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

Gibbons, Charles; Davies, A; Amis, Andrew A.; Olearnik, Henryk; Parker, B; Scott, J. E.

doi:10.1007/s002640100246

Cited by 74 publications

(58 citation statements)

References 12 publications

(18 reference statements)

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“…Most of the remodelling is established at the end of the first post-operative year, when the BMD seems to reach a plateau in all of the areas around the stem [6,9,17,22,24]. The results of our study suggest that this stability appears between the sixth and twelfth months, reflecting the biomechanical response of the bone according to Wolff's law.…”

Section: Discussionmentioning

confidence: 51%

“…Recently, femoral stems with reduced stiffness showed a 15% reduction of BMD in the calcar at the end of the second year [7,9,16]. The patterns of remodelling produced by these anatomic, cementless stems were similar to those shown by other second-generation cementless stems [6,9,17].…”

Section: Discussionmentioning

confidence: 51%

“…Second-generation cementless stems (anatomic design, metaphyseal press-fit, proximal coating) made of titanium still had a decrease of BMD at the end of the second year that ranged from 20% to 25% [9,17]. Tapered femoral components had a proximal loss between 10% to 30% [1,6,19]. Custommade implants reported the best results regarding the proximal loss of BMD, but with a fall of between 10% to 15% at the end of the third year [12,13].…”

Section: Discussionmentioning

confidence: 99%

“…The size of the sample was calculated by considering the average loss of BMD reported in previous studies in the seven zones of Gruen [6,8,10,18,20,21,23]. So, a minimum of 60 patients were considered necessary to be included in the study group.…”

Section: Methodsmentioning

confidence: 99%

“…Periprosthetic bone remodelling following the insertion of a cementless femoral stem can be attributed to mechanical [7,14] and biological factors [6,23] in response to the new biomechanical situation created by the prostheses. In the last 20 years, dual-energy X-ray absorptiometry (DEXA) has been used to quantify the changes of bone mineral density (BMD) attributed to periprosthetic remodelling, and it is thought to be ideal for long-term follow-up studies [1,11,21].…”

Section: Introductionmentioning

confidence: 99%

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Changes in periprosthetic bone remodelling after redesigning an anatomic cementless stem

Panisello

Canales

Herrero

et al. 2008

International Orthopaedics (SICOT)

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The aim of this prospective cohort study was to determine the densitometric relevance of minor design modifications of a cementless stem designed to improve proximal load transfer. We used a prospective cohort study with densitometric analysis over a five-year period of two groups of patients with primary osteoarthritis. The first group, 56 hips, received the first version of the ABG stem (ABG-I); the second group, 54 hips, had the ABG-II stem. The results obtained with the ABG-I stem showed a decrease of bone density in proximal areas that ranged from 13% to 37%. However, the new design had a decrease of the same areas that ranged from 9% to 23%. These differences were noted at the end of the first post-operative year and remained stable, except in zone 7, where they were progressive. There is little evidence that the modified stem reduces femoral bone density loss.Résumé Nous avons revu de façon rétrospective 68 hanches chez 62 patients présentant une dysplasie acétabulaire et ayant bénéficié d'une ostéotomie péri-acétabulaire. Parmi ces 68 hanches, 33 avaient en préopératoire une rétroversion acétabulaire (groupe rétroversion) et 35 une antéversion (groupe contrôle). Toutes les hanches ont été évaluées selon le score de Harris. L'évaluation radiographique de la rétroversion acétabulaire et du mur postérieur déficient ont été basées sur le signe du croisement et le signe du mur extérieur. Les scores cliniques des deux groupes au suivi final était semblable. Dans le groupe rétroversion, 12 hanches avaient antéversé leur acétabulum en post-opéra-toire le signe du mur postérieur disparaissant, mais celui-ci restant présent dans 21 hanches avec un acétabulum en rétroversion post-opératoire. Parmi les 21 hanches avec acétabulum rétroversé une coxarthrose postérieure s'est développée à 5 ans post-opératoire. Lorsque l'on réalise une correction par ostéotomie pour une hanche dysplasique avec un acétabulum rétroversé, il est important de corriger cette rétroversion de façon à prévenir une coxarthrose secondaire due à la déficience du mur postérieur.

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