BIOCHEMICAL SERUM BONE MARKERS AND TOTAL HIP REPLACEMENT

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 骨溶解和无菌性松动是全髋关节置换术长期失败的主要原因。据报道，骨溶解最早发生在植入后12个月，但其表现形式多种多样。最初，患者没有临床症状，尽管有放射学证据表明假体周围有骨丢失。或者，骨溶解最初可能表现为疼痛，提示松动和严重的骨丢失。无菌性松动的诊断通常基于临床表现和放射学评估。然而，关于辐射透射线的意义还没有达成一致意见。此外，传统的X光片被证明低估了骨丢失的量。计算机断层扫描和数字射线照相并没有被证明有很大的价值。骨扫描可能有帮助，但特异性较低。磁共振成像已经被证明在临床上对颗粒性疾病患者是有效的，与传统的X线片相比，它显示出更好的髋臼周围骨丢失的检测。骨转换生化标记物已成为治疗骨病(骨质疏松症、软骨病、原发性和继发性甲状旁腺功能亢进症)的重要临床工具。近年来，骨标志物在敏感性和特异性方面有了很大的提高。在不同的骨吸收标记物中，I型胶原的降解产物被证明特别有用。本研究建议测量围手术期和术后患者的骨标记物。此外，这项研究还将对相同的患者进行MRI评估，并将骨标记物与MRI表现相关联。

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.