title: Arthroplasty in veterans: analysis of cartilage, bone, serum, and synovial fluid reveals differences and similarities in osteoarthritis with and without comorbid diabetes.
abstract: Osteoarthritis patients with diabetes who receive total knee arthroplasty are more vulnerable to complications, including aseptic loosening and need for revision surgery. To elucidate mechanisms related to arthroplasty failure in diabetes, we examined serum and synovial fluid markers as well as collagen crosslinks in bone and cartilage of 20 patients (10 with diabetes, 10 controls without) undergoing this procedure. Hemoglobin A1c, body mass index, bone alkaline phosphatase, leptin, osteocalcin, and pyridinium were analyzed along with tissue content of the crosslinks hydroxylysylpyridinoline, lysylpyridinoline, and pentosidine. Pentosidine levels in tissue specimens from diabetic subjects were higher than in control subjects. Osteocalcin levels negatively correlated with hydroxylysylpyridinoline levels in cartilage. Osteocalcin levels also negatively correlated with pentosidine levels in cartilage, but only in subjects with diabetes. This study suggests potential metabolic mechanisms for arthroplasty failure in patients with diabetes.
authors.affiliation: Department of Orthopaedics, University of Colorado School of Medicine, 12800 E. 19th Avenue, Aurora, CO 80045, USA.
authors.forename: Trevor W
authors.initials: TW
authors.lastname: Oren
authors.forename: Sergiu
authors.initials: S
authors.lastname: Botolin
authors.forename: Allison
authors.initials: A
authors.lastname: Williams
authors.forename: Allan
authors.initials: A
authors.lastname: Bucknell
authors.forename: Karen B
authors.initials: KB
authors.lastname: King
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001120:Arginine / Q000031:analogs & derivatives / Q000378:metabolism; D019645:Arthroplasty, Replacement, Knee; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D002356:Cartilage / Q000737:chemistry* / Q000378:metabolism; D016022:Case-Control Studies; D003094:Collagen / Q000378:metabolism; D003120:Colorado / Q000453:epidemiology; D015897:Comorbidity; D003432:Cross-Linking Reagents / Q000378:metabolism; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology / Q000378:metabolism*; D004797:Enzyme-Linked Immunosorbent Assay; D006442:Glycated Hemoglobin / Q000378:metabolism; D017127:Glycation End Products, Advanced / Q000378:metabolism; D006801:Humans; D008239:Lysine / Q000031:analogs & derivatives / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000378:metabolism; D020370:Osteoarthritis, Knee / Q000097:blood / Q000453:epidemiology / Q000378:metabolism* / Q000601:surgery; D011446:Prospective Studies; D013582:Synovial Fluid / Q000737:chemistry* / Q000378:metabolism; D014728:Veterans
chemical_list: D001120:Arginine; D015415:Biomarkers; D003094:Collagen; D003432:Cross-Linking Reagents; D006442:Glycated Hemoglobin; D017127:Glycation End Products, Advanced; D008239:Lysine; C062187:pentosidine