Periacetabular Bone Mineral Density Changes After Resurfacing Hip Arthroplasty Versus Conventional Total Hip Arthroplasty. A Randomized Controlled DEXA Study

Smolders, José M.H.; Pakvis, D.F.M.; Hendrickx, Baudewijn W.; Susante, Job L C van

doi:10.1016/j.arth.2012.08.025

Cited by 13 publications

(16 citation statements)

References 33 publications

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“…This method is applied not only for evaluation of bone remodeling around the stem but also of the cup. 20 The shape and length of the Metha stem with its unique coating offers great potential for bone remodeling around this stem. Although the position of the Metha stem ensures primary load stability, the additional circumferential Plasmapore µ-CaP coating of the entire proximal surface supports rapid secondary fixation, has an osteoconductive effect, and accelerates contact between the bone and the prosthesis stem.…”

Section: Discussionmentioning

confidence: 99%

Periprosthetic Bone Remodeling Around Short Stem

Synder¹,

Krajewski²,

Sibiński³

et al. 2015

Orthopedics

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Total hip arthroplasty (THA) has become standard treatment for advanced degenerative changes of the hip. A few studies have reported promising clinical outcomes with the Metha stem fixated by metaphyseal anchoring. This study evaluated early bone remodeling around the Metha stem during 12 months of follow-up. The study population included 36 patients (18 women and 18 men) with a mean age of 50.4 years who underwent THA between 2009 and 2011 for advanced degenerative changes of the hip with the Metha stem. Patients were evaluated on the day of surgery, 10 days postoperatively, and then at 3, 6, and 12 months postoperatively. Evaluation included Harris Hip Score and dual-energy x-ray absorptiometry (DEXA) scanning in 7 Gruen zones. At 12 months postoperatively, Harris Hip Score increased significantly by 38 points. A significant change in bone mineral density (BMD) was found immediately after surgery; this change was most pronounced in Gruen zone 3 (+36%), followed by Gruen zones 2 and 5. The smallest postoperative BMD increase was observed in Gruen zone 7 (+3.66%). In contrast, at 3 months postoperatively, a trend toward decreased BMD was observed in all Gruen zones. At 6 months postoperatively, mean BMD decreased in all Gruen zones except for Gruen zone 6. At 12 months postoperatively, mean BMD increased in Gruen zones 2 through 6, with the highest value (30%) observed in Gruen zone 3; in Gruen zones 1 and 2, mean BMD decreased. Short-term assessment of periprosthetic bone remodeling after uncemented Metha stem implantation revealed different host-bone responses. Apparently, the Metha stem can reduce BMD loss in the proximal femur. DEXA is a precise method for assessing BMD changes around implanted Metha stem.

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Section: Discussionmentioning

confidence: 99%

Periprosthetic Bone Remodeling Around Short Stem

Synder¹,

Krajewski²,

Sibiński³

et al. 2015

Orthopedics

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“…In previous studies, regarding acetabular BMD changes after resurfacing and total hip arthroplasty, repeated measurements were also perfomed in study patients resulting in a mean coefficient of variation of 2.6% (SD 0.9) (Smolders et al. 2013 ); this was not repeated for the current study. Quality controls for the DXA equipment were undertaken daily according to the manufacturer’s guidelines to verify the stability of the system.…”

Section: Methodsmentioning

confidence: 99%

“… 2013 , Smolders et al. 2013 , Lazarinis et al. 2014 ) and was also used to monitor the incorporation of bone graft after spinal fusion (Hagenmaier et al.…”

mentioning

confidence: 99%

Bone mineral density changes in the graft after acetabular impaction bone grafting in primary and revision hip surgery

et al. 2018

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Background and purposeImpaction bone grafting (IBG) is an established method in hip revision surgery to reconstruct loss of bone stock. There is limited knowledge concerning the actual bone remodelling process within the allograft. We investigated with repeated bone mineral density (BMD) measurements the biological process of bone remodelling in the allograft in vivo. We hypothesized that an initial decrease in BMD would be followed by an increase towards baseline values.Patients and methodsDual-energy X-ray absorptiometry (DXA) was used to measure BMD values in 3 regions of interest (ROI) in 20 patients (average age at surgery 70 years, 11 males) after an acetabular reconstruction with IBG and a cemented cup. A postoperative DXA was used as baseline and DXA was repeated at 3 and 6 months and at 1 and 2 years. The Oxford Hip Score (OHS), the 12-Item Short Form Health Survey (SF12), and a 0 to 100 mm visual analogue scale (VAS) for pain and satisfaction were obtained simultaneously.ResultsThe overall mean BMD in the IBG regions increased significantly by 9% (95% CI 2–15) at 2 years’ follow-up. In the cranial ROI BMD increased 14% (CI 6–22), whereas the BMD in the medial and caudal ROI showed an increase of 10% (CI 1–18) and 4% (CI –6–16), respectively. The OHS, SF12-mental, and VAS for pain all improved statistically significantly 2 years after surgery, with a mean VAS for satisfaction of 77 (CI 63–90) out of 100 points. The SF12-physical showed non-significant improvement.InterpretationThe BMD in the allograft gradually increased after IBG for acetabular reconstruction arthroplasties, particularly in the cranial ROI. An initial decrease in the BMD was not encountered. These BMD changes, as proxy measurements for bone remodeling, may indicate progressive apposition of vital new host bone in the grafted area.

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“…The most common systems used for HR were Durom hybrid resurfacing [10][11][12][13][14][15][16] followed by Conserve plus. 7,9,20,23,26,30 For the THR group the variety of implants used are shown in Table 3. In the TAAG data, the most commonly used system for resurfacing was Birmingham Hip Resurfacing (BHR) in 96% of cases.…”

Section: Resultsmentioning

confidence: 99%

“…In all these studies, age has not been considered as a specific factor. Of the 27 included studies, five studies projected higher revisions risk in THR group as compared to HR group, 9,16,[28][29]32 eight studies could not estimate revision risks as there were no revisions in each group and 11 studies favoured THR by showing higher revision risk in HR. Three studies 7,30,33 showed exact equal revision rates with both procedures.…”

Section: Discussionmentioning

confidence: 99%