{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T23:58:24Z","timestamp":1792108704376,"version":"4.4.0"},"reference-count":41,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2017,9,11]],"date-time":"2017-09-11T00:00:00Z","timestamp":1505088000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot Ankle Int."],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The study objective was to examine the effect of time and fracture severity on the undiluted synovial fluid (SF) microenvironment during the acute phase following intra-articular fracture (IAF) of the human ankle.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Ankle SF from 54 patients with an acute IAF was analyzed for concentrations of 10 cytokines, 5 matrix metalloproteinases, 2 products of cartilage catabolism, and combined products of heme metabolism. All analytes were correlated with time from fracture and further analyzed for an effect of 3 time subgroups (0-2 days, 3-9 days, and \u226510 days) corresponding to timepoints for clinical ankle fracture interventions. The effect of fracture severity was determined by grouping SF according to the number of radiographic intra-articular fracture lines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Fifteen of 18 analytes were significantly correlated with time. Temporal grouping of SF revealed an initial (0-2 days) spike of pro-inflammatory (IL-12p70, IL-1\u03b2, IL-6) and anti-inflammatory (IL-10 and IL-4) cytokines, matrix metalloproteinases (MMP) MMP-9, and sGAG, followed immediately (3-9 days) by products of heme metabolism and an unchallenged surge in mediators and products of cartilage catabolism (MMP-1, MMP-2, MMP-3, MMP-10, and CTX-II). After 10 days, there was a decrease in pro- and anti-inflammatory cytokines but a persistence of mediators of ECM catabolism. There was no clear relationship between the number of fracture lines and SF levels of analytes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This study demonstrated acute temporal fluctuations following ankle IAF resulting in an overall catabolic environment by 10 days post-fracture and supports consideration of an early evacuation of the joint space to reduce the intra-articular inflammatory burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relavence:<\/jats:title>\n                    <jats:p>This study contributes to the understanding of the intra-articular events that potentially contribute to the development of posttraumatic osteoarthritis acutely following IAF in the ankle.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1071100717728234","type":"journal-article","created":{"date-parts":[[2017,9,11]],"date-time":"2017-09-11T11:05:33Z","timestamp":1505127933000},"page":"1055-1063","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":40,"title":["Time-Dependent Effects on Synovial Fluid Composition During the Acute Phase of Human Intra-articular Ankle Fracture"],"prefix":"10.1177","volume":"38","author":[{"given":"Samuel B.","family":"Adams","sequence":"first","affiliation":[{"name":"Duke University Medical Center, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel M.","family":"Reilly","sequence":"additional","affiliation":[{"name":"Duke University Medical Center, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet L.","family":"Huebner","sequence":"additional","affiliation":[{"name":"Duke University Medical Center, Durham, NC, USA"},{"name":"Duke Molecular Physiology Institute, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia B.","family":"Kraus","sequence":"additional","affiliation":[{"name":"Duke University Medical Center, Durham, NC, USA"},{"name":"Department of Medicine, Division of Rheumatology and Immunology, Duke University, Durham, NC, USA"},{"name":"Duke Molecular Physiology Institute, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana L.","family":"Nettles","sequence":"additional","affiliation":[{"name":"Duke University Medical Center, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,9,11]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100717690427"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100715611176"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100714550652"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/jor.21359"},{"key":"e_1_3_2_6_2","first-page":"46","article-title":"Expedited CT-based methods for evaluating fracture severity to assess risk of post-traumatic osteoarthritis after articular fractures","volume":"36","author":"Anderson DD","year":"2016","unstructured":"Anderson DD, Kilburg AT, Thomas TP, Marsh JL. 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