Longitudinal Evaluation of Time Related Bone Remodeling After Cementless Total Hip Arthroplasty

Nishii, Takashi; Sugano, Nobuhiko; Masuhara, Kensaku; Shibuya, Takaaki; Ochi, Takahiro; Tamura, Shinichi

doi:10.1097/00003086-199706000-00017

Cited by 142 publications

(137 citation statements)

References 27 publications

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“…The precision error was found to be 2.3% in Gruen zone 1, 1.0% in zone 2, 2.0% in zone 3, 3.5% in zone 4, 4.2% in zone 5, 1.3% in zone 6, and 3.7% in zone 7 (Bodén and Adolphson 2004). This precision is of the same order as reported by Kilgus et al (1993) and Nishii et al (1997).…”

Section: Methodssupporting

confidence: 86%

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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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Section: Methodssupporting

confidence: 86%

“…One factor known to influence the periprosthetic BMD is stem size of the femoral implant (Huiskes et al 1992, Nishii et al 1997, especially after insertion of a stem with a large diameter (Maloney et al 1996). To achieve "fit and fill", uncemented stems are typically larger than cemented stems.…”

mentioning

confidence: 99%

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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“…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 development of the prosthesis was based on several preclinical studies, including the use of Computer Tomography (CT) in preoperative planning and stem design, evaluation of changes in femoral cortical strain pattern following stem insertion and also testing of the mechanical stability of movements and predict later revisions [19]. Using DXA it is possible to accurately detect even small changes in bone mineral density (BMD) near the prosthesis [21,22,27]. We designed a prospective randomized study using RSA and DXA comparing the Unique stem with a standard modular cemented stem, the Elite Plus.…”

Section: Introductionmentioning

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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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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“…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%

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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Longitudinal Evaluation of Time Related Bone Remodeling After Cementless Total Hip Arthroplasty

Cited by 142 publications

References 27 publications

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

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

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

Changes in periprosthetic bone remodelling after redesigning an anatomic cementless stem

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