Biomarkers for early diagnosis of aseptic loosening after total hip replacement

Numbers of patients are suffering from aseptic loosening after total hip replacement, which can need further revision surgery. Particle-induced osteolysis has been considered as a major cause of aseptic loosening after hip joint replacement. This is a prospective study, and there are 82 patients of unilateral osseous arthritis and 10 normal physical examination people in our hospital for this study. The participants were divided into four groups, including control group, No arthroplasty group, joint replacement group and loosened THA group. The osteoclasts cell morphology and osteoclast activity were observed by using the microscopy. The mRNA levels of MCP-1, TNF and RANKL were detected by using the Quantitative reverse transcriptase-polymerase chain reaction (RT-PCR). The results indicated that the bone erosion rates of the joint replacement respectively reached 12.9% and 31.6% after cultured 14 d and 21 d, compare with control, which was remarkably increased (P<0.05). The bone erosion rates of loosened THA also reached 43.4% and 88.4%, respectively, after cultured 14 d and 21 d, compare with control, which remarkably increased (P<0.01). The loosened THA group of expression level of MCP-1 gene were much higher than joint replacement. Expression level of RANKL gene of loosened THA group was higher 7.4 times than joint replacement. In conclusion, the osteoclast morphology and activity in the peripheral blood and expression levels of MCP-1 can be used for early diagnosis of aseptic loosening after total hip replacement.