Levels of chondroitin 4-sulfate, chondroitin 6-sulfate and carboxy- terminal type II procollagen peptide in knee synovial fluid after injury to the anterior cruciate ligament

Changes in the metabolism of articular cartilage associated with injury to the anterior cruciate ligament (ACL) is known to be one of the important factors for the progression to secondary osteoarthritis. To investigate the efficacy of biochemical markers for monitoring the cartilage metabolism after injury to ACL, we measured the levels of chondroitin 4-sulfate (C- 4S), chondroitin 6-sulfate (C-6S) and carboxy-terminal type II procollagen peptide (pCOL II-C) in knee synovial fluid (SF) from the patients with ACL rupture and compared with those in knee osteoarthritis (OA). Within 10 days after ACL, rupture, levels of C-6S and C-4S in SF were significantly higher than those in early stage of OA. Both levels decreased gradually and became to the same levels as those in early stage of OA at 30 days after the injury. In contrast, pCOL II-C levels in SF just after the injury were observed to be lower than those in early stage of OA. Then they increased gradually to the levels of those in early stage of OA at 30 days after the injury. High levels of C-6S and C-4S in SF just after ACL rupture seemed to reflect the increased release of matrix fragments caused by cartilage destruction associated with the injury. pCOL II-C levels in SF seemed to reflect the repairing process that increased slowly after the cartilage destruction. Measurement of these cartilage derived macromolecules in SF could be useful tools for monitoring the metabolism in articular cartilage after injury.