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Association of oestrogen receptor gene polymorphism with the long-term results of rotational acetabular osteotomy

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Abstract

Acetabular dysplasia (AD) contributes to the development of osteoarthritis of the hip. A rotational acetabular osteotomy (RAO) is one of the methods of pelvic osteotomy to prevent or treat secondary osteoarthritis of the hip. Although most of the patients that undergo RAO show satisfactory results, some have poor results. This study investigated whether gene polymorphisms of both the vitamin D receptor (VDR) and oestrogen receptor (ER) are involved in both AD and the postoperative results following RAOs. Sixty-four Japanese patients with AD who were treated by an RAO were enrolled in this study (59 women and 5 men, aged 13–59, with an average age of 40.3). Gene polymorphisms of the VDR [ApaI and TaqI restriction fragment length polymorphisms (RFLPs)] and ER (PvuII and XbaI RFLPs) were determined in these patients. The relationship between both the AD and radiographic postoperative changes of the hip joint after an RAO with these gene polymorphisms were examined. The frequencies of ER gene polymorphism coded as pp (RFLP/PvuII) in patients with AD were statistically significantly different (p = .011) from those coded as both PP and Pp. The joint space width narrowed even after RAO in 90% of the patients with the pp gene polymorphism, while it narrowed in only 35% of the patients with either PP or Pp seven years or longer after an RAO. The PvuII polymorphism in the ER gene was associated with the postoperative result of an RAO, while no association was observed between the AD with VDR and ER gene polymorphisms.

Résumé

La dysplasie acétabulaire (AD) contribue à l’apparition d’une arthrose de hanche. L’ostéomie de rotation acétabulaire (RAO) est une des méthodes d’ostéotomie pelvienne pouvant prévenir ou traiter cette arthrose de hanche. Cependant, si la plupart des patients qui ont bénéficié d’une RAO montrent des résultats satisfaisants, certains ont de mauvais résultats. Cette étude a pour but d’analyser l’influence du polymorphisme génique sur le récepteur de la vitamine D (VDR) et sur le récepteur d’oestrogène (ER), afin d’analyser son influence sur la dysplasie acétabulaire et sur les résultats de l’ostéotomie de rotation acétabulaire. Méthode : 64 patients originaires du Japon présentant une dysplasie de hanche ont été traités par une RAO et inclus dans cette étude, 59 ,femmes et 5 hommes âgés de 13 à 59 ans (âge moyen 40,3 ans). Le polymorphisme génique de la VDR (Apa I et Taq I avec diminution de la longueur du bras Apa I et Taq I (RFLPs) sur le récepteur d’oestrogène ER (Pvu II et Xba I RFLPs) ont été analysés. La relation entre dysplasie acétabulaire et les modifications post-opératoires de la hanche après ostéotomie et le polymorphisme génique ont également été étudiées. Résultat : la fréquence du polymorphisme génique du récepteur de l’oestrogène (pp RFLP/Pvu II) chez ces patients présentant une dysplasie acétabulaire est statistiquement et significativement différent des patients codés PP et Pp. L’espace articulaire est souvent diminué après RAO pour 90% des patients présentant un polymorphisme génique avec pp alors qu’il est simplement réduit chez 35% des patients présentant un polymorphisme PP ou Pp 7 ans ou plus après l’ostéotomie. En conclusion, le polymorphisme génique des récepteurs de l’oestrogène PvuII peut être associé avec un bon résultat post-opératoire de RAO, alors qu’aucune relation n’a pu être observée entre la dysplasie acétabulaire et un polymorphisme génique portant sur VDR et ER.

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Acknowledgement

We thank Dr. Koji Akiyama, Dr. Fumiyo Enomoto and Dr. Tomohiko Hirose for their valuable help in data collection. We appreciate Dr. Tsuyoshi Sugamori for his help in statistics. We also give special thanks to Ms. Yumiko Sakurai for her laboratory work.

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The authors declare that they have no conflict of interest.

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Correspondence to Muneaki Ishijima.

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Makoto Yamanka and Muneaki Ishijima contributed equally to this work.

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Yamanaka, M., Ishijima, M., Tokita, A. et al. Association of oestrogen receptor gene polymorphism with the long-term results of rotational acetabular osteotomy. International Orthopaedics (SICOT) 33, 1155–1164 (2009). https://doi.org/10.1007/s00264-009-0730-4

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