Periprosthetic Bone Density Around Fully Hydroxyapatite Coated Femoral Stem

Trévisan, C.; Bigoni, Marco; Randelli, G; Marinoni, E. C.; Peretti, Giuseppe M.; Ortolani, S.

doi:10.1097/00003086-199707000-00015

Cited by 61 publications

(45 citation statements)

References 9 publications

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“…A number of prospective studies of uncemented femoral implants have shown a significant bone loss (10-40%) in the calcar region after 1 4 years [S,lS, 23,26,27,30,34,35]. Our findings of the Unique stem are in agreement with this.…”

Section: Bone-mineral Densitysupporting

confidence: 90%

“…The bone loss that we found for the Elite Plus was similar to what Cohen found for the Charnley prosthesis after 1 year [l 11. Some studies following patients up to 10 years have shown a progressive recovery or a minimal loss of BMD after the first to second postoperative year [ 16,20,30,34]. A different pattern of BMD changes has been found around loosened implants [9,23,31,32].…”

Section: Bone-mineral Densitymentioning

confidence: 99%

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Differences in stability and bone remodeling between a customized uncemented hydroxyapatite coated and a standard cemented femoral stem A randomized study with use of radiostereometry and bone densitometry

Grant¹,

Aamodt

Falch³

et al. 2005

J. Orthop. Res.

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The custom made Unique® stem is designed to fit closely to the metaphyseal region of the femur in order to obtain maximum mechanical stability and optimal load transfer. Thirty‐seven patients (38 hips) with non‐inflammatory arthritis were randomized to the uncemented custom made Unique® stem or the Elite Plus stem inserted with cement. The patients have been followed clinically as well as with radiostereometry (RSA) and Dual‐energy X‐ray Absorptiometry (DXA) for 2 years. After 2 years the RSA result showed minimal translation and rotation for the Unique® stem while the Elite Plus rotated slightly (mean 1.05°) into retroversion. Compared to previous studies the Elite Plus was as stable as the Charnley prosthesis. The DXA results showed a significantly higher proximal and total (10% for the Unique versus 5% for Elite) bone loss for the Unique® stem compared to the Elite Plus. Thus the optimal proximal press‐fit of the custom made stem did secure a stable fixation, but did not decrease the proximal bone loss. © 2005 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved.

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Section: Bone-mineral Densitysupporting

confidence: 90%

Section: Bone-mineral Densitymentioning

confidence: 99%

Differences in stability and bone remodeling between a customized uncemented hydroxyapatite coated and a standard cemented femoral stem A randomized study with use of radiostereometry and bone densitometry

Grant¹,

Aamodt

Falch³

et al. 2005

J. Orthop. Res.

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“…Kilgus et al (1993) noted largest BMD loss (35%) in the most proximal 1 cm of the medial femoral cortex. Longitudinal studies have also been performed (Trevisan et al 1997, Venesmaa et al 2001, confirming the results of cross-sectional studies.…”

Section: Discussionsupporting

confidence: 72%

Periprosthetic proximal bone loss after uncemented hip arthroplasty is related to stem size: DXA measurements in 138 patients followed for 2–7 years

et al. 2006

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Background Periprosthetic bone loss occurs around uncemented femoral stems and may be influenced by the stem size.Patients and methods We studied 138 consecutive patients, 3 (2-7) years on average after a total hip arthroplasty operation (THA) for unilateral osteoarthritis with the Bi-Metric uncemented femoral stem. We analyzed Harris hip score and bone mineral density.Results The mean Harris hip score was 97 at followup. Bone mineral density decreased proximally by 19% in both Gruen zones 1 and 7. Bone loss in zones 1, 2, 6, and 7 was significantly associated with stem size. Distally, a small gain in bone mass was found in zones 3 and 5 for medium femoral sizes.Interpretation We found a marked proximal BMD loss, especially for the larger stems, which may be specific for this particular implant. Long-term studies should reveal whether this proximal bone loss will affect the longevity of the THA.

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“…Many factors affect the periprosthetic bone mineral density (BMD) around cementless femoral implants [13] including age, gender, pre-operative diagnosis and bone mineral content [8], the type of implant used [7,9,14] and duration of implantation [11], and the mechanical loading environment.…”

Section: Introductionmentioning

confidence: 99%

Periprosthetic bone mineral density changes with femoral components of differing design philosophy

Gibbons

Davies

Amis

et al. 2001

International Orthopaedics (SICOT)

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We measured the bone mineral density in 22 patients with the cylindrical stemmed cobalt-chrome AML prosthesis (collared) and in 22 patients with the tapered stem titanium CLS prosthesis (collarless). DEXA scanning was undertaken at a mean of 40 months in the AML and 52 months in the CLS group from the time of implant insertion. In both groups the greatest mean loss of BMD was found in Gruen zone 7 and the least change in Gruen zone 5. In all zones the BMD loss was greater in the AML group but only statistically significant in zones 6 (P<0.05) and 7 (P<0.01). Although numerous factors affect BMD changes around cementless implants, this study suggests that less bone loss can be associated with the titanium CLS stem.Résumé Nous avons mesuré la densité minérale de l'os chez 22 patients porteur d'une prothèse AML en cobaltchrome à tige cylindrique (avec colerette) et chez 22 malades avec une prothèse CLS en titane avec une tige conique et sans colerette. Une scanographie DEXA a été entreprise en moyenne 40 mois après implantation des prothèses AML et 52 mois après prothèse CLS. Dans les deux groupes la plus grande perte moyenne de DMO a été trouvée dans la zone 7 de Gruen et le plus petit changement dans la zone 5 de Gruen. Dans tous les zone la perte de densité osseuse était plus grande dans le groupe AML mais statistiquement uniquement dans les zones 6 (P<0.05) et 7 (P<0.01). Bien que de nombreux facteurs affectent les changements de DMO autour des implants sans ciment, cette étude suggère qu'il y a moins de perte osseuse avec la tige CLS en titane.

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Periprosthetic Bone Density Around Fully Hydroxyapatite Coated Femoral Stem

Cited by 61 publications

References 9 publications

Differences in stability and bone remodeling between a customized uncemented hydroxyapatite coated and a standard cemented femoral stem A randomized study with use of radiostereometry and bone densitometry

Differences in stability and bone remodeling between a customized uncemented hydroxyapatite coated and a standard cemented femoral stem A randomized study with use of radiostereometry and bone densitometry

Periprosthetic proximal bone loss after uncemented hip arthroplasty is related to stem size: DXA measurements in 138 patients followed for 2–7 years

Periprosthetic bone mineral density changes with femoral components of differing design philosophy

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