Purpose
To evaluate the efficacy of selective interleukin (IL)-1 inhibitor therapy in the
reduction of posttraumatic osteoarthritis (PTOA) progression following knee ligament
or meniscal injury.
Methods
A systematic review was conducted evaluating the disease-modifying efficacy of selective
IL-1 inhibition in the setting of knee PTOA.
Results
The literature search identified 364 articles and 11 studies were included (n = 10
preclinical, n = 1 clinical). Drug delivery in preclinical studies was administered
using IL-1Ra–encoded helper-dependent adenovirus particles (n = 3), synovial cells
transfected with an IL-1Ra–encoded retroviral vector (n = 3), or varying chemical
compositions of nonviral microcapsule gene carriers (n = 4). Intervention with selective
IL-1 inhibitor therapy within 2 weeks of injury provided the greatest protective benefits
in reducing the progression of PTOA regardless of drug delivery methodology in preclinical
models. The majority of studies reported significantly better cartilage integrity
and reduction in lesion size in animals treated with gene therapy with the greatest
effects seen in those treated within 5 to 7 days of injury.
Conclusions
Early intervention with selective IL-1 inhibitor therapy were effective in reducing
proinflammatory IL-1β levels in the acute and subacute phases following traumatic
knee injury in preclinical animal model studies, while significantly reducing cartilage
damage, lesion size, and PTOA progression at short-term follow-up. However, it was
found that the effect of these therapies diminished over time.
Clinical Relevance
Acute, intra-articular injection of selective IL-1 inhibitors may reduce PTOA progression,
supporting the need for additional basic and clinical investigation.
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Article info
Publication history
Published online: February 18, 2022
Accepted:
February 4,
2022
Received:
July 23,
2021
Footnotes
The authors report the following potential conflicts of interest or sources of funding: J.F.D. reports other from Supreme Orthopedic Systems, Arthrex, and Smith & Nephew, outside the submitted work. R.F.L. receives royalties from Arthrex and Smith & Nephew; is a paid consultant for Arthrex, Ossur, and Smith & Nephew; receives research support from Arthrex, Linvatec, Ossur, and Smith & Nephew; is on the editorial/governing board for AJSM and KSSTA; and has committee/member appointments for AOSSM, ISAKOS, AANA, and ESSKA. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2022 Published by Elsevier on behalf of the Arthroscopy Association of North America
