Peri-prosthetic bone remodeling and change in bone mineral density in the femur after cemented polished tapered stem implantation
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We examined longitudinal changes in bone mineral density (BMD) around the femur for 5 years after total hip arthroplasty (THA) using cemented collarless polished double-tapered stem implantation and investigated the influence of BMD changes on radiological remodeling of the femur.
Materials and methods
Sixty hips from 56 patients who underwent cemented THA with a collarless polished double-tapered stem were included. BMD was measured 2 weeks postoperatively (baseline), 3 months, 6 months, 1 year and annually thereafter until 5 years after surgery using dual-energy X-ray absorptiometry on the lumbar spine and proximal femur of the operated side according to the Gruen’s zone classification. We analyzed predictable factors for BMD preservation in the proximal femur and compared radiological remodeling of the femur and changes in BMD.
BMD at 5 years in zone 7 decreased less than 10%, whereas BMD in zone 1 increased to over the baseline (+ 1.9%). Multiple linear regression analyses revealed that body weight was a predictor for positive BMD change in the proximal femur. The frequency of radiolucency of the femur was significantly lower in patients who exhibited an increase in BMD at 5 years compared with BMD at 2 weeks in zone 7.
BMD preservation of the proximal femur after cemented collarless polished double-tapered stem implantation was more effective in heavier patients. Furthermore, the frequency of radiolucency around the stem was significantly lower in patients who exceeded 100% of the baseline BMD in zone 7 at 5 years.
KeywordsBone mineral density Cemented collarless polished tapered stem Dual-energy X-ray absorptiometry Total hip arthroplasty Radiolucency
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
The study was performed according to the Declaration of Helsinki and approved by the Local Research Ethics Committee (No. H28-23).
- 1.Huiskes R (1990) The various stress patterns of press-fit, ingrown, and cemented femoral stems. Clin Orthop Relat Res 261:27–38Google Scholar
- 6.Gruen TA, McNeice GM, Amstutz HC (1979) “Modes of failure” of cemented stem-type femoral components. Clin Orthop Relat Res 141:17–27Google Scholar
- 7.Fowler JL, Gie GA, Lee AJC, Ling RSM (1988) Experience with the Exeter total hip replacement since 1970. Orthop Clin N Am 19(3):477–489Google Scholar