Pre-operative bone mineral density is a predictive factor for excellent early patient-reported outcome measures in cementless total hip arthroplasty using a proximally fixed anatomic stem. A prospective study at two year minimum follow-up

Sariali, Elhadi; Gaujac, Nicolas; Grimal, Quentin; Klouche, Shahnaz

doi:10.1007/s00264-020-04683-x

Cited by 10 publications

(6 citation statements)

References 17 publications

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“…Although the CT examination comes with considerable radiation exposure. Even a low-dose CT, utilized in some studies, is not deprived of this disadvantage [ 14 , 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…This way, we will be able to observe the changes in the BMD and compare the pre- to postoperative values in further research. We were not the only authors who have chosen to conduct the study with the preoperative BMD measurement before THA [ 15 , 16 , 19 , 20 ]. However, in some studies, the measurement was made only postoperatively [ 17 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

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Bone Quality Assessment Before Total Hip Arthroplasty: The Role of Densitometry

Żarnowska,

Wilk,

Chilińska

et al. 2024

Cureus

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Background Total hip arthroplasty (THA) is effective in the treatment of hip osteoarthritis. Radiographic evaluation, standard in THA planning, is sufficient in examining hip anatomy, although it may not precisely assess bone quality. A routinely implemented method in bone quality assessment is densitometry. The technique allows for a measurement of bone mineral density (BMD). Methodology In the study, we included 26 participants who qualified for THA. All the patients were preoperatively examined with radiographs and densitometry of the affected hip. On the preoperative anteroposterior radiograph, we measured the canal-to-calcar isthmus ratio (CC ratio) and the cortical index (CI). Intraoperatively, during the THA procedure, we measured the thickness of the cortical bone and the diameter of the femoral neck in the line of neck resection. Results The examination with Pearson’s correlation coefficient revealed that BMD significantly positively correlates with the intraoperatively measured diameter of the femoral neck ( r = 0.5, P = 0.009), and with the measured thickness of the cortical bone ( r = 0.47, P = 0.015), CI significantly positively correlates with the intraoperatively measured diameter of the femoral neck ( r = 0.6, P = 0.001), and with the CC ratio ( r = 0.44, P = 0.024), the intraoperatively measured diameter of the femoral neck significantly positively correlates with the intraoperatively measured thickness of the cortical bone ( r = 0.59, P = 0.001). All of the other correlations were not statistically significant. Conclusions BMD measurements can be used in THA planning as they positively correlate with intraoperative measurements. The radiological parameters (CC ratio and CI) may not be as precise in bone quality assessment.

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“…Although the CT examination comes with considerable radiation exposure. Even a low-dose CT, utilized in some studies, is not deprived of this disadvantage [ 14 , 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Bone Quality Assessment Before Total Hip Arthroplasty: The Role of Densitometry

Żarnowska,

Wilk,

Chilińska

et al. 2024

Cureus

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“…The initial mHHSs (91 points) were normalized to 100 by multiplying the raw values by 1.1. Scores ≥90 were defined as excellent mHHS 22 . The mHHS and UCLA activity scores were evaluated preoperatively and at the 1‐year follow‐up.…”

Section: Methodsmentioning

confidence: 99%

“…Scores ≥90 were defined as excellent mHHS. 22 The mHHS and UCLA activity scores were evaluated preoperatively and at the 1-year follow-up.…”

Section: Clinical Evaluationmentioning

confidence: 99%

Anterior acetabular coverage and femoral head–neck measurements predict postoperative anterior impingement: A simulation study

