Moreover, ADAMTS-4 can degrade other constitutive molecules in the ECM of the human cartilage, such as cartilage oligomeric matrix protein, hyalectan, decorin, brevican, fibromodulin, etc. Therefore, ADAMTS-4 shows a broader proteolytic role in the metabolism, which should be addressed in terms of involvement in DDH-induced secondary OA pathogenesis (60). Here, ADAMTS4 is linked to Hip dysplasia.