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Objective . Osteoarthritis is a long-term complication of acute articular infections. However, the roles of cartilage and synovia in this process are not yet fully understood.  Methods . Patients with acute joint infections were enrolled in a prospective clinical trial and the cytokine composition of effusions compared in patients with arthroplasty ( n  = 8) or with intact joints ( n  = 67). Cytokines and cell function were also analyzed using a human  in vitro  model of joint infection.  Results . Synovial IL-1 β  levels were significantly higher in patients with arthroplasty ( p  = 0.004). Higher IL-1 β  concentrations were also found in the  in vitro  model without chondrocytes ( p  < 0.05). The anti-inflammatory cytokines IL-4 and IL-10 were consistently expressed  in vivo  and  in vitro , showing no association with the presence of cartilage or chondrocytes. In contrast, FasL levels increased steadily  in vitro , reaching higher levels without chondrocytes ( p  < 0.05). Likewise, the viability of synovial fibroblasts (SFB) during infection was higher in the presence of chondrocytes. The cartilage-metabolism markers aggrecan and bFGF were at higher concentrations in intact joints, but also synthesized by SFB.  Conclusions . Our data suggest an anti-inflammatory effect of cartilage associated with the SFBs' increased resistance to infections, which displayed the ability to effectively synthesize cartilage metabolites.The trial is registered with DRKS  00003536 , MISSinG.

Clinical Trial andIn VitroStudy for the Role of Cartilage and Synovia in Acute Articular Infection