Serum levels of BMP-2, 4, 7 and AHSG in patients with degenerative joint disease requiring total arthroplasty of the hip and temporomandibular joints

J Orthop Res. 2013 Jan;31(1):44-52. doi: 10.1002/jor.22182. Epub 2012 Jul 9.


To date, there is no objective or reliable means of assessing the severity of degenerative joint disease (DJD) and need for joint replacement surgery. Hence, it is difficult to know when an individual with DJD has reached a point where total arthroplasty is indicated. The purpose of the present study is to determine whether serum levels of Alpha-2 HS-glycoprotein (AHSG) as well as bone morphogenetic proteins (BMP-2, 4, 7) can be used to predict the presence of severe DJD of the hip and/or temporomandibular joint (TMJ) (specifically: joints that require replacement). A total of 30 patients scheduled for arthroplasty (diseased) (15 HIP, 15 TMJ) and 120 age-matched controls (healthy/non-diseased) were included. Blood samples were collected from all patients ≥8 weeks after the last arthroplasty. Concentrations of serum analytes were measured using enzyme-linked immunosorbent assays, and these were compared between the Diseased and Healthy groups, utilizing the Mann-Whitney U-test. Patients with disease had significantly higher levels of BMP-2 and BMP-4 and lower levels of AHSG in serum compared to non-diseased humans (p < 0.01). Higher levels of BMP-2, 4 and reduced levels of AHSG appear to characterize patients who have DJD that is severe enough to require total joint replacement. Perhaps measurements of these proteins can be used to make objective decisions regarding the need for total arthroplasty as opposed to the current subjective approaches.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement
  • Arthroplasty, Replacement, Hip
  • Biomarkers / blood
  • Bone Morphogenetic Protein 2 / blood
  • Bone Morphogenetic Protein 4 / blood
  • Bone Morphogenetic Protein 7 / blood
  • Bone Morphogenetic Proteins / blood*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Osteoarthritis, Hip / blood*
  • Osteoarthritis, Hip / diagnosis*
  • Osteoarthritis, Hip / surgery
  • Predictive Value of Tests
  • Preoperative Care / methods
  • Severity of Illness Index
  • Temporomandibular Joint Disorders / blood*
  • Temporomandibular Joint Disorders / diagnosis*
  • Temporomandibular Joint Disorders / surgery
  • Young Adult
  • alpha-2-HS-Glycoprotein / metabolism*


  • AHSG protein, human
  • BMP2 protein, human
  • BMP4 protein, human
  • BMP7 protein, human
  • Biomarkers
  • Bone Morphogenetic Protein 2
  • Bone Morphogenetic Protein 4
  • Bone Morphogenetic Protein 7
  • Bone Morphogenetic Proteins
  • alpha-2-HS-Glycoprotein