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. 2013 Nov;41(11):2585-90.
doi: 10.1177/0363546513499308. Epub 2013 Aug 19.

Elevation in circulating biomarkers of cartilage damage and inflammation in athletes with femoroacetabular impingement

Asheesh Bedi  1 , Evan B Lynch, Elizabeth R Sibilsky Enselman, Max E Davis, Paul D Dewolf, Tarek A Makki, Bryan T Kelly, Christopher M Larson, Phillip T Henning, Christopher L Mendias
Affiliations

Elevation in circulating biomarkers of cartilage damage and inflammation in athletes with femoroacetabular impingement

Asheesh Bedi et al. Am J Sports Med. 2013 Nov.

Abstract

Background: Femoroacetabular impingement (FAI) is one of the most common causes of early cartilage and labral damage in the nondysplastic hip. Biomarkers of cartilage degradation and inflammation are associated with osteoarthritis. It was not known whether patients with FAI have elevated levels of biomarkers of cartilage degradation and inflammation.

Hypothesis: Compared with athletes without FAI, athletes with FAI would have elevated levels of the inflammatory C-reactive protein (CRP) and cartilage oligomeric matrix protein (COMP), a cartilage degradation marker.

Study design: Controlled laboratory study.

Methods: Male athletes with radiographically confirmed FAI (n = 10) were compared with male athletes with radiographically normal hips with no evidence of FAI or hip dysplasia (n = 19). Plasma levels of COMP and CRP were measured, and subjects also completed the Short Form-12 (SF-12) and Hip Disability and Osteoarthritis Outcome Score (HOOS) surveys.

Results: Compared with controls, athletes with FAI had a 24% increase in COMP levels and a 276% increase in CRP levels as well as a 22% decrease in SF-12 physical component scores and decreases in all of the HOOS subscale scores.

Conclusion: Athletes with FAI demonstrate early biochemical signs of increased cartilage turnover and systemic inflammation.

Clinical relevance: Chondral injury secondary to the repetitive microtrauma of FAI might be reliably detected with biomarkers. In the future, these biomarkers might be used as screening tools to identify at-risk patients and assess the efficacy of therapeutic interventions such as hip preservation surgery in altering the natural history and progression to osteoarthritis.

Keywords: C-reactive protein; HOOS; SF-12; cartilage oligomeric matrix protein; osteoarthritis.

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Figures

Figure 1
Figure 1. Circulating COMP Levels
Compared with control athletes (FAI-, N=19), athletes with FAI (FAI+, N=10) had an elevation in circulating COMP levels. Values are mean±SD. *, significantly different from FAI- (P<0.05).
Figure 2
Figure 2. Circulating CRP Levels
Compared with control athletes (FAI-, N=19), athletes with FAI (FAI+, N=10) had an elevation in circulating CRP levels. Values are mean±SD. *, significantly different from FAI- (P<0.05).
Figure 3
Figure 3. SF-12 Scores
Compared with control athletes (FAI-, N=19), athletes with FAI (FAI+, N=10) had lower SF-12 PCS scores but no difference in MCS scores. Values are mean±SD. *, significantly different from FAI- (P<0.05).
Figure 4
Figure 4. HOOS Scores
Compared with control athletes (FAI-, N=19), athletes with FAI (FAI+, N=10) had decreased pain, symptoms (Symp), hip related activities of daily living (ADL), sport and recreation (SR) and hip related quality of life (QOL) HOOS subscale values. Values are mean±SD. *, significantly different from FAI- (P<0.05).
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