Yoshitani Junya, Ekhtiari Seper, Dulleston Joseph, Malviya Ajay, Khanduja Vikas
Young Adult Hip Service, Department of Trauma and Orthopaedics Addenbrooke's - Cambridge University Hospitals NHS Foundation Trust Cambridge UK.
School of Clinical Medicine University of Cambridge Cambridge UK.
J Exp Orthop. 2025 Sep 22;12(3):e70417. doi: 10.1002/jeo2.70417. eCollection 2025 Jul.
Early diagnosis of femoroacetabular impingement syndrome (FAIS) is essential. This systematic review aimed to identify biomarkers useful for diagnosing FAIS and predicting its progression to hip osteoarthritis. Our hypothesis was that there are biomarkers that are useful for the diagnosis and/or prognosis of FAIS. Our research questions were: (1) which biomarkers support diagnosis or screening of FAIS? and (2) which biomarkers predict disease progression?
A systematic review using the PRISMA guidelines was conducted to investigate the relationship between biomarkers and FAIS. The diagnosis of FAIS was based on the criteria used in each original study, typically involving clinical symptoms and radiographic evidence of CAM or pincer morphology. The protocol for the review has been published in PROSPERO. Literature search was performed using three databases: Embase, MEDLINE and Cochrane Library. The initial search yielded 683 articles of which 16 articles were included for final analysis. Data from a total of 2134 participants were analysed. Sixty-eight unique biomarkers associated with FAIS were identified and measured.
Diagnostically, 19 biomarkers were identified, of which 12 could significantly detect a difference between patients with FAIS and healthy controls. Forty-two biomarkers predicting the association of FAIS with hip osteoarthritis or late FAIS were identified, of which 16 biomarkers were statistically significant. Only 4-aminobutyrate aminotransferase promoter (ABAT) and peroxisome proliferator-activated receptor gamma (PPARγ) were associated with both diagnosis and prognosis.
Biomarkers may support the diagnosis and monitoring disease progression in patients with FAIS. Twelve biomarkers may detect early changes, and 16 may predict progression to osteoarthritis. Further refinement is required to identify those most useful in clinical practice. ABAT and PPARγ may be linked to both diagnosis and progression. While primarily preclinical, these findings may improve diagnostic accuracy, reduce overtreatment and aid decisions regarding joint preservation strategies.
Level III.
早期诊断股骨髋臼撞击综合征（FAIS）至关重要。本系统评价旨在确定有助于诊断FAIS并预测其发展为髋骨关节炎的生物标志物。我们的假设是存在对FAIS的诊断和/或预后有用的生物标志物。我们的研究问题是：（1）哪些生物标志物支持FAIS的诊断或筛查？（2）哪些生物标志物可预测疾病进展？
采用PRISMA指南进行系统评价，以研究生物标志物与FAIS之间的关系。FAIS的诊断基于每项原始研究中使用的标准，通常包括临床症状以及CAM或钳夹形态的影像学证据。该评价方案已在国际前瞻性系统评价注册库（PROSPERO）中发表。使用三个数据库进行文献检索：Embase、MEDLINE和Cochrane图书馆。初步检索得到683篇文章，其中16篇文章纳入最终分析。共分析了来自2134名参与者的数据。确定并测量了68种与FAIS相关的独特生物标志物。
在诊断方面，确定了19种生物标志物，其中12种能够显著检测出FAIS患者与健康对照之间的差异。确定了42种预测FAIS与髋骨关节炎或晚期FAIS关联的生物标志物，其中16种生物标志物具有统计学意义。只有4-氨基丁酸转氨酶启动子（ABAT）和过氧化物酶体增殖物激活受体γ（PPARγ）与诊断和预后均相关。
生物标志物可能有助于FAIS患者的诊断和疾病进展监测。12种生物标志物可能检测到早期变化，16种可能预测发展为骨关节炎。需要进一步完善以确定在临床实践中最有用的生物标志物。ABAT和PPARγ可能与诊断和进展均相关。虽然主要是临床前研究，但这些发现可能提高诊断准确性、减少过度治疗并有助于制定关节保留策略的决策。
三级。
