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Tartrate-resistant acid phosphatase 5b and C-terminal telopeptides of type I collagen as markers for diagnosis of aseptic loosening after total hip replacement

  • Orthopaedic Surgery
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Abstract

Introduction

Plain radiography, bone scintigraphy, digital subtraction arthrography and various other techniques can be used to evaluate loosening of hip replacements. These methods are associated with radiation exposure and some of them have an increased morbidity. Furthermore, in some cases the results are not conclusive.

Method

The osteoclast biomarkers tartrate-resistant acid phosphatase 5b (TRAP 5b) and C-terminal telopeptides of type I collagen (CTX) in serum taken from 12 patients with aseptic loosening were measured. Serum samples from 24 other patients, 12 with an intact arthroplasty and 12 without any kind of joint replacement, served as control groups.

Results

The serum level of CTX was increased in comparison to the control groups, but the differences were not significant. In contrast, the increase in TRAP 5b in patients with aseptic loosening was highly significant (P < 0.001). A TRAP 5b value of 3.365 U/L was determined as a cut-off value, giving a sensitivity of 83.3% and specificity of 91.7% to differentiate the patients with aseptic loosening from those with an intact arthroplasty. Measurement of serum TRAP 5b may be a clinically relevant assay for monitoring patients after arthroplasty.

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References

  1. Silva MJ, Sandell LJ (2002) What’s new in orthopaedic research. J Bone Joint Surg Am 84-A:1490

    PubMed  Google Scholar 

  2. Ozonek W, Bednarek A, Gagala J, Gorecki A, Purski K (2001) Outcome of revision hip arthroplasty. Ortop Traumatol Rehabil 3:48

    CAS  PubMed  Google Scholar 

  3. von Knoch M, Barden B, Saxler G, Loer F (2004) The diagnostic value of digital subtraction arthrography and radionuclide arthrography in revision total hip arthroplasty. Biomed Tech (Berl) 49:351

    Article  Google Scholar 

  4. Temmerman OP, Raijmakers PG, Berkhof J, Hoekstra OS, Teule GJ, Heyligers IC (2005) Accuracy of diagnostic imaging techniques in the diagnosis of aseptic loosening of the femoral component of a hip prosthesis: a meta-analysis. J Bone Joint Surg Br 87:781

    CAS  PubMed  Google Scholar 

  5. Temmerman OP, Raijmakers PG, Berkhof J, David EF, Pijpers R, Molenaar MA, Hoekstra OS, Teule GJ, Heyligers IC (2006) Diagnostic accuracy and interobserver variability of plain radiography, subtraction arthrography, nuclear arthrography, and bone scintigraphy in the assessment of aseptic femoral component loosening. Arch Orthop Trauma Surg 126:316

    Article  PubMed  Google Scholar 

  6. Temmerman OP, Raijmakers PG, Deville WL, Berkhof J, Hooft L, Heyligers IC (2007) The use of plain radiography, subtraction arthrography, nuclear arthrography, and bone scintigraphy in the diagnosis of a loose acetabular component of a total hip prosthesis: a systematic review. J Arthroplasty 22:818

    Article  PubMed  Google Scholar 

  7. Mumme T, Reinartz P, Alfer J, Muller-Rath R, Buell U, Wirtz DC (2005) Diagnostic values of positron emission tomography versus triple-phase bone scan in hip arthroplasty loosening. Arch Orthop Trauma Surg 125:322

    Article  CAS  PubMed  Google Scholar 

  8. Leeming DJ, Koizumi M, Byrjalsen I, Li B, Qvist P, Tanko LB (2006) The relative use of eight collagenous and noncollagenous markers for diagnosis of skeletal metastases in breast, prostate, or lung cancer patients. Cancer Epidemiol Biomarkers Prev 15:32

    Article  CAS  PubMed  Google Scholar 

  9. Pagani F, Francucci CM, Moro L (2005) Markers of bone turnover: biochemical and clinical perspectives. J Endocrinol Invest 28:8

    CAS  PubMed  Google Scholar 

  10. Janckila AJ, Neustadt DH, Nakasato YR, Halleen JM, Hentunen T, Yam LT (2002) Serum tartrate-resistant acid phosphatase isoforms in rheumatoid arthritis. Clin Chim Acta 320:49

    Article  CAS  PubMed  Google Scholar 

  11. Halleen JM, Alatalo SL, Janckila AJ, Woitge HW, Seibel MJ, Vaananen HK (2001) Serum tartrate-resistant acid phosphatase 5b is a specific and sensitive marker of bone resorption. Clin Chem 47:597

    CAS  PubMed  Google Scholar 

  12. Hannon RA, Clowes JA, Eagleton AC, Al Hadari A, Eastell R, Blumsohn A (2004) Clinical performance of immunoreactive tartrate-resistant acid phosphatase isoform 5b as a marker of bone resorption. Bone 34:187

    Article  CAS  PubMed  Google Scholar 

  13. Bjarnason NH, Christiansen C (2000) Early response in biochemical markers predicts long-term response in bone mass during hormone replacement therapy in early postmenopausal women. Bone 26:561

    Article  CAS  PubMed  Google Scholar 

  14. Habermann B, Eberhardt C, Feld M, Zichner L, Kurth AA (2007) Tartrate-resistant acid phosphatase 5b (TRAP 5b) as a marker of osteoclast activity in the early phase after cementless total hip replacement. Acta Orthop 78:221

    Article  PubMed  Google Scholar 

  15. Harris WH, McGann WA (1986) Loosening of the femoral component after use of the medullary-plug cementing technique. Follow-up note with a minimum five-year follow-up. J Bone Joint Surg Am 68:1064

    CAS  PubMed  Google Scholar 

  16. Hodgkinson JP, Shelley P, Wroblewski BM (1988) The correlation between the roentgenographic appearance and operative findings at the bone-cement junction of the socket in Charnley low friction arthroplasties. Clin Orthop Relat Res 228:105

    PubMed  Google Scholar 

  17. McAuley JP, Moore KD, Culpepper WJ 2nd, Engh CA (1998) Total hip arthroplasty with porous-coated prostheses fixed without cement in patients who are sixty-five years of age or older. J Bone Joint Surg Am 80:1648

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedics, University of Duisburg-Essen, Pattbergstrasse 1-3, 45239, Essen, Germany

    Stefan Landgraeber, Franz Löer, Hansjörg Heep, Tim Classen & Marius von Knoch

  2. Institute of Pathology and Neuropathology, University of Duisburg-Essen, Hufelandstrasse 55, 45122, Essen, Germany

    Florian Grabellus & Martin Totsch

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  1. Stefan Landgraeber
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  2. Franz Löer
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  3. Hansjörg Heep
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  4. Tim Classen
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  5. Florian Grabellus
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  6. Martin Totsch
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  7. Marius von Knoch
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Correspondence to Stefan Landgraeber.

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Landgraeber, S., Löer, F., Heep, H. et al. Tartrate-resistant acid phosphatase 5b and C-terminal telopeptides of type I collagen as markers for diagnosis of aseptic loosening after total hip replacement. Arch Orthop Trauma Surg 130, 441–445 (2010). https://doi.org/10.1007/s00402-009-0905-x

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  • DOI: https://doi.org/10.1007/s00402-009-0905-x

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