Mylène Jansen

Osteophyte formation after KJD and HTO 361 17 baseline, increasing with 0.2 points (95%CI -0.6 to 0.9; p= 0.653). As the biomarkers were not normally distributed, they were log transformed. In case of negative change values, the log transformation of the absolute change was subtracted from zero. Two patients did not have biomarker results after treatment, and 1 patient did not have a baseline value for TGF β -1 only, leaving 14 patients for TGF β -1 analysis and 15 patients for IL-6 analysis. Both biomarkers showed statistically significant changes during the distraction period, as shown previously 24 : TGF β -1 (1527.9 (SD 3346.8) to 8027.9 (10534.8) pg/mL; p< 0.001); IL-6 (24.4 (31.3) to 466.3 (936.4) pg/mL; p= 0.011). There was no apparent association between baseline values of these biomarkers and the baseline total Altman osteophyte score, or between the changes in these parameters (all p≥0.28; Supplementary Table S4). Trichotomization of patients in groups with a decrease (n=5), no change (n=3) or increase (n=6 for TGF β -1; n=7 for IL-6) in total Altman osteophyte score showed there was a statistically significant difference in changes in analyte levels during treatment between the 3 groups for TGF β -1 ( p= 0.044), but not for IL-6 ( p= 0.898), as shown in Figure 4. Figure 4 : Box plots for the changes in synovial fluid concentrations over the course of 6 weeks of knee joint distraction, of (A) transforming growth factor- β 1 (TGF- β 1) and (B) interleukin-6 (IL-6), categorized into groups of patients with a decrease (n=5), no change (n=3) or increase (n=6 for TGF β -1; n=7 for IL-6) in total Altman osteophyte score. The bar represents the median, whiskers represent the minimum and maximum value, the + represents the mean.