title: Multiple biomarkers analysis for the early detection of prosthetic aseptic loosening of hip arthroplasty.
abstract: OBJECTIVE
  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).
  
  
  METHODS
  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 I(2) =0). Patients who had cemented implants had significantly higher levels of TNF-α than patients with cementless varieties (p = 0.042).
  
  
  CONCLUSIONS
  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.
authors: Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedics, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China. minglun1012@126.com
authors: Tao
authors: T
authors: He
authors: Wen
authors: W
authors: Wu
authors: Yan
authors: Y
authors: Huang
authors: Xiaoling
authors: X
authors: Zhang
authors: Tingting
authors: T
authors: Tang
authors: Kerong
authors: K
authors: Dai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D015415:Biomarkers / Q000097:blood; D016723:Bone Remodeling / Q000502:physiology; D016022:Case-Control Studies; D024042:Collagen Type I / Q000097:blood; D042241:Early Diagnosis; D005260:Female; D005271:Femur Head Necrosis / Q000601:surgery*; D006617:Hip Dislocation / Q000601:surgery*; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D053583:Interleukin-1beta / Q000097:blood; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery*; D010014:Osteolysis / Q000097:blood; D053244:Osteoprotegerin / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D010455:Peptides / Q000097:blood; D011347:Procollagen / Q000097:blood; D011475:Prosthesis Failure; D053245:RANK Ligand / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D015415:Biomarkers; D024042:Collagen Type I; D053583:Interleukin-1beta; D053244:Osteoprotegerin; D010446:Peptide Fragments; D010455:Peptides; D011347:Procollagen; D053245:RANK Ligand; D014409:Tumor Necrosis Factor-alpha; C052929:collagen type I trimeric cross-linked peptide; C042813:procollagen type I carboxy terminal peptide