of Type I,II and III bone contusion in the experimental group were analyzed by univariate repeated measurement of variance.(5)The content of TNF-?,MMP-2,VAS score and ROIA in the experimental group was analyzed by linear correlation analysis.(6)The experimental group VAS score as the dependent variable Y,with TNF-? content as independent variable X1,MMP-2 as X2,ROIA as X3 for multiple linear regression analysis.Results:(1)There were no statistically significant differences in the injury causes,sex,age,injury side and post-injury admission time between the two groups(P> 0.05).(2)The content of TNF-? and MMP-2 in the joint fluid of the experimental group were significantly higher than those in the control group(P<0.05),which is of statistical significance while the difference of VAS scores was not statistically significant(P> 0.05).(3)There were no significant statistical differences in the comparison of TNF-?,MMP-2 and VAS scores between type ?,? and ? bone contusion(P> 0.05).ROIA was statistically significant(P<0.05).(4)The content of TNF-?,MMP-2 and VAS scores in the joint fluid were significantly lower than those one month and three months after the injury,and the difference was statistically significant(P<0.05).(5)The results of linear correlation analysis of TNF-?,MMP-2,VAS and ROIA in the experimental group in different periods: the VAS scores in the experimental group was correlated with the content of TNF-? and MMP-2,correlation coefficient r is 0.774,0.419,which was not correlated with the ROIA,correlation coefficient r is-0.027;ROIA was smaller correlated with TNF-? and MMP-2,correlation coefficient r is 0.080,0.056.TNF-? was smaller correlated with MMP-2,correlation coefficient r is 0.254,The results showed that TNFand MMP-2 had no synergistic effect.(6)Multiple linear regression analysis indicate that: the VAS scores in the experimental group was correlated with the content of TNF-? and MMP-2(P<0.05),which was not correlated with the ROIA of bone contusion(P> 0.05).Conclusion:(1)MRI showed BME signal is able to contribute to the clinical diagnosis of bone contusion around the knee joint,but BME are not the cause of knee pain.(2)The VAS scores of patients with bone contusion around knee joint is positively correlated with the content of TNF-? and MMP-2 in synovial fluid. |
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