Assessment of Early Biological Fixation of Cementless Tapered-Wedge Stems Using Digital Tomosynthesis

Oishi, Kazuki; Inoüe, Ryo; Yamamoto, Yuji; Harada, Yoshifumi; Sasaki, Eiji; Ishibashi, Yasuyuki

doi:10.1016/j.arth.2021.04.021

Cited by 6 publications

(3 citation statements)

References 25 publications

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“…This is most evident when comparing the morphometrically designed dual-taper stem against its previous model, which had a different geometric profile and was manufactured from an alloy with a lower modulus of elasticity. Our RCT indicated preservation of bone density in the medial calcar region, which corroborates the results of other studies involving this implant 22,23 . Conversely, a reduction in proximal femoral BMD has been reported with its predecessor 24 .…”

Section: Discussionsupporting

confidence: 91%

Evaluation of Proximal Femoral Bone Mineral Density in Cementless Total Hip Arthroplasty

Hooper,

Thompson,

Frampton

et al. 2023

Journal of Bone and Joint Surgery

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Background: Femoral stem design affects periprosthetic bone mineral density (BMD), which may impact long-term survival of cementless implants in total hip arthroplasty (THA). The aim of this study was to examine proximal femoral BMD in 3 morphologically different uncemented femoral stem designs to investigate whether any particular design resulted in better preservation of BMD. Methods: A total of 119 patients were randomized to receive a proximally coated collarless dual-taper wedge stem, a proximally coated collarless anatomic stem, or a fully coated collarless triple-taper stem. All surgeries were performed via the posterior approach, with mobilization on the day of surgery. Dual x-ray absorptiometry scans (Lunar iDXA, GE Healthcare) assessed BMD across the 7 Gruen zones preoperatively and at 6 weeks and 2 years postoperatively; if available, the native contralateral femur was also assessed as a control. Patient-reported outcomes of pain, function, and health were also assessed at these follow-ups. Results: Averaged across all stems, BMD increased in zones 1 (2.5%), 2 (17.1%), 3 (13.0%), 5 (10%), and 6 (17.9%) at 2 years. Greater preservation of BMD was measured on the lateral cortex (zone 2) for both the dual-taper wedge and anatomic stems (p = 0.019). The dual-taper wedge stem also demonstrated preservation of BMD in the medial calcar (zone 7), while the anatomic and triple-taper stems declined in this region; however, the difference did not reach significance (p = 0.059). Averaged across all stems, BMD decreased in the mid-diaphysis region, distal to the stem tip (zone 4). All stems performed similarly at the time of final follow-up with respect to the patient-reported outcomes. Conclusions: This study demonstrated maintenance of femoral BMD after use of 3 different cementless femoral stem designs, with all achieving excellent improvements in patient-reported outcomes. The stems designed to load the proximal metaphyseal region resulted in higher BMD in that region. No significant stress-shielding was observed; however, longer follow-up is required to elucidate the impact of this finding on implant survivorship. Level of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

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Section: Discussionsupporting

confidence: 91%

Evaluation of Proximal Femoral Bone Mineral Density in Cementless Total Hip Arthroplasty

Hooper,

Thompson,

Frampton

et al. 2023

Journal of Bone and Joint Surgery

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“…In our study, spot weld was defined as new cancelous bone formation between the stem and the endosteal surface of the femur. 10 The SW is similar to the cancellous condensation shown by Kashi et al 3 This new bone tissue acts to fill the gap between the implant and the cortex. Of importance, however, TBR may capture changes in the already existing trabecular bone architecture.…”

Section: To the Editormentioning

confidence: 56%

Reply to “Letter to the Editor Concerning ‘Trabecular Bone Remodeling as a New Indicator of Osteointegration After Posterior Lumbar Interbody Fusion.’ by Segi et al.”

Segi

Nakashima

Shinjo

et al. 2023

Global Spine Journal

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“…In terms of CO 2 stationary storage, carbon capture and storage (CCS) technology 2 is extremely expensive to run, and all the complex processes involved need to be continuously monitored to avoid leakage. 3 As a superior method, biological fixation 4 is free of complicated operation, but it poses a challenge to the survival of many microalgal species. In comparison with direct storage, it is an attractive way to reduce CO 2 into valuable organic fuels (CO, CH 4 , HCHO, HCOOH and CH 3 OH).…”

Section: Introductionmentioning

confidence: 99%

A review on TiO_2−x-based materials for photocatalytic CO₂ reduction

Wang

Chen

et al. 2022

Nanoscale

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Assessment of Early Biological Fixation of Cementless Tapered-Wedge Stems Using Digital Tomosynthesis

Cited by 6 publications

References 25 publications

Evaluation of Proximal Femoral Bone Mineral Density in Cementless Total Hip Arthroplasty

Evaluation of Proximal Femoral Bone Mineral Density in Cementless Total Hip Arthroplasty

Reply to “Letter to the Editor Concerning ‘Trabecular Bone Remodeling as a New Indicator of Osteointegration After Posterior Lumbar Interbody Fusion.’ by Segi et al.”

A review on TiO_2−x-based materials for photocatalytic CO₂ reduction

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Assessment of Early Biological Fixation of Cementless Tapered-Wedge Stems Using Digital Tomosynthesis

Cited by 6 publications

References 25 publications

Evaluation of Proximal Femoral Bone Mineral Density in Cementless Total Hip Arthroplasty

Evaluation of Proximal Femoral Bone Mineral Density in Cementless Total Hip Arthroplasty

Reply to “Letter to the Editor Concerning ‘Trabecular Bone Remodeling as a New Indicator of Osteointegration After Posterior Lumbar Interbody Fusion.’ by Segi et al.”

A review on TiO2−x-based materials for photocatalytic CO2 reduction

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A review on TiO_2−x-based materials for photocatalytic CO₂ reduction