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Uncoupling of bone turnover following hip replacement.
H Whitson1, D DeMarco, D Reilly
1Department of Medicine, Duke University Medical Center, Durham, NC, USA.
Calcified Tissue International
|August 30, 2002
Summary
Total hip replacement surgery reduces bone formation markers serum osteocalcin (OC) and serum bone-specific alkaline phosphatase (BSAP) significantly. Bone resorption markers (NTx) did not change, suggesting uncoupled bone turnover and potential bone loss after hip surgery.
Area of Science:
- Orthopedics
- Biochemistry
- Bone Metabolism
Background:
- Total hip replacement surgery is a model for acute hip injury.
- Proximal femur bone mineral density decreases 6-18% within 6 months post-surgery.
Purpose of the Study:
- To investigate the acute biochemical mechanisms driving bone loss post-hip replacement.
- To analyze changes in bone formation and resorption markers.
Main Methods:
- Measured serum osteocalcin (OC) and serum bone-specific alkaline phosphatase (BSAP) as bone formation indicators.
- Measured urine and serum N-telopeptide cross-linked collagen type 1 (NTx) as bone resorption indicators.
- Assessed 20 patients before and 1-2 days after hip replacement surgery.
Main Results:
- Serum OC decreased by 57.3% and BSAP by 27.6% post-surgery (P <0.001).
- Urine NTx and serum NTx levels showed no significant change after surgery.
- Bone mass remained unchanged at 6 months post-surgery compared to baseline.
Conclusions:
- Hip replacement surgery leads to uncoupled bone turnover, with reduced bone formation and unchanged resorption.
- This imbalance may contribute to post-surgical bone loss.
- Further long-term studies are required to evaluate sustained bone mass changes.