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Cell Adhesion Molecule Identifies Osteoarthritis Patients Requiring Joint Replacement

A study found that high levels of vascular cell adhesion molecule 1 (VCAM-1) in the blood predicts patients with osteoarthritis who are at increased risk for requiring hip or knee joint replacement.

According to the study, patients with highest VCAM-1 tertile had four times more risk to undergo joint replacement in the future than patients in the lowest tertile (p < 0.001). Multivariate analysis proved that high VCAM-1 levels independently predict severe disease.

The current study is the first to establish a laboratory marker for the risk of severe osteoarthritis in a long-term prospective population-based study, Dr. Georg Schett, from the University of Erlangen-Nuremberg, Germany, and co-researchers state.

Unlike most other common diseases, they add, little is known about the etiology of osteoarthritis, and predictors of a severe disease course remain to be identified.

The Bruneck cohort study, a prospective, population-based survey conducted from 1990 to 2005 provided data to support the findings. Total 60 patients underwent joint replacement during follow-up and 852 who did not.

Joint replacement rates for patients in the lowest VCAM-1 tertiles was 1.9 and for intermediate, and highest VCAM-1 tertiles were 4.2, and 10.1 per 1000 person-years, respectively.

An association between VCAM-1 levels and joint replacement risk was consistent across patient subgroups and in various sensitivity analyses. Moreover, adding VCAM-1 to a predictive model that included age, gender, and body mass index further increased risk assessment.

The authors suggested for further research to determine how VCAM-1 levels relate to the osteoarthritis disease process and to validate the current findings before possible implementation into clinical practice.