Skip to main content

Research Repository

Advanced Search

ADAMTS-4 activity in synovial fluid as a biomarker of inflammation and effusion

Roberts, S.; Evans, H.; Wright, K.; van Niekerk, L.; Caterson, B.; Richardson, J.B.; Kumar, K.H.S.; Kuiper, J.H.

ADAMTS-4 activity in synovial fluid as a biomarker of inflammation and effusion Thumbnail


S. Roberts

H. Evans

L. van Niekerk

B. Caterson

J.B. Richardson

K.H.S. Kumar


To evaluate the potential of ADAMTS-4 (aggrecanase -1) activity in synovial fluid (SF) as a biomarker of knee injury and joint disease.

We have measured ADAMTS-4 activity in the synovial fluid of 170 orthopaedic patients with different degrees of joint pathology, using a commercial ADAMTS-4 fluorescence resonance energy transfer (FRET) substrate assay. Patients were classified at arthroscopy as (i) macroscopically normal, (ii) with an injury of the meniscus, anterior cruciate ligament or chondral/osteochondral defects or (iii) with osteoarthritis, and the influence of independent factors (age, patient group, effusion and synovial inflammation) on ADAMTS-4 activity levels was assessed.

In most patients (106/170) ADAMTS-4 activity was undetectable; ADAMTS-4 ranged from 0 to 2.8 ng/mL in synovial fluid from patients with an injury, 0–4.1 ng/mL in osteoarthritic patients and 4.0–12.3 ng/mL in patients with large effusions. Four independent variables each significantly influenced ADAMTS-4 activity in synovial fluid (all P < 0.001): age (concordance = 0.69), presence of osteoarthritis (OA) (concordance = 0.66), level of effusion (concordance = 0.78) and inflammation (concordance = 0.68). Not only did effusion influence the amount of ADAMTS-4 activity most strongly, but it also did this in an ordered manner (P < 0.001).

The main finding of this study is that ADAMTS-4 levels in synovial fluid are most strongly correlated with inflammation and severity of effusion in the knee. Further study is required to determine if it could provide a useful tool to aid clinical diagnoses, indicate treatment, to monitor progression of joint degeneration or OA or alternatively the success of treatment.


Roberts, S., Evans, H., Wright, K., van Niekerk, L., Caterson, B., Richardson, J., …Kuiper, J. (2015). ADAMTS-4 activity in synovial fluid as a biomarker of inflammation and effusion. Osteoarthritis and Cartilage, 23(9), 1622-1626.

Journal Article Type Article
Acceptance Date May 12, 2015
Online Publication Date May 21, 2015
Publication Date Sep 1, 2015
Publicly Available Date May 26, 2023
Journal Osteoarthritis and Cartilage
Print ISSN 1063-4584
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 23
Issue 9
Pages 1622-1626
Keywords ADAMTS-4 activity, Synovial fluid, Inflammation, Effusion, Knee osteoarthritis
Publisher URL


You might also like

Downloadable Citations