Top

International Orthopaedics

Published in:

01-06-2013 | Original Paper

Multiple biomarkers analysis for the early detection of prosthetic aseptic loosening of hip arthroplasty

Authors: Tao He, Wen Wu, Yan Huang, Xiaoling Zhang, Tingting Tang, Kerong Dai

Published in: International Orthopaedics | Issue 6/2013

Abstract

Purpose

Our aim was to define the effect of multiple biomarkers of osteolysis or bone remodelling in the early detection of aseptic loosening (AL) of total hip arthroplasty (THA).

Method

One hundred subjects were recruited, including 31 candidates for revision THA (Late AL group), 15 patients who had undergone THA and had clinical and radiographic evidence of AL (early AL group), 19 patients with no sign of AL (stable group), and 40 healthy volunteers. Plasma levels of osteoprotegerin (OPG), receptor activator of nuclear factor-kappaB ligand (RANKL), cross-linked N-terminal telopeptide (NTX), procollagen I C-terminal extension peptide (PICP), tumour necrosis factor-alpha (TNF-α), and interleukin (IL)-1β1 were measured using an immunoenzymatic method. The outcomes of biomarkers were analysed separately and synthetically using Revman software.

Results

The plasma level of OPG, RANKL, NTX, TNF-α, and IL-1β declined from late AL, early AL, stable to the healthy group, while the level of PICP inclined reversely. There was a significant difference in synthetic analysis of six biomarkers between the AL group and the stable group, and between the stable group and the healthy group (both p = 0.02). Heterogeneity of six biomarkers in either comparison was extremely low (both I² =0). Patients who had cemented implants had significantly higher levels of TNF-α than patients with cementless varieties (p = 0.042).

Conclusion

There was significant change in the plasma level of multiple biomarkers in patients with prosthetic AL of THA, especially in the cemented arthroplasties and in patients without traditional clinical or radiographic evidence of AL.

Malchau H, Herberts P, Ahnfelt L (1993) Prognosis of total hip replacement in Sweden: follow-up of 92,675 operations performed 1978–1990. Acta Orthop Scand 64:497–506PubMedCrossRef

Purdue PE, Koulouvaris P, Potter HG (2007) The cellular and molecular biology of periprosthetic osteolysis. Clin Orthop Relat Res 454(1):251–261PubMedCrossRef

Hernigou P, Intrator L, Bahrami T et al (1999) Interleukin-6 in the blood of patients with total hip arthroplasty without loosening. Clin Orthop Relat Res 366:147–154PubMedCrossRef

Hundrić-Haspl Z, Pecina M, Haspl M et al (2006) Plasma cytokines as markers of aseptic prosthesis loosening. Clin Orthop Relat Res 453(12):299–304PubMedCrossRef

Granchi D, Pellacani A, Spina M et al (2006) Serum levels of osteoprotegerin and receptor activator of nuclear factor-kappaB ligand as markers of periprosthetic osteolysis. J Bone Joint Surg Am 88(7):1501–1509PubMedCrossRef

Savarino L, Granchi D, Cenni E et al (2005) Systemic cross-linked N-terminal telopeptide and procollagen I C-terminal extension peptide as markers of bone turnover after total hip arthroplasty. J Bone Joint Surg Br 87-B:571–576CrossRef

Li MG, Thorsen K, Nilsson KG (2004) Increased bone turnover as reflected by biochemical markers in patients with potentially unstable fixation of the tibial component. Arch Orthop Trauma Surg 124:404–409PubMedCrossRef

Lavernia CJ, Alcerro JC (2011) Quality of life and cost-effectiveness 1 year after total hip arthroplasty. J Arthroplasty 26(5):705–709PubMedCrossRef

Gruen TA, McNeice GM, Amstutz HC (1979) “Modest of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop 141:17–27PubMed

10.

Delee JG, Charnley J (1976) Radiological demarcation of cemented sockets in total hip replacement. Clin Orhop 121:20–32

11.

Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty: an end result study using a new method of evaluation. J Bone Joint Surg Am 51-A:737–755

12.

TNC Centre (2011) Review manager (RevMan), 5.1 for Windows edn. The Cochrane Collaboration, Copenhagen

13.

Schmidt-Rohlfing B, Thomsen M, Niedhart C et al (2002) Correlation of bone and cartilage markers in the synovial fluid with the degree of osteoarthritis. Rheumatol Int 21:193–199PubMedCrossRef

14.

Li YL, Wang L, Li J, Huang Y et al (2011) The correlation between uric acid and the incidence and prognosis of kidney diseases: a systematic review and meta-analysis of cohort studies. Chin J Intern Med 50:555–561

15.

Mertens MT, Singh JA (2011) Biomarkers in arthroplasty: A systematic review. Open Orthop J 5:92–105PubMedCrossRef

16.

