BIOCHEMICAL SERUM BONE MARKERS AND TOTAL HIP REPLACEMENT

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Osteolysis and aseptic loosening are related processes which constitute the primary cause of long-term failure of total hip arthroplasty. Osteolysis has been reported to occur as early as 12 months after implantation, but its presentation can be very variable. Initially, patients have no clinical symptoms despite radiographic evidence of periprosthetic bone loss. Alternatively, osteolysis may present initially with pain that is suggestive of loosening and severe bone loss. The diagnosis of aseptic loosening is usually based on clinical presentation and radiographic evaluation. However, there is no agreement about the significance of radiolucent lines. Furthermore, conventional radiographs have been shown to underestimate the amount of bone loss. Computed tomography and digital radiographs have not been shown to be of great value. Bone scan can be helpful but the specificity is low. Magnetic resonance imaging has been shown to be clinically efficacious in a cohort of patients with particle disease, demonstrating superior detection of periacetabular bone loss compared to conventional radiographs. Biochemical markers of bone turnover have been important clinical tools in management of patients with bone diseases (osteoporosis, rickets and osteomalacia, primary and secondary hyperparathyroidism). Bone markers have improved in sensitivity and specificity in recent years. Among the different bone resorption markers, degradation products of type I collagen have proved particularly useful. This study proposes to measure the bone markers in patients perioperatively and postoperatively. Also this study is going to evaluate the same patients with MRI and to correlate the bone markers with MRI findings.