Gene Variations Linked to Hip Replacement Failure

Vitamin D receptor, protease gene variants associated with adverse outcome

THURSDAY, March 15 (HealthDay News) -- The long-term survival of a hip replacement may be adversely influenced by genes encoding the vitamin D receptor and a protease involved in breaking down substances such as collagen, according to a study published online March 15 in the Annals of the Rheumatic Diseases.

M. Hammad A. Malik, from the University of Manchester in the United Kingdom, and colleagues examined single-nucleotide polymorphisms (SNPs) in the genes for matrix metalloproteinase-1 (MMP-1), interleukin-6 (IL-6), and vitamin D receptor in 312 patients who had undergone total hip arthroplasty. Of these, 91 had early aseptic loosening, 71 had deep sepsis, and the remaining 150 were asymptomatic with no radiographic signs of loosening over 10 years after surgery.

The researchers found a strong association between aseptic loosening and the C allele of MMP-1 (odds ratio, 3.27) as well as the C/C genotype. There was also a strong association between osteolysis due to deep infection and the T allele of the vitamin D receptor (odds ratio, 1.76) as well as the T/T genotype. There was no association between outcomes and variations in the IL-6 gene, according to the study.

"Aseptic loosening and possibly deep infection of total hip replacement may be due to the genetic influence of candidate susceptibility genes," Malik and colleagues conclude. "SNP markers may serve as predictors of implant survival and aid in pharmacogenomic prevention of total hip replacement failure."

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