Periprosthetic Bone Remodeling Around Short Stem

Synder, Marek; Krajewski, Karol; Sibiński, Marcin; Drobniewski, Marek

doi:10.3928/01477447-20150215-55

Cited by 27 publications

(20 citation statements)

References 22 publications

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“…The Harris Hip Score (HHS) revealed good to excellent clinical results. These are comparable to other studies using the Metha 1 stem, 3,7,8 or other short stems. 1,5,6 Pain values decreased to 0.4 of 10 points.…”

Section: Discussionsupporting

confidence: 89%

“…Over the years, dualenergy X-ray absorptiometry (DXA) became a proven method to examine changes of bone mineral density (BMD) around implants. [1][2][3][4][5][6][7][8][9] To describe changes of the interface between bone and femoral implants the Gruen zone system has been established as standard. Originally, it was developed for classifying zones of lucency on plain x-rays following the implantation of standard stems.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Bone remodelling around the Metha ® short stem implant – Clinical and dual-energy x-ray absorptiometry (DXA) results

Fischer¹,

Beckmann

Simank³

2017

Journal of Orthopaedics

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Bone remodelling around the Metha ® short stem implant – Clinical and dual-energy x-ray absorptiometry (DXA) results

Fischer¹,

Beckmann

Simank³

2017

Journal of Orthopaedics

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“…Consequently, short hip stems and even neck stems have become the latest concepts. These stems help preserve the femoral neck, keep the anatomical elasticity of the femur and introduce the forces in the upper part of the femur [18,51,[58][59][60][61][62][63][64]. And studies evaluated periprosthetic bone remodeling with DEXA showed a more balanced remodeling and favorable load transfer of the short stem in comparison to standard hip stem [16,51,[60][61][62][63][64][65].…”

Section: Implant-related Factorsmentioning

confidence: 99%

Short to Midterm Follow-Up of Periprosthetic Bone Mineral Density after Total Hip Arthroplasty with the Ribbed Anatomic Stem

Tian

et al. 2019

BioMed Research International

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Background. Femoral bone remodeling around hip prosthesis after total hip arthroplasty (THA) is definite but unpredictable in time and place. This study aimed to investigate the implant-specific remodeling and periprosthetic bone mineral density (BMD) changes after implantation of the Ribbed anatomic cementless femoral stem. Methods. After power analysis, 41 patients who had undergone primary unilateral THA with the Ribbed anatomic cementless stem were included. BMD of the seven Gruen zones was measured by dual-energy X-ray absorptiometry, and the contact, fitness, and fixation of the femoral stem and proximal femur were analyzed by X-ray. Additional clinical outcome parameters were also recorded. Results. Compared with the contralateral unoperated side, significant reductions of BMD were detected in the distal zone (Gruen zone 4: 1.665±0.198 versus 1.568±0.242 g/cm2, P=0.001) and middle distal zone (Gruen zone 5: 1.660±0.209 versus 1.608±0.215 g/cm2, P=0.026) on the prosthetic side, but no significant differences in BMD were detected in other zones (Gruen zones 1, 2, 3, 6, and 7). Subgroups analyses indicated no significant correlation between periprosthetic BMD changes and clinical factors including primary disease and body mass index. Visible areas of bone ingrowth indicated solid fixation of the femoral stem and there was no case of loosening. Clinical and functional outcome scores were excellent with mean HHS of 93.13 points and mean WOMAC score of 5.20 points, and three patients described intermittent mild thigh pain at the final follow-up. Conclusions. For the Ribbed femoral stem, the periprosthetic BMD was well maintained in the proximal femur, while periprosthetic BMD was significantly reduced in the distal and middle distal zones of the femur. Further clinical investigations are required to examine the efficacy of the Ribbed stem, particularly with regard to long-term survival. This trial is registered with ChiCTR1800017750.

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“…Some authors investigated the bone remodelling characteristics of the femur after THA with a METHA stem by using DEXA assessment and adapting Gruen zones (R1 to R7) to the short stem design. 89 – 92 In all studies including 176 hips with at least one year of follow-up, the bone mineral density (BMD) significantly increased in the lateral regions (R2 and R3) and significantly decreased in the proximal regions (R1 and R7). On the other hand, changes in distal (R4), distal-medial (zone 5) and lesser trochanter (R6) regions were less relevant and reliable across the analysed studies.…”

Section: Stem Features and Outcomesmentioning

confidence: 99%

Uncemented short stems in primary total hip arthroplasty

Loppini

Grappiolo

2018

EFORT Open Reviews

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Over the last two decades, several conservative femoral prostheses have been designed. The goals of conservative stems include: the spearing of the trochanteric bone stock; a more physiological loading in the proximal femur reducing the risk of stress shielding; and to avoid a long stem into the diaphysis preventing impingement with the femoral cortex and thigh pain.All stems designed to be less invasive than conventional uncemented stems are commonly named ‘short stems’. However, this term is misleading because it refers to a heterogeneous group of stems deeply different in terms of design, biomechanics and bearing. In the short-term follow-up, all conservative stems provided excellent survivorship. However, variable rates of complications were reported, including stem malalignment, incorrect stem sizing and intra-operative fracture.Radiostereometric analysis (RSA) studies demonstrated that some conservative stems were affected by an early slight migration and rotation within the first months after surgery, followed by a secondary stable fixation. Dual-energy x-ray absorptiometry (DEXA) studies demonstrated an implant-specific pattern of bone remodelling.Although the vast majority of stems demonstrated a good osseointegration, some prostheses transferred loads particularly to the lateral and distal-medial regions, favouring proximal stress shielding and bone atrophy in the great trochanter and calcar regions.Cite this article: EFORT Open Rev 2018;3:149-159. DOI: 10.1302/2058-5241.3.170052

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Periprosthetic Bone Remodeling Around Short Stem

Cited by 27 publications

References 22 publications

Bone remodelling around the Metha ® short stem implant – Clinical and dual-energy x-ray absorptiometry (DXA) results

Bone remodelling around the Metha ® short stem implant – Clinical and dual-energy x-ray absorptiometry (DXA) results

Short to Midterm Follow-Up of Periprosthetic Bone Mineral Density after Total Hip Arthroplasty with the Ribbed Anatomic Stem

Uncemented short stems in primary total hip arthroplasty

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