A Prospective Assessment of Periprosthetic Bone Mineral Density and Osteoimmunological Biomarkers Variations After Total Knee Replacement Surgery

Davide Cucchi, Alessandra Menon, Emanuela Galliera, Carmelo Messina, Beatrice Zanini, Monica Gioia Marazzi, Luca Massaccesi, Riccardo Compagnoni, Massimiliano M. Corsi Romanelli, Pietro Randelli

Research output: Contribution to journalArticlepeer-review

Abstract

Aseptic loosening is a major cause of premature failure of total knee replacement (TKR). Variations in periprosthetic bone mineral density (BMD) and osteoimmunological biomarkers levels could help to quantify prosthesis osteointegration and predict early aseptic loosening. The gene expression of 5 selected osteoimmunological biomarkers was evaluated in tibial plateau bone biopsies by real-time polymerase chain reaction and changes in their serum levels after TKR were prospectively evaluated with enzyme-linked immunosorbent assay for 1 yr after surgery. These variations were correlated to changes in periprosthetic BMD. Sixteen patients were evaluated. A statistically significant decrease in serum levels of Sclerostin (p = 0.0135) was observed immediately after surgery. A specular pattern was observed between dickkopf-related protein 1 and osteoprotegerin expression. No statistically significant changes were detectable in the other study biomarkers. Periprosthetic BMD did not change significantly across the duration of the follow-up. Prosthetic knee surgery has an impact on bone remodeling, in particular on sclerostin expression. Although not showing statistically significant changes, in the patterns of dickkopf-related protein 1, osteoprotegerin, and the ligand of the receptor activator of nuclear factor kappa-B symmetries and correspondences related to the biological activities of these proteins could be identified. Variation in osteoimmunological biomarkers after TKR surgery can help in quantifying prosthesis osteointegration.

Original languageEnglish
Pages (from-to)86-95
Number of pages10
JournalJournal of Clinical Densitometry
Volume22
Issue number1
DOIs
Publication statusPublished - 2019

Keywords

  • Biomarker
  • bone mineral density
  • level II
  • osteoimmunology
  • Prospective cohort study
  • sclerostin
  • total knee replacement

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Orthopedics and Sports Medicine
  • Radiology Nuclear Medicine and imaging

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