Early periprosthetic bone remodelling around cemented and uncemented custom-made femoral components and their uncemented acetabular cups

Mulier, Michiel; Jaecques, Siegfried; Raaijmaakers, Martijn; Nijs, J; Perre, Georges Van der; Jonkers, Ilse

doi:10.1007/s00402-010-1239-4

Cited by 26 publications

(35 citation statements)

References 26 publications

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“…Independently of each other, Korovessis et al [13] and Sköldenberg et al [14] reported no correlation between age and periprosthetic changes in BMD. However, there seems to be consensus around the belief that stem design and fixation remain major aspects in influencing periprosthetic bone remodeling [15,16], particularly in Gruen zones 4 and 7 [17]. Most patients in our study had good to excellent clinical outcomes, in accord with previous studies on shortstemmed implants.…”

Section: Discussionsupporting

confidence: 85%

Bone remodelling around the Metha short stem in total hip arthroplasty: a prospective dual-energy X-ray absorptiometry study

Lerch

Haar-Tran

Windhagen

et al. 2011

International Orthopaedics (SICOT)

111

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Section: Discussionsupporting

confidence: 85%

Bone remodelling around the Metha short stem in total hip arthroplasty: a prospective dual-energy X-ray absorptiometry study

Lerch

Haar-Tran

Windhagen

et al. 2011

International Orthopaedics (SICOT)

111

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“…However, we found the same difference in bone defects when only looking at THAs revised because of aseptic loosening. This can either be the result of different pathology of osteolysis around cemented femoral stems [8,15,20,22,29] or the result of delayed revision of cemented implants, as suggested by the older age of patients in this group. A potential confounder to this finding is change in type of polyethylene used for primary THA.…”

Section: Discussionmentioning

confidence: 99%

Do Rerevision Rates Differ After First-time Revision of Primary THA With a Cemented and Cementless Femoral Component?

Gromov

Pedersen

Overgaard

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Worldwide use of cementless fixation for total hip arthroplasty (THA) is on the rise despite some evidence from the world's registries suggesting inferior survivorship compared with cemented techniques. The patterns of bone loss associated with failed cementless and cemented THAs may prejudice the results of future revision procedures; however, this has not been documented. Questions/purposes The purpose of this study was to compare (1) the risk for rerevision of first revision THA; (2) the patterns of femoral bone loss at the time of first revision of primary THA; (3) the reasons for first revision of primary THA; and (4) the time to first revision of primary THA between primary cementless and cemented femoral components. Methods Primary THAs with cemented (n = 1791) and uncemented (n = 805) femoral components that subsequently sustained first revision of the femoral component were identified from the Danish Hip Arthroplasty Registry (DHR). As of 2012, 120,988 primary THAs and 19,282 revisions were registered in the DHR with completeness of 97% and 90% for primary and revision THA, respectively. Median followup for revisions of primary THA with cemented and cementless femoral component was 4 years (range, 0-17 years) and 2 years (range, 0-16 years), respectively. Survival of first revision THA, with second revision of the femur as outcome, was evaluated using hazard ratios (HRs) with 95% confidence interval (CI) adjusting for potential confounding. All patient-and surgery-related data are collected from Danish medical databases. Recording of bone defects in the DHR is based on surgeons' intraoperative findings. Results With the numbers studied, we found no differences in the risk of second revision between the overall cohort between cementless and cemented techniques (HR, 1.32; 95% CI, 0.97-1.80; p = 0.076); however, a second revision for Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained. Conclusions We found no differences in the risk of second revision in the overall cohort between cementless and cemented techniques; however, we observed an increased risk for rerevision THA performed on patients \ 70 years whose index THAs were performed using cementless components when looking at all causes for revision, even after adjusting for the most likely confounding factors. Our data suggest that increased use of cemen...

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“…No clinical studies have assessed between-scan reliability in the acetabulum, but one study focused on femoral and vertebral BMD (15) and another focused solely on the femoral side (16). Furthermore, the previous studies did not evaluate BMD solely in close proximity to the prostheses but used combined ROIs with bone tissue near and farther away from the metal (9–11,13,17–21). The interface between bone and cup is different in cemented and uncemented cups because the uncemented cup has a perfect hemispherical shape while the cement mantle surrounding cemented cups is more irregular which might affect BMD measurements.…”

Section: Introductionmentioning

confidence: 99%

Bone density measurements adjacent to acetabular cups in total hip arthroplasty using dual-energy CT: an in vivo reliability and agreement study

Mussmann

Andersen

Torfing

et al. 2018

Acta Radiologica Open

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BackgroundMeasuring bone mineral density (BMD) around acetabular prosthetic components with computed tomography (CT) is challenged by the complex anatomy and metal artifacts. Three-dimensional (3D) segmentation is required for the analysis, but it is usually not practically applicable on current CT workstationsPurposeTo test the between-scan agreement and reliability of custom segmentation software for BMD measurements adjacent to cemented and uncemented acetabular cups in dual-energy CT (DECT).Material and MethodsTwenty-four male patients with total hip arthroplasty were scanned and rescanned using 130-keV virtual monochromatic DECT images. Hemispherical regions of interest were defined slice-by-slice and BMD was calculated around the acetabular cup using custom segmentation software.ResultsIn the uncemented cup, the mean BMD was 153 mg/cm3 with a between-scan difference of 10 mg/cm3 (P < 0.0001). In the cemented cup, the mean BMD was 186 mg/cm3 with a between-scan difference of 6 mg/cm3 (P = 0.15). In both uncemented and cemented cups the intraclass correlation coefficient between repeated measurements was >0.95 and narrow Bland–Altman Limits of Agreement.ConclusionBMD can be measured with high absolute between-scan agreement and good reliability adjacent to acetabular cemented and uncemented cups using DECT and segmentation software.

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Early periprosthetic bone remodelling around cemented and uncemented custom-made femoral components and their uncemented acetabular cups

Cited by 26 publications

References 26 publications

Bone remodelling around the Metha short stem in total hip arthroplasty: a prospective dual-energy X-ray absorptiometry study

Bone remodelling around the Metha short stem in total hip arthroplasty: a prospective dual-energy X-ray absorptiometry study

Do Rerevision Rates Differ After First-time Revision of Primary THA With a Cemented and Cementless Femoral Component?

Bone density measurements adjacent to acetabular cups in total hip arthroplasty using dual-energy CT: an in vivo reliability and agreement study

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