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VOLUME 7 , ISSUE 1 ( January-June, 2025 ) > List of Articles

Original Article

Serum C-terminal Telopeptides of Type II Collagen Level Estimation can Identify Early Knee Osteoarthritis

Sudhir Singh, Rajat Khanna, Divyam Jindal

Keywords : Biomarker, C-terminal telopeptides of type II collagen, Cutoff value, K–L grade, Knee osteoarthritis, Osteoarthritis

Citation Information : Singh S, Khanna R, Jindal D. Serum C-terminal Telopeptides of Type II Collagen Level Estimation can Identify Early Knee Osteoarthritis. J Orth Joint Surg 2025; 7 (1):38-42.

DOI: 10.5005/jojs-10079-1198

License: CC BY-NC 4.0

Published Online: 15-01-2025

Copyright Statement:  Copyright © 2025; The Author(s).


Abstract

Aims: This study aimed to examine the usefulness of serum C-terminal cross-linking telopeptide fragments of type II collagen (CTX II) levels to identify the normal population with patients of knee osteoarthritis (KOA) and its utility in identifying the severity of disease in primary KOA. Materials and methods: This research recruited 80 cases of KOA and 80 healthy adults (160 subjects). Patients with primary KOA were graded according to the Kellgren–Lawrence grade (K–L grade), and serum CTX II (sCTX II) values were analyzed. The age, gender, and body mass index (BMI) of the subjects were recorded. Results: The sCTX II value in cases (719.87 ± 256.1 pg/mL) was higher than in controls (419.26 ± 208.18 pg/mL, p < 0.05). The sCTX II value in the case group was significantly higher in males (812.67 ± 289.24) than in females (680.11 ± 236.59). In the control group, males (426.13 ± 221.06) and females (398.66 ± 166.92) had similar values (p = 0.60). The sCTX II level was higher with increasing age, but this difference was significant in the case group only (p = 0.003). Multivariate analysis revealed that the sCTX II level was dependent only on the severity of the disease. Analysis of the receiver operating characteristic (ROC) curve revealed a cutoff value of sCTX II as 557.5 pg/mL among cases and controls, 407.5 pg/mL between K–L grades 0 and I, 528.5 pg/mL between K–L grades I and II, 681.1 pg/mL between K–L grades II and III, and 866.4 pg/mL between K–L grades III and IV. Conclusion: sCTX II values are dependent only on the severity of the disease. Estimation of sCTX II levels is an excellent diagnostic tool for identifying the normal population with KOA patients and has clinical significance in identifying KOA of K–L grades I and II disease severity.

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