Synovial biomarkers in the diagnosis of post-traumatic osteoarthritis following anterior cruciate ligament and meniscus injuries: protocol for a systematic review

Introduction This review aims to synthesise research evidence regarding biomarkers in the synovial fluid that may predict the risk of post-traumatic osteoarthritis (PTOA) in young adults. Considering the high prevalence of knee joint injuries, particularly among youth sports athletes, this review wi...

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Main Authors: Helena Donato, Fernando Fonseca, João Pedro Oliveira, João Castro Mendes, José Casanova, Alexandrina Ferreira Mendes
Format: Article
Language:English
Published: BMJ Publishing Group 2025-01-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/1/e090225.full
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author Helena Donato
Fernando Fonseca
João Pedro Oliveira
João Castro Mendes
José Casanova
Alexandrina Ferreira Mendes
author_facet Helena Donato
Fernando Fonseca
João Pedro Oliveira
João Castro Mendes
José Casanova
Alexandrina Ferreira Mendes
author_sort Helena Donato
collection DOAJ
description Introduction This review aims to synthesise research evidence regarding biomarkers in the synovial fluid that may predict the risk of post-traumatic osteoarthritis (PTOA) in young adults. Considering the high prevalence of knee joint injuries, particularly among youth sports athletes, this review will focus on anterior cruciate ligament and/or meniscal ruptures. These injuries are highly associated with PTOA, with studies indicating that even with surgical reconstruction, 50%–80% of affected individuals develop knee PTOA within a 10-year follow-up.Methods and analysis The results of this systematic review will be reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Diagnostic Test Accuracy guidelines. Comprehensive electronic searches will be conducted across five platforms: four bibliographic databases (PubMed, Cochrane Central Register of Controlled Trials, Web of Science Core Collection and Embase) and ClinicalTrials.gov registry. These searches will use combinations of predefined keywords, such as “knee”, “synovial fluid”, “post-traumatic osteoarthritis”, “anterior cruciate ligament”, “meniscus”, “trauma”, “inflammation” and “biomarker”. We will include randomised clinical trials, non-randomised prospective or retrospective clinical studies, case controls, cohort studies and case series, ranging from database inception to 30 June 2024 and published in English. Two independent reviewers will screen and evaluate the retrieved studies to determine their eligibility. Any reviewer disagreements will be resolved through discussion and consensus or, if necessary, by consultation with a third reviewer. The data will be extracted from the included studies and analysed, with the risk of bias assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. A narrative synthesis will be performed to evaluate the strength and consistency of the findings, considering both the methodological quality of the included studies and the reliability of the results.Ethics and dissemination Ethical approval is not required for this review as it is a secondary study based on public and published data. The findings from this work will be submitted for publication in a peer-reviewed journal and presented at relevant academic conferences. Any amendments to the protocol arising from deviations during the study’s execution will be documented and reported in the final publication.PROSPERO registration number CRD42024534272.
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spelling doaj-art-f33735bf297b40ffa0ec644c49a74c222025-01-31T00:35:10ZengBMJ Publishing GroupBMJ Open2044-60552025-01-0115110.1136/bmjopen-2024-090225Synovial biomarkers in the diagnosis of post-traumatic osteoarthritis following anterior cruciate ligament and meniscus injuries: protocol for a systematic reviewHelena Donato0Fernando Fonseca1João Pedro Oliveira2João Castro Mendes3José Casanova4Alexandrina Ferreira Mendes56 Documentation and Scientific Information Service, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal1 Orthopaedic Department, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal1 Orthopaedic Department, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal1 Orthopaedic Department, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal1 Orthopaedic Department, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal3 University of Coimbra Center for Neuroscience and Cell Biology, Coimbra, PortugalIntroduction This review aims to synthesise research evidence regarding biomarkers in the synovial fluid that may predict the risk of post-traumatic osteoarthritis (PTOA) in young adults. Considering the high prevalence of knee joint injuries, particularly among youth sports athletes, this review will focus on anterior cruciate ligament and/or meniscal ruptures. These injuries are highly associated with PTOA, with studies indicating that even with surgical reconstruction, 50%–80% of affected individuals develop knee PTOA within a 10-year follow-up.Methods and analysis The results of this systematic review will be reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Diagnostic Test Accuracy guidelines. Comprehensive electronic searches will be conducted across five platforms: four bibliographic databases (PubMed, Cochrane Central Register of Controlled Trials, Web of Science Core Collection and Embase) and ClinicalTrials.gov registry. These searches will use combinations of predefined keywords, such as “knee”, “synovial fluid”, “post-traumatic osteoarthritis”, “anterior cruciate ligament”, “meniscus”, “trauma”, “inflammation” and “biomarker”. We will include randomised clinical trials, non-randomised prospective or retrospective clinical studies, case controls, cohort studies and case series, ranging from database inception to 30 June 2024 and published in English. Two independent reviewers will screen and evaluate the retrieved studies to determine their eligibility. Any reviewer disagreements will be resolved through discussion and consensus or, if necessary, by consultation with a third reviewer. The data will be extracted from the included studies and analysed, with the risk of bias assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. A narrative synthesis will be performed to evaluate the strength and consistency of the findings, considering both the methodological quality of the included studies and the reliability of the results.Ethics and dissemination Ethical approval is not required for this review as it is a secondary study based on public and published data. The findings from this work will be submitted for publication in a peer-reviewed journal and presented at relevant academic conferences. Any amendments to the protocol arising from deviations during the study’s execution will be documented and reported in the final publication.PROSPERO registration number CRD42024534272.https://bmjopen.bmj.com/content/15/1/e090225.full
spellingShingle Helena Donato
Fernando Fonseca
João Pedro Oliveira
João Castro Mendes
José Casanova
Alexandrina Ferreira Mendes
Synovial biomarkers in the diagnosis of post-traumatic osteoarthritis following anterior cruciate ligament and meniscus injuries: protocol for a systematic review
BMJ Open
title Synovial biomarkers in the diagnosis of post-traumatic osteoarthritis following anterior cruciate ligament and meniscus injuries: protocol for a systematic review
title_full Synovial biomarkers in the diagnosis of post-traumatic osteoarthritis following anterior cruciate ligament and meniscus injuries: protocol for a systematic review
title_fullStr Synovial biomarkers in the diagnosis of post-traumatic osteoarthritis following anterior cruciate ligament and meniscus injuries: protocol for a systematic review
title_full_unstemmed Synovial biomarkers in the diagnosis of post-traumatic osteoarthritis following anterior cruciate ligament and meniscus injuries: protocol for a systematic review
title_short Synovial biomarkers in the diagnosis of post-traumatic osteoarthritis following anterior cruciate ligament and meniscus injuries: protocol for a systematic review
title_sort synovial biomarkers in the diagnosis of post traumatic osteoarthritis following anterior cruciate ligament and meniscus injuries protocol for a systematic review
url https://bmjopen.bmj.com/content/15/1/e090225.full
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