Texture analysis of trabecular bone around RM-Pressfit cementless acetabulum in a series of 46 patients during a 5 year period

Peri-acetabular bone remodelling after uncemented total hip arthroplasty with monoblock press-fit cups: an observational study

“…In contrast, a recent clinical study involving texture analysis of elastic xation with a monoblock press-t acetabular cup showed statistically signi cant changes in peri-acetabular stress distribution with an increase in peri-prosthetic bone in zone II up to ve years post-operatively [7]. A second study involving the same monoblock press-t acetabular cup found both a homogeneous appearance of the bone trabeculae around the cup and resolution of pre-operative sclerosis one and a half years post-operatively, suggesting that the implant distributed loads more evenly [9].…”

“…Contemporary modular press-t acetabular cups have stiffer metal shells than monoblock press-t cups, which result in rigid xation. Such a xation is known to transmit forces in the equatorial region (DeLee and Charnley zones I and III), increasing stress concentrations around the acetabular rim and reducing stress within the bone proximal to the implant (DeLee and Charnley zone II) [7,8]. In fact, nite element analysis and computer-simulated modelling have shown that changes in peri-acetabular bone mineral density (BMD) occur in response to altered pelvic stress patterns [5].…”

“…In fact, nite element analysis and computer-simulated modelling have shown that changes in peri-acetabular bone mineral density (BMD) occur in response to altered pelvic stress patterns [5]. Over time, BMD changes translate into increased central osteolysis around stiff metal-backed cups eventually leading to loosening [7,8], one of the leading causes of failure of the acetabular component after primary THA [4,5].…”

“…Monoblock press-t cups, on the other hand, are less stiff [7]. Consequently, xation of these cups is expected to result in less equatorial stress and less central osteolysis [7]. However, little clinical evidence exists to support this xation concept [7,9].…”

“…Consequently, xation of these cups is expected to result in less equatorial stress and less central osteolysis [7]. However, little clinical evidence exists to support this xation concept [7,9]. Therefore, in this prospective observational study, we examined bone remodelling around a monoblock acetabular cup using dual-energy X-ray absorptiometry (DEXA).…”