Urinary markers suggests bone problems after hip replacement

Identification of biomarkers for peri‐implant osteolysis before radiographic diagnosis.

X-ray showing lytic area medial wall right acetabulum adjacent to the acetabular cup of a total hip replacement. ?osteolysis ?neoplasia.
X-ray showing lytic area medial wall right acetabulum adjacent to the acetabular cup of a total hip replacement. ?osteolysis ?neoplasia.

Hip replacement surgery is a procedure in which a doctor surgically removes a painful hip joint with arthritis and replaces it with an artificial joint often made from metal and plastic components. It usually is done when all other treatment options have failed to provide adequate pain relief.

In a new study published in the Journal of Orthopaedic Research, scientists have identified urinary markers that differentiate total hip replacement patients who eventually develop bone tissue destruction, or osteolysis, from patients who do not.

Scientists 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.

The levels of certain markers helped the investigators identify patients at risk for osteolysis. Albeit single markers indicated precision, the mix of α-CTX, a bone resorption marker, and IL-6, a provocative marker, prompted high precision in the separation of patients who eventually developed osteolysis from those without any indications of osteolysis.

Senior author Dr. D. Rick Sumner, of Rush University Medical Center, in Chicago said, “We are hopeful that early biomarkers for implant loosening will alert surgeons to be especially vigilant in their follow-up of at-risk patients and may eventually lead to treatments delaying or avoiding the need for revision surgery. Perhaps even more intriguing is that the two biomarkers we identified also differed before surgery among patients who eventually developed peri-implant osteolysis and those who did not, supporting the concept that other researchers have proposed of genetic risk factors for loosening.”