Garnero P, et al. - A 18-year evaluation of the OFELY prospective cohort was conducted to evaluate the correlation of urinary CTX-II, a biochemical marker of cartilage breakdown, with the risk of total joint replacement (TJR). They examined a sum of 478 postmenopausal women (mean age 65.5±7.5 yr.) including from the OFELY cohort. They assessed CTX-II, serum CTX-I (bone resorption) and PINP (bone formation), at baseline. They measured the correlation between CTX-II and incidence of TJR by Cox Hazard Regression. Thirty-eight women sustained a TJR, including hip or knee replacement during a median 17.8 years follow-up. They found higher CTX-II -but not CTX-I or PINP- in individuals with TJR. In postmenopausal women, CTX-II is an independent risk indicator of TJR suggesting that it may be useful to distinguish subjects at high risk of TJR.