title: Bone turnover markers failed to predict the occurrence of osteonecrosis of the femoral head: a preliminary study.
abstract: BACKGROUND
  The early detection of osteonecrosis of the femoral head (ONFH) is difficult, but important for prevention of destruction of the femoral head. The objective of this study was to determine whether the occurrence of osteonecrosis of the femoral head (ONFH) correlates with changes in bone turnover markers.
  
  
  METHODS
  In 40 patients undergoing primary total hip arthroplasty (THA), different bone turnover markers and hormones (bone specific alkaline phosphatase, osteocalcin, beta cross-laps, 25-hydroxy-cholecalciferol, and parathormone) gained from blood were determined on the morning of the surgery. Twenty-two patients needed a THA due to progressed ONFH. In 18 cases blood was gained from patients with the indication for a THA given due to advanced osteoarthritis (AO) of the hip.
  
  
  RESULTS
  Bone specific alkaline phosphatase, osteocalcin, beta cross-laps, and parathormone did not show any deviation from standard values, neither for the group of osteonecrosis nor for the osteoarthritis group. 25-Hydroxy-cholecalciferol revealed on average decreased values without significant differences between both groups (P < 0.05). The tested bone turnover markers and hormones failed to predict the occurrence of ONFH. Thus, the focus has to be put on different parameters to find a specific parameter that possibly predicts the risk of ostenecrosis and that is suited to follow up ONFH.
authors.affiliation: Department of Orthopaedic Surgery, Hannover Medical School, Hannover, Germany. Thilo.Floerkemeier@ddh-gruppe.de
authors.forename: Thilo
authors.initials: T
authors.lastname: Floerkemeier
authors.forename: Stefanie
authors.initials: S
authors.lastname: Hirsch
authors.forename: Stefan
authors.initials: S
authors.lastname: Budde
authors.forename: Kerstin
authors.initials: K
authors.lastname: Radtke
authors.forename: Fritz
authors.initials: F
authors.lastname: Thorey
authors.forename: Henning
authors.initials: H
authors.lastname: Windhagen
authors.forename: Gabriela
authors.initials: G
authors.lastname: von Lewinski
mesh_terms: D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000378:metabolism; D015415:Biomarkers / Q000097:blood; D016723:Bone Remodeling / Q000502:physiology*; D002112:Calcifediol / Q000097:blood; D005260:Female; D005271:Femur Head Necrosis / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000097:blood / Q000503:physiopathology; D015675:Osteocalcin / Q000097:blood; D010281:Parathyroid Hormone / Q000097:blood; D012016:Reference Values; D055815:Young Adult
chemical_list: D015415:Biomarkers; D010281:Parathyroid Hormone; D015675:Osteocalcin; D000469:Alkaline Phosphatase; D002112:Calcifediol