Researchers from the University of Missouri School of Medicine have developed panels of protein biomarkers present in teens and young adults that distinguish individuals with healthy hips from those with developmental dysplasia of the hip, also known as hip dysplasia, which often progresses to hip osteoarthritis if not recognized before early adulthood.
The researchers tested standard blood and urine samples for the presence of targeted protein biomarkers and discovered that specific protein combinations were consistently different between patients with hip dysplasia when compared to age-matched individuals with healthy hips. Clinical application of these tests could enable early and accurate diagnosis for this common hip ailment. This would be a major improvement over current diagnostic methods and allow for implementation of optimal prevention and treatment strategies that could help some patients avoid hip replacement surgery later in life.
“The results from this study suggest that these biomarker panels could be further developed into routine lab tests that help physicians accurately identify patients with hip dysplasia so that nonsurgical and surgical joint preservation treatments can be implemented when they are most effective,” said senior author James Cook, DVM, PhD, William & Kathryn Allen Distinguished Chair in Orthopaedic Surgery and director of the Thompson Laboratory for Regenerative Orthopaedics. “Further optimization of these biomarker panels could result in highly effective tools that significantly decrease the number of patients who suffer from debilitating hip osteoarthritis as they age.”
The researchers collected blood and urine samples from 13-to-34-year-old patients with physician confirmed developmental dysplasia of the hip along with a control group of 13-to 34-year-old volunteers with healthy hips. Panels including serum and urine biomarkers differentiated the two groups with high degrees of sensitivity and specificity.
The biomarker differences between the two groups suggest that hips with developmental dysplasia before the onset of osteoarthritis of the hip are mechanistically distinct from healthy hips in terms of inflammatory and joint remodeling processes that typically lead to osteoarthritis if left untreated.
Osteoarthritis is the primary reason that patients opt for total hip replacement surgery.
“The potential to screen young individuals at-risk for hip problems could aid nonsurgical treatment interventions earlier in life rather than developing arthritis,” said Brett Crist, MD, professor of Orthopaedic Surgery. “Based upon the ease of sample collection, this panel could be readily incorporated into clinical practice as a screening tool for future risk of hip problems.”
Along with Cook and Crist, the research team included Preston Wolfe, PhD, Aaron Stoker, PhD, Emily Leary, PhD and Chantelle Bozynski, DVM, MSc, DACVP, of the Thompson Laboratory for Regenerative Orthopaedics at the University of Missouri.
“Evaluation of Serum and Urine Biomarker Panels for Development Dysplasia of the Hip before Onset of Secondary Osteoarthritis” was recently published in Cartilage. The study was approved by the University of Missouri Institutional Review Board and informed consent was documented for all patients involved.
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Evaluation of Serum and Urine Biomarker Panels for Developmental Dysplasia of the Hip Prior to Onset of Secondary Osteoarthritis
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The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Preston N. Wolfe is a full-time employee with Arthrex, Inc. • Brett D. Crist is a board or committee member for AO Trauma North America: Board or committee member; receives IP royalties from Globus Medical; is a board or committee member for International Geriatric Fracture Society; is on the editorial or governing board of the Journal of Hip Preservation and Journal of Orthopedic Trauma; is a paid presenter or speaker for KCI; has stock or stock options for Orthopedic Implant Company; is a board or committee member for Orthopedic Trauma Association; is an unpaid consultant for Osteocentric; has stock or stock options for RomTech; is on the editorial or governing board for SLACK Incorporated; receives publishing royalties, financial or material support from Springer; is a paid consultant and receives research support from Synthes. • Aaron M. Stoker receives IP royalties from Musculoskeletal Transplant Foundation • Emily Leary is on the editorial or governing board for JISAKOS and The Journal of Knee Surgery • James L. Cook is a paid consultant, paid presenter or speaker and receives research support from Arthrex, Inc; is a paid consultant for Bioventus; receives research support from the Coulter Foundation; receives research support from DePuy, A Johnson & Johnson company; receives research support from GE Healthcare; is on the editorial or governing board of the Journal of Knee Surgery; receives research support from Merial; is a board or committee member for Midwest Transplant Network; is a board or committee member, receives IP royalties and research support from Musculoskeletal Transplant Foundation; receives research support from National Institutes of Health (NIAMS and NICHD); receives research support from Purina; receives publishing royalties, financial or material support from Thieme; is a paid consultant for Trupanion; and receives research support from the U.S. Department of Defense. Chantelle Bozynski has no conflict of interest(s) to disclose.