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Future studies are required
to confirm FAC and COMP application as a diagnostic tool in predicting clinical
responses, evaluating disease severity and predicting long-term OA.
According to the
results of a recent systematic review and meta-analysis, the femoroacetabular
impingement (FAI) and early hip osteoarthritis (OA) can be effectively
diagnosed using the fibronectin-aggrecan complex (FAC) and cartilage oligomeric
matrix protein (COMP).
Early diagnosis and treatment of patients with hip lesions may prevent considerable hip morbidity, and diagnosis can only be made with the help of reliable biomarkers. The present study involved the evaluation of the biomarkers that have been linked with FAI. The study also identified synovial, urinary and serum analytes that have presented clinical efficacy in predicting hip OA.
Cochrane Library, Google Scholar, Web of Science, Scopus, PubMed were searched using the terms - "labral tear," "femoroacetabular impingement," "hip arthroscopy," "osteoarthritis," and "biomarker" and 276 articles were selected. Only seven articles were included after screening. Fixed-effects inverse-variance models weighted for individual study size were used to measure the pooled estimates.
A total of 43
distinctive biomarkers were evaluated. Conflicting trends in arthritic hips
were shown by general pro-inflammatory cytokines IL-1 and TNF-α whereas IL-6
showed a consistent increase. The participants with OA exhibited a considerable
difference in the fibronectin-aggrecan complex (FAC) levels as compared to
controls. Only this specific analyte exhibited a notable difference between
those with and without OA. After adjusting for concurrent knee and hip OA, the
cartilage oligomeric matrix protein (COMP) found to be increased significantly
in athletes in FAI setting. A statistically significant difference was observed
in FAI-positive hips as compared to the controls. CXCL3 showed statistically
notable differences as compared to controls, but did not control for other
factors like concomitant lesions and age. The findings presented that the FAC
and COMP are the potential biomarkers used for early FAI and hip OA diagnosis.
However, additional investigation is required to recognize their capacity in
evaluating disease severity, predicting the treatment response to, and building
a relationship with the risk of long-term OA.
The American Journal of Sports Medicine
Biomarkers for Femoroacetabular Impingement and Hip Osteoarthritis: A Systematic Review and Meta-analysis
T. Sean Lynch et al.
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