The Use of Type I Collagen Cross-Linked C-Telopeptide (CTX-1) as a Biomarker Associated with the Formation of Periprosthetic Ossifications Following Total Hip Joint Arthroplasty

The aim of this study was to determine the co-occurrence of heterotopic ossifications (HO) and elevated bone biomarkers level (urine type I collagen cross-linked C-telopeptide - CTX-1, serum alkaline phosphatase - ALP) and assess the effectiveness of pharmacological prophylaxis of HO. The study group consisted of (N=54) patients qualified for total hip arthroplasty. In N=19 (35%) patients new HO were formed (48th week vs to baseline). On baseline, the mean CTX-1 value in the HO (-) patients was 8.60+/-5.37 ug/mmol vs HO (+) 11.73+/-6.02 ug/mmol (p<0,05). On the 5th day after the surgery, the mean value in HO (-) patients was 8.45+/-4.04 ug/mmol vs HO (+)14.46+/- 5.91 ug/mmol (p<0,05). The mean increase in CTX-1 levels in HO (+) patients' vs HO (-) compared to the initial value was 21% vs 47%. Correlation between CTX-1 concentration on the 5th day and the appearance of new ossifications (r=0.48, p<0.05) was demonstrated. In group covered by prophylaxis diclofenac 150 mg for 6 weeks, HO assessment in Brooker's scale was on average 0.78 points lower than in the group without prophylaxis and 0.89 points lower than in the group without prophylaxis and no risk factors of HO (p<0,05). The study also reported a correlation between the corrected ALP concentration in the 12th week and HO (r=0.59, p<0.05).