Peri-prosthetic bone remodeling and change in bone mineral density in the femur after cemented polished tapered stem implantation

  • Toshiki IwaseEmail author
  • Daigo Morita
  • Genta Takemoto
  • Hiroshi Fujita
  • Naoyuki Katayama
  • Hiromi Otsuka
Original Article • HIP - ARTHROPLASTY



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.


Bone 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.

Ethical approval

The study was performed according to the Declaration of Helsinki and approved by the Local Research Ethics Committee (No. H28-23).


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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Orthopedic SurgeryHip & Knee Reconstruction and Arthroplasty Center, Hamamatsu Medical CenterHamamatsuJapan
  2. 2.Department of Orthopedic Surgery, Institute for Joint ReplacementKyoto Katsura HospitalKyotoJapan
  3. 3.Department of Orthopedic SurgeryHokkaido Orthopedic Memorial HospitalSapporoJapan
  4. 4.Joint Reconstruction Center, Gifu Municipal HospitalGifuJapan

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