Yamaguchi Ryosuke, Yamamoto Takuaki, Motomura Goro, Ikemura Satoshi, Iwasaki Kenyu, Zhao Garida, Doi Toshio, Iwamoto Yukihide
Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Rheumatology (Oxford). 2014 Dec;53(12):2191-5. doi: 10.1093/rheumatology/keu253. Epub 2014 Jun 23.
The aim of this study was to compare the levels of bone and cartilage metabolism markers in the synovial fluid of the hip joint between patients with secondary OA due to osteonecrosis of the femoral head (ONFH), rapidly destructive arthrosis (RDA) and developmental dysplasia of the hip (DDH).
We studied 70 synovial fluid samples obtained from 57 patients with ONFH (mean age 46 years, 34 males, 23 females), 21 samples obtained from 21 patients with RDA (mean age 70 years, 2 males, 19 females) and 20 samples obtained from 20 patients with DDH (mean age 56 years, 2 males, 18 females). The levels of bone alkaline phosphatase (BAP) and tartrate-resistant acid phosphatase 5b (TRACP-5b), as bone metabolism markers, and matrix metalloproteinase 3 (MMP-3) and keratan sulphate (KS), as cartilage metabolism markers, were analysed.
The levels of BAP, MMP-3 and KS were significantly higher in the ONFH group than in the RDA and DDH groups. The levels of TRACP-5b were highest in the RDA group. The levels of BAP in the ONFH group after the development of osteoarthritic changes were significantly lower than those observed in earlier stages. In comparisons between the samples obtained from each group with a terminal condition, the ONFH samples exhibited significantly higher MMP-3 and KS levels, while the TRACP-5 levels were highest in the RDA group.
The ONFH patients showed a relatively bone formative condition before the osteoarthritic stage and maintained a higher rate of cartilage turnover throughout several stages compared with the RDA and DDH patients. RDA patients were characterized by a significantly high osteoclast activity.
本研究旨在比较股骨头坏死（ONFH）继发骨关节炎、快速破坏性关节病（RDA）和髋关节发育不良（DDH）患者髋关节滑液中骨与软骨代谢标志物的水平。
我们研究了从57例ONFH患者（平均年龄46岁，男性34例，女性23例）获取的70份滑液样本、从21例RDA患者（平均年龄70岁，男性2例，女性19例）获取的21份样本以及从20例DDH患者（平均年龄56岁，男性2例，女性18例）获取的20份样本。分析了作为骨代谢标志物的骨碱性磷酸酶（BAP）和抗酒石酸酸性磷酸酶5b（TRACP-5b）以及作为软骨代谢标志物的基质金属蛋白酶3（MMP-3）和硫酸角质素（KS）的水平。
ONFH组的BAP、MMP-3和KS水平显著高于RDA组和DDH组。TRACP-5b水平在RDA组中最高。骨关节炎改变出现后ONFH组的BAP水平显著低于早期观察到的水平。在对每组终末期样本进行比较时，ONFH样本的MMP-3和KS水平显著更高，而TRACP-5水平在RDA组中最高。
与RDA和DDH患者相比，ONFH患者在骨关节炎阶段之前表现出相对的骨形成状态，并且在几个阶段中软骨周转率均维持较高水平。RDA患者的特征是破骨细胞活性显著较高。