Savarino L, Avnet S, Greco M (2010) Potential role of tartrate-resistant acid phosphatase 5b (TRACP 5b) as a surrogate marker of late loosening in patients with total hip arthroplasty: a cohort study. J Orthop Res 28(7):887–892PubMed

17.

Schwarz EM, Lu AP, Goater JJ et al (2000) Tumor necrosis factor alfa/nuclear transcription factor-kappa B signaling in periprosthetic osteolysis. J Orthop Res 18:472–480PubMedCrossRef

18.

Sipniewska G, Lis K, Bilinski PJ (2002) Bone turnover markers and cytokines in joint fluid: analyses in 10 patients with loose hip prosthesis and 39 with coxarthrosis. Acta Orthop Scand 73:518–522CrossRef

19.

Urban RL, Shanbhag AS, Lee SH et al (1996) Particulate-induced, prostaglandin and cytokine mediated bone resorption in an experimental system and failed joint replacements. Am J Ther 3:27–41PubMedCrossRef

20.

Lassus J, Salo J, Jiranek WA et al (1998) Macrophage activation results in bone resorption. Clin Orthop Relat Res 352:7–15PubMedCrossRef

21.

van der Heide HJ, van der Kraan PM, Rijnberg WJ et al (2010) Elevated levels of numerous cytokines in drainage fluid after primary total hip arthroplasty. Int Orthop 34:1099–1102PubMedCrossRef

22.

Takagi M, Santavirta S, Ida H et al (2001) High-turnover periprosthetic bone remodeling and immature bone formation around loose cemented total hip joints. J Bone Miner Res 16:79–88PubMedCrossRef

23.

Arabmotlagh M, Sabljic R, Rittmeister M et al (2006) Changes of the biochemical markers of bone turnover and periprosthetic bone remodeling after cemented hip arthroplasty. J Arthroplasty 21:129–134PubMedCrossRef

24.

Anderson DM, Maraskovsky E, Billingsley WL et al (1997) A homologue of the TNF receptor and its ligand enhance T-cell growth and dendritic-cell function. Nature 390:175–179PubMedCrossRef

25.

Lacey DL, Timms E, Tan HL, Kelley MJ et al (1998) Osteoprotegerin ligand is a cytokine that regulates osteoclast differentiation and activation. Cell 93:165–176PubMedCrossRef

26.

Masui T, Sakano S, Hasegawa Y et al (2005) Expression of inflammatory cytokines, RANKL and OPG induced by titanium, cobalt-chromium and polyethylene particles. Biomaterials 26:1695–1702PubMedCrossRef

27.

Kim KJ, Kotake S, Udagawa N et al (2001) Osteoprotegerin inhibits in vitro mouse osteoclast formation induced by joint fluid from failed total hip arthroplasty. J Biomed Mater Res 58:393–400PubMedCrossRef

28.

Zhou X, Zhang P, Zhang C et al (2010) Promotion of bone formation by naringin in a titanium particle-induced diabetic murine calvarial osteolysis model. J Orthop Res 28(4):451–456PubMed

29.

Kovacik MW, Gradisar IA, Haprian JJ et al (2000) Osteolytic indicators found in total knee arthroplasty synovial fluid aspirates. Clin Orthop Relat Res 379:186–194PubMedCrossRef

30.

Woitge HW, Petchersdorfer M, Li Y et al (1999) Novel serum markers of bone resorption: clinical assessment and comparison of established urinary indices. J Bone Miner Res 14:782–801CrossRef

31.

Shanbhag AS, Kaufman AM, Hayata K et al (2007) Assessing osteolysis with use of high-throughout protein chips. J Bone Joint Surg Am 89:1081–1089PubMedCrossRef

Title: Multiple biomarkers analysis for the early detection of prosthetic aseptic loosening of hip arthroplasty
Authors: Tao He
Wen Wu
Yan Huang
Xiaoling Zhang
Tingting Tang
Kerong Dai
Publication date: 01-06-2013
Publisher: Springer-Verlag
Published in: International Orthopaedics / Issue 6/2013
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-013-1837-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Multiple biomarkers analysis for the early detection of prosthetic aseptic loosening of hip arthroplasty

Abstract

Purpose

Method

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Method

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 6/2013

A minimally invasive approach for total hip arthroplasty does not diminish early post-operative outcome in obese patients: a prospective, randomised trial

Double acetabular wall—a misleading point for hip arthroplasty: an anatomical, radiological, clinical study

Cement augmentation of the navigated iliosacral screw in the treatment of insufficiency fractures of the sacrum. A new method using modified implants

Fresh-stored osteochondral allografts for the treatment of femoral head defects: surgical technique and preliminary results

Modified posterior soft tissue repair for the prevention of early postoperative dislocation in total hip arthroplasty

Effect of implanted bisphosphonate-enriched cement on the trabecular microarchitecture of bone in a rat model using micro-computed tomography