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

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

doi:10.1007/s00264-013-1837-1

Cited by 22 publications

(18 citation statements)

References 32 publications

(44 reference statements)

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“…Therefore, it is not surprising to find increased accuracy when combining a marker of bone resorption, α-CTX, and one of inflammation, IL-6, compared to either marker alone. He et al 37 similarly found that the combination of six biomarkers, including markers associated with both bone resorption and inflammation showed larger between-group differences at the time of diagnosis compared to any single biomarker alone. In the current study, we found that the combination of α-CTX and IL-6 provided diagnostic accuracy comparable to a panel of seven biomarkers.…”

Section: Discussionmentioning

confidence: 99%

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

Ross¹,

Deng

Fang

et al. 2018

Journal Orthopaedic Research

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Peri-implant osteolysis is commonly diagnosed after substantial bone loss has occurred, making revision surgery more challenging. The goal of the current study was to identify urinary biomarkers that differentiate total hip replacement patients who eventually develop osteolysis from patients who do not. We used a repository of 24-h urine samples collected prior to surgery and annually thereafter in 26 patients, 16 who developed osteolysis, and 10 who did not. We examined the markers at radiographic diagnosis, annually for 6 years preceding diagnosis, at the first post-operative sampling point, and pre-operatively. Patients in the osteolysis and non-osteolysis groups were matched according to time post-surgery and did not differ in the male:female ratio or age at surgery. Seven candidate biomarkers were measured, including free deoxypyridinoline (DPD), cross-linked N-telopeptides (NTX), interleukin-6 (IL-6), interleukin-8 (IL-8), osteoprotegerin (OPG), α-crosslaps (α-CTX), and β-crosslaps (β-CTX). As an individual biomarker, DPD demonstrated the highest ability to predict osteolysis, with an area under the curve (AUC) in Receiver Operating Characteristic (ROC) analyses of 0.844 at 6 years prior to diagnosis. A panel of α-CTX and IL-6 was able to identify at-risk patients with an AUC of 0.941 or greater at all post-operative time points and an AUC of 1.000 pre-operatively. The results demonstrate the potential of using non-invasive biomarkers to identify patients at risk for peri-implant osteolysis long before the emergence of radiographic signs. Further, the high accuracy of the pre-operative biomarker levels demonstrates the potential importance of pre-existing, patient-specific factors driving subsequent osteolysis. Study Design © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2754-2761, 2018.

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Section: Discussionmentioning

confidence: 99%

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

Ross¹,

Deng

Fang

et al. 2018

Journal Orthopaedic Research

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“…[26]- [31] and differentiation into bone resorbing cells [24] [32] [44]. Development of simple and reliable biomarkers to identify those patients who are at high risks for developing AL is important for the early therapeutic intervention to potentially extend the longevity of the prosthesis [9].…”

Section: Discussionmentioning

confidence: 99%

“…It is unclear why some patients develop AL/osteolysis while others do not. It is not currently possible to identify patients who are at risk of AL progression at a stage where the "end result" can be reversed [9] [10]. Therefore, the development of biomarkers that could predict or assess the risk of early implant failure and bone loss is clinically important [11].…”

Section: Introductionmentioning

confidence: 99%

CD16<sup>+</sup> Monocyte Subsets in Patients with Total Joint Arthroplasty

Markel¹,

Jackson²,

Flynn³

et al. 2017

OJO

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“…This makes sense from a theoretical point of view given that implant failure is likely a highly multifactorial disorder involving multiple cell types and signaling pathways as well as significant contributions from host genetic factors. The value of biomarker panels is highlighted by the article by He et al [10] that showed increased capacity of combined analysis of several biomarkers over each biomarker considered in isolation. This promising study suggests that future studies focusing on panels should be emphasized.…”

Section: Discussionmentioning

confidence: 99%

“…These authors also found that osteocalcin (OC) was elevated at 12 months in the patients with potentially unstable implants, but procollagen I C-terminal propeptide (PICP) was not different between the two groups. Using a unique statistical approach in which a panel of markers was studied, He et al [10] compared serum levels of interleukin-1b (IL1b), crosslinked n-telopeptide of type I collagen (NTx), osteoprotegerin (OPG), PICP, receptor activator of nuclear factor kappa-B ligand (RANKL), and tumor necrosis factora (TNF-a) among patients with late aseptic loosening, early aseptic loosening, and stable implants. Although none of the individual markers showed between-group differences, a statistical analysis in which all six markers were included showed a difference between patients with late aseptic loosening and those with stable implants and a nearly significant difference between patients with early aseptic loosening and patients with stable implants.…”

Section: Search Strategy and Criteriamentioning

confidence: 99%

Are There Biological Markers for Wear or Corrosion? A Systematic Review

Sumner

Ross

Purdue

2014

Clin Orthop Relat Res

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Background Identification of biomarkers associated with wear and tribocorrosion in joint arthroplasty would be helpful to enhance early detection of aseptic loosening and/ or osteolysis and to improve understanding of disease progression. There have been several new reports since the last systematic review (which covered research through mid-2008) justifying a new assessment. Questions/purposes We sought to determine which biomarkers have the most promise for early diagnosis and monitoring of aseptic loosening and/or osteolysis related to wear or corrosion in total joint arthroplasty. Methods We performed a systematic review using MED-LINE and EMBASE databases, covering the period through December 2013, and identified 1050 articles. We restricted the definition of biomarker to biomolecules and imaging parameters useful for diagnosis and monitoring of disease progression, only including articles in English. We chose 65 articles for full review, including 44 from the original search and 21 from subsequent hand searches. We used the 22 articles in which patients with total joint arthroplasty who had aseptic loosening and/or periimplant osteolysis unrelated to sepsis had been compared with patients with total joint arthroplasty with stable implants. There were 90 comparisons of these two patient populations involving 35 different biomarkers. Results Diagnostic accuracy was assessed in nine of the 90 comparisons with the highest accuracy found for tartrateresistant acid phosphatase 5b (0.96), although a separate comparison for this biomarker found a lower accuracy (0.76). Accuracy of [ 0.80 was also found for crosslinked n-telopeptide of type I collagen, osteoprotegerin, and deoxypyridinoline. The most studied markers, tumor necrosis factor-a and interleukin-1b, were found to differ in the affected and control groups in\30% of the comparisons. Thirty of the 35 biomarkers were studied in four or fewer separate comparisons with nearly half of the biomarkers (17) studied in only one comparison. Many of the comparisons were not able to eliminate a number of confounding variables, and there was only one prospective study. Conclusions Currently, there are no validated biomarkers for early diagnosis and monitoring of the biological sequelae of wear or tribocorrosion, although there are some promising leads, including markers of bone turnover.

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

Cited by 22 publications

References 32 publications

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

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

CD16<sup>+</sup> Monocyte Subsets in Patients with Total Joint Arthroplasty

Are There Biological Markers for Wear or Corrosion? A Systematic Review

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

Cited by 22 publications

References 32 publications

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

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

CD16&lt;sup&gt;+&lt;/sup&gt; Monocyte Subsets in Patients with Total Joint Arthroplasty

Are There Biological Markers for Wear or Corrosion? A Systematic Review

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CD16<sup>+</sup> Monocyte Subsets in Patients with Total Joint Arthroplasty