Hayashi

Hashimoto

Kuroda

et al. 2022

Journal Orthopaedic Research

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The aim of this simulation study was to evaluate the relationship of elements of anterior acetabular coverage and femoral head–neck shape with the occurrence of postoperative anterior impingement after curved periacetabular osteotomy (PAO). Sixty‐two patients with symptomatic developmental dysplasia of the hip who had undergone curved PAO were selected. The likelihood of developing postoperative anterior impingement was explored through simulations of the range of motion by collision detection of the pelvis and femur. Postoperative anterior impingement was defined as impingement that occurred during postoperative bone flexion <105° or postoperative internal rotation <20° at 90° flexion. The three‐dimensional center‐edge (CE) angles, acetabular and femoral versions, radiographic alpha angles of the femoral head, combination angles of anterior CE and alpha angles, and combined anteversions of acetabular and femoral versions were compared between patients with postoperative anterior impingement and nonimpingement. A receiver operator characteristic (ROC) analysis was conducted to determine thresholds of the examined radiographic parameters and calculate their accuracy for predicting postoperative anterior impingement. A multivariate analysis was performed to test whether combined anteversion, anterior CE angle, and combination angle are associated with excellent modified Harris Hip Scores (mHHSs). ROC analysis demonstrated a combination angle ≥108° was predictive of the occurrence of postoperative anterior impingement after curved PAO, which can lead to impaired clinical outcomes. Conversely, a combination angle <108° was significantly associated with mHHS ≥ 90 points. To avoid postoperative anterior impingement, osteochondroplasty of the femoral head or anterior CE angle control should be performed for patients with preoperative combination angles ≥90°.

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“…Several studies have shown that low bone mineral density (BMD) in the hip affects the longevity of prosthetic implants following total hip arthroplasty [ 4 ]. Low bone mineral density in combination with a high body mass index increases the risk of early femoral component failure following hip arthroplasty [ 5 ]. Periprosthetic bone loss is proportional to the pre-operative bone mineral density in the periprosthetic Gruen zones, which leads to implant loosening.…”

Section: Introductionmentioning

confidence: 99%

Short-Term Analysis of the Changes in the Bone Mineral Density of the Proximal Femur After Uncemented Total Hip Arthroplasty: A Prospective Study of 110 Patients

Mohanty¹,

Vasavda²,

Rai³

et al. 2022

Cureus

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Introduction Mechanical loading continuously exposes the bone to remodeling processes. Increased load leads to a gain in bone mass, and reduced load results in a loss. After inserting a prosthesis, the proximal femur is bypassed in loading as the bodyweight shifts distally. This lack of load induces bone resorption according to Wolff’s law. To avoid this bone resorption, the implant's bending stiffness should be less than the femoral bone. Dual-energy X-ray absorptiometry (DEXA) is a well-accepted method to measure periprosthetic bone mineral density (BMD) after total hip arthroplasty (THA). Since the strength and durability of the fixation of a femoral prosthesis in cementless hip arthroplasty depend largely on the quantity and quality of the surrounding bone, preoperative and postoperative evaluation of the quantity and quality of the femoral bone is very important in the long-term prognosis of hip arthroplasty. Materials and methods A prospective study of 110 patients in the age group of 25-60 years who underwent uncemented total hip arthroplasty in our tertiary healthcare institution was performed. An uncemented, fully hydroxyapatite-coated implant from a single manufacturer was used in all the patients. All the patients were mobilized on the first post-operative day. The BMD was measured at the proximal femur and the distal tip using a DEXA scan. Gruen zones were used for calculating BMD at different anatomical locations in the femur, with particular importance to zones 1, 4, and 7. Results The pre-operative BMD in all zones measured, viz. zones 1, 4, and zone 7 of the affected side, was found to be significantly lower as compared to the BMD values on the control side (P< 0.05). The mean change in the mean BMD was calculated for all the zones and compared with each other using an unpaired t-test. The mean BMD changes were found to be significantly higher in zone 7 in comparison to both zones 1 and 4 (p<0.05). Conclusion Significant periprosthetic bone loss after uncemented THA in the femur was noted in Gruen zones 1, 4, and 7 during the first six months after THA, with the greatest bone loss in the femoral calcar area (zone 7). The lower the preoperative BMD of the patient, the greater the postoperative bone loss.

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Pre-operative bone mineral density is a predictive factor for excellent early patient-reported outcome measures in cementless total hip arthroplasty using a proximally fixed anatomic stem. A prospective study at two year minimum follow-up

Cited by 10 publications

References 17 publications

Bone Quality Assessment Before Total Hip Arthroplasty: The Role of Densitometry

Bone Quality Assessment Before Total Hip Arthroplasty: The Role of Densitometry

Anterior acetabular coverage and femoral head–neck measurements predict postoperative anterior impingement: A simulation study

Short-Term Analysis of the Changes in the Bone Mineral Density of the Proximal Femur After Uncemented Total Hip Arthroplasty: A Prospective Study of 110 Patients

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