Bone quality makes a difference

Aro, Hannu T.

doi:10.1080/17453674.2021.1941632

Cited by 2 publications

(2 citation statements)

References 13 publications

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“…The quality of bone plays an important role for the success of THA. 25 This might explain why the type of stem did not influence the rate of revision in the Young cohort three years postoperatively. Cemented stems in young patients with a clear increase in the rate of revision in mid term were an exception, probably due to the selection of the patients, which is partly highlighted by the slightly higher ASA grades in those who were aged < 80 years.…”

Section: Discussionmentioning

confidence: 97%

Influence of the type of stem and its fixation on revision and immediate postoperative mortality in elective total hip arthroplasty

Morlock,

Perka,

Melsheimer

et al. 2024

Bone Joint J

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AimsDespite higher rates of revision after total hip arthroplasty (THA) being reported for uncemented stems in patients aged > 75 years, they are frequently used in this age group. Increased mortality after cemented fixation is often used as a justification, but recent data do not confirm this association. The aim of this study was to investigate the influence of the design of the stem and the type of fixation on the rate of revision and immediate postoperative mortality, focusing on the age and sex of the patients.MethodsA total of 333,144 patients with primary osteoarthritis (OA) of the hip who underwent elective THA between November 2012 and September 2022, using uncemented acetabular components without reconstruction shells, from the German arthroplasty registry were included in the study. The revision rates three years postoperatively for four types of stem (uncemented, uncemented with collar, uncemented short, and cemented) were compared within four age groups: < 60 years (Young), between 61 and 70 years (Mid-I), between 71 and 80 years (Mid-II), and aged > 80 years (Old). A noninferiority analysis was performed on the most frequently used designs of stem.ResultsThe design of the stem was found to have no significant influence on the rate of revision for either sex in the Young group. Uncemented collared stems had a significantly lower rate of revision compared with the other types of stem for females in the Mid-I group. There was a significantly higher rate of revision for uncemented stems in females in the Mid-II group compared with all other types of stem, while in males the rate for uncemented stems was only significantly higher than the rate for cemented stems. Cemented stems had a significantly lower revision rate compared with uncemented and short stems for both sexes in the Old cohort, as did females with collared stems. The rate of immediate postoperative mortality was similar for all types of stem in the Old age group, as were the American Society of Anesthesiologists grades.ConclusionIn patients aged > 80 years, uncemented and short stems had significantly higher revision rates compared with cemented and collared stems, especially in females. The design of the stem and type of fixation have to be analyzed in more detail than only considering cemented and uncemented fixation, in order to further improve the success of THA.Cite this article: Bone Joint J 2024;106-B(3 Supple A):130–136.

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Section: Discussionmentioning

confidence: 97%

Influence of the type of stem and its fixation on revision and immediate postoperative mortality in elective total hip arthroplasty

Morlock,

Perka,

Melsheimer

et al. 2024

Bone Joint J

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“…[53][54][55][56] Bone health remains a very strong predictor of operative outcomes and recovery. [57][58][59][60] Our findings have potential for use in all bone surgery, but have immediate applications for median sternotomies, which remain the most common approach for cardiac surgery. The sternotomy is the most commonly performed osteotomy or bone-breaking surgery in the world.…”

Section: Figmentioning

confidence: 99%

Near-infrared spectroscopy for structural bone assessment

et al. 2023

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AimsDisorders of bone integrity carry a high global disease burden, frequently requiring intervention, but there is a paucity of methods capable of noninvasive real-time assessment. Here we show that miniaturized handheld near-infrared spectroscopy (NIRS) scans, operated via a smartphone, can assess structural human bone properties in under three seconds.MethodsA hand-held NIR spectrometer was used to scan bone samples from 20 patients and predict: bone volume fraction (BV/TV); and trabecular (Tb) and cortical (Ct) thickness (Th), porosity (Po), and spacing (Sp).ResultsNIRS scans on both the inner (trabecular) surface or outer (cortical) surface accurately identified variations in bone collagen, water, mineral, and fat content, which then accurately predicted bone volume fraction (BV/TV, inner R2 = 0.91, outer R2 = 0.83), thickness (Tb.Th, inner R2 = 0.9, outer R2 = 0.79), and cortical thickness (Ct.Th, inner and outer both R2 = 0.90). NIRS scans also had 100% classification accuracy in grading the quartile of bone thickness and quality.ConclusionWe believe this is a fundamental step forward in creating an instrument capable of intraoperative real-time use.Cite this article: Bone Jt Open 2023;4(4):250–261.

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Bone quality makes a difference

Cited by 2 publications

References 13 publications

Influence of the type of stem and its fixation on revision and immediate postoperative mortality in elective total hip arthroplasty

Influence of the type of stem and its fixation on revision and immediate postoperative mortality in elective total hip arthroplasty

Near-infrared spectroscopy for structural bone assessment

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