Average Periosteal Stress of the Proximal Femur Before and After Cementless Total Hip Arthroplasty

2009 ◽  
Author(s):  
Joseph D. Yutzy ◽  
Erik R. Bardy
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Stress Shielding ◽  
Stress Distributions ◽  
Stress Concentrations ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty ◽  
Before And After ◽  
Hip Replacements ◽  
Neck Fracture

Cementless Total Hip Arthroplasty (THA) is a standard surgical technique for the treatment of several types of joint diseases and damages including, but not limited to, osteoarthritis and femoral neck fracture [1]. An estimated one half to one million total hip replacements are performed each year [2]. Two drawbacks to THA are (1): micromotions as a result of improper implant fit in the bone cavity [1], and (2): stress shielding due to unnatural stress concentrations near the implant [3]. The latter causes bone resorption in other areas found in the bone-implant interface [1]. Therefore, the geometry and size of the implant is a major factor in determining cortical stress distributions and stress shielding [4].

scholarly journals The comparison of results in treating primary degenerative lesions of the hip joint using the cementless total hip arthroplasty method with the Corail and Fitmore stems

2021 ◽  
Vol 86 (1) ◽  
pp. 30-32
Author(s):  
Michał Urbaniak ◽  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Provincial Hospital ◽  
Cementless Total Hip Arthroplasty ◽  
Comparison Of Results ◽  
Before And After ◽  
Hip Replacements ◽  
Arthroplasty Surgery

The aim of this study is to clinically assess the results of a total hip arthroplasty surgery among patients with idiopathic hip degenerative lesions. These patients were treated using endoprosthesis with the standard Corail stem and the short Fitmore stem. The scope of this assessment includes surgeries carried out in the Provincial Hospital Complex in Kalisz in the Department of Orthopedics and Traumatology during years 2012-2015. In total, 64 patients with 70 endoprosthetics were analyzed (including 6 bilateral hip replacements). To assess the results before and after the treatment, both HHS and WOMAC scales were applied. The results achieved after the hip arthroplasty with both stem types were very similar and both produce good results for the patients. These results that are close to both Polish and international statistics.

scholarly journals Preventing Loss of Femoral Periprosthetic Bone Mineral Density in Cementless Total Hip Arthroplasty Using a Tapered Wedge Stem in Patients With Osteoporosis Treated With Denosumab: a Retrospective, Cohort Study

2021 ◽  
Author(s):  
Keiji Kamo ◽  
Hiroaki Kijima ◽  
Koichiro Okuyama ◽  
Tetsuya Kawano ◽  
Nobutoshi Seki ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Total Hip Arthroplasty ◽  
Bone Mineral ◽  
Hip Arthroplasty ◽  
Stress Shielding ◽  
Control Group ◽  
Mineral Density ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty ◽  
Periprosthetic Bone Mineral Density

Abstract Background: Bone mineral density (BMD) of the proximal femur around the stem decreases due to stress shielding after cementless total hip arthroplasty (THA). When severe stress shielding occurs, the risk of periprosthetic femoral fractures increases, and this bone loss can also increase the difficulty of future revision THA. Denosumab is known to improve the quality and strength of cortical bone in the proximal femurs of patients with osteoporosis. The purpose of this study was to investigate whether denosumab prevents loss of proximal femoral periprosthetic BMD in cementless THA using a tapered wedge stem in patients with osteoporosis.Methods: Sixty-three consecutive patients who had undergone unilateral primary THA using a tapered wedge stem were included in this retrospective study. Twenty-four patients who received denosumab for osteoporosis were the denosumab group, and the 39 without denosumab were the control group. At 2 weeks, 6 months, and 12 months after THA, bone turnover markers and femoral periprosthetic BMD were measured.Results: BMD in zone 1 was significantly increased from baseline at both 6 and 12 months after THA in the denosumab group and significantly decreased in the control group. BMD in zone 7 was significantly decreased compared to baseline at both 6 and 12 months after THA in the control group, but not in the denosumab group. The use of denosumab for THA patients with osteoporosis was independently related to preventing loss of periprosthetic BMD of the femur at 12 months after surgery in zones 1 and 7 on multivariate analysis.Conclusions: Denosumab significantly increased proximal femoral periprosthetic BMD in zone 1 and prevented loss of BMD in zone 7 in patients with osteoporosis after cementless THA using a tapered wedge stem at both 6 and 12 months after surgery.

Evaluation of Stress Shielding for Three Types