Preoperative bone quality as a factor in dual-energy X-ray absorptiometry analysis comparing bone remodelling between two implant types

Abstract

Recently it was shown that the design changes from the ABG-I to ABG-II hip stem resulted in a better, although not significant, proximal bone preservation. Our hypothesis was that by matching patients for preoperative bone quality, statistical power would increase and that the trend of better proximal bone preservation in ABG-II might become significant. Twenty-four ABG-II patients were compared to two different ABG-I groups: (1) 25 patients from our earlier prospective study and (2) a group of 24 patients selected to perfectly match the ABG-II group regarding gender, age and preoperative bone quality. Postoperative changes in periprosthetic bone mineral density (BMD) were quantified at 2 years postoperatively using DEXA scanning. Bone preservation (less BMD loss) was better for the ABG-II than the ABG-I (all two groups) in the proximal zones 1 and 7. In Gruen zone 7, a statistically significant difference was found for group B (p = 0.03). By matching patients for preoperative bone quality and gender, a statistical significant difference was found in proximal bone preservation in favour of ABG-II. In future comparative bone remodelling studies using DEXA, patients should be matched for preoperative bone quality and gender.

Perioperative Patient-specific Factors-based Nomograms Predict Short-term Periprosthetic Bone Loss After Total Hip Arthroplasty

“…Similarly, we also found that age was negatively related to the postoperative bone loss in Gruen zone 1, 7, and total zones. In consistent with previous studies [13,28], preoperative hip BMD was found to be predictable of less postoperative periprosthetic bone loss in the present study. Similar to our results, the meta-analysis reported that patients using straight stems experienced less bone loss than those using anatomic designs at the 1-year time point [12].…”

Densitometric evaluation of bone remodelling around Trabecular Metal Primary stem: a 24-month follow-up

“…Some authors have suggested that systemic BMD can predict periprosthetic bone loss [17,18]. In this study the non-osteoporotic population showed a slight bone resorption at 3 and 6 months and a rapid bone enhancement in both proximal ROIs, with positive values al 24 months.…”

Quality of intertrochanteric cancellous bone as predictor of femoral stem RSA migration in cementless total hip arthroplasty

“…The anatomically shaped femoral component with proximal hydroxyapatite coating, made of a beta titanium alloy with a low elastic modulus (TMZF TM , Young's modulus 85 GPa) in eight sizes, was designed to achieve proximal press-fit in metaphyseal bone and the distal stem was undersized and polished to prevent bone ongrowth (von Rietbergen and Huiskes, 2001, van der Wal et al, 2008, Panisello et al, 2009. In the achievement of the best metaphyseal fill, the manufacturer's recommendation was to preserve the most cancellous bone but only if excellent intraoperative rotational stability was achieved (Operative Technique, ABG II Cement Free Hip System, 2001).…”