Biochemical markers of bone turnover in aseptic loosening in hip arthroplasty

Abstract

The aim of this study was to determine the diagnostic value of systemic biochemical markers of bone turnover in aseptic loosening in hip arthroplasty, namely the urine levels of three bone resorption peptides -crosslinked n-telopeptides (NTX), c-telopeptides (CTX I) and deoxypyridinoline (DPD). We compared 52 patients with surgically proven component loosening with 52 patients without clinical or radiological signs of endoprosthetic loosening and 52 healthy individuals. All three markers were measured using commercially available enzyme-linked immunoassays. We found significantly increased levels of DPD in the loosening group (p<0.05), but there was no significant difference between the loosening group and the two reference groups for the other two markers tested. Our data suggest that DPD can be used as an additional tool in the diagnosis of aseptic loosening in hip arthroplasty but CTX I and NTX have no predictive value in this context. Résumé Le but de cette étude est de déterminer la valeur diagnostic de marqueurs bio-chimiques dans le descellement aseptique des prothèses totales de hanche, en mesurant un certain nombre peptides issus de la résorption osseuse (crosslinked n-telpeptides [NTX], c-telpepetides [CTX I] et deoxypyridinoline [DPD]. nous avons comparé les paramètres de 52 individus présentant un descellement aseptique à 52 individus sains. Tous les paramètres ont été mesurés par la méthode ELISA. nous avons trouvé une augmentation significative des DPD dans le groupe prothèses descellées (p<0.05). Il n'y a pas de différence significative entre les deux groupes pour les autres marqueurs. nous suggérons que la DPD peut être utilisée comme un marqueur additionnel du diagnostic des descellements aseptiques des prothèses totales de hanche par contre, il n'y a pas de valeurs prédictives pour les marqueurs CTX1 et NTX.

Particle‐induced osteolysis is not accompanied by systemic remodeling but is reflected by systemic bone biomarkers

“…The elevated peri-implant bone resorption was consistent with the dramatic increases in serum concentrations of CTX-1 and cathepsin K. Previous studies of CTX-1 reported variable ability to discriminate between patients with stable and patients with loosened implants, [21][22][23] while cathepsin K has not been studied as a biomarker for osteolysis. Interestingly, we found no difference in the concentration of TRAP 5b, which contradicts some previous clinical reports.…”

Discovery of biomarkers to identify peri‐implant osteolysis before radiographic diagnosis

“…β-CTX is a commonly measured biomarker of osteoclastic bone resorption used to predict bone mass loss, response to treatment, and risk of osteoporotic fractures 40 . A previous study evaluating the utility of urinary β-CTX as a biomarker of peri-implant osteolysis reported no difference between groups 41 , which is consistent with results in the current study. α-CTX is emerging as a biomarker for osteolysis caused by the skeletal invasion of metastatic cancers, such as breast cancer 27; 28 .…”

Sophocarpine attenuates wear particle‐induced implant loosening by inhibiting osteoclastogenesis and bone resorptionviasuppression of the NF‐κB signalling pathway in a rat model

“…As wear-induced peri-implant osteolysis is a long-term process of net bone resorption that precedes aseptic loosening in the clinic, we chose to sample at 12 weeks of SPC administration in order to observe osteoclasts. Elevated levels of serum CTX-1, a biomarker of bone resorption, have been reported in patients with loosened implants, as compared to those with stable implants (Wilkinson et al, 2003;Streich et al, 2009), which corroborates our results. Moreover, we found that elevated levels of serum CTX-1 were reduced by SPC.…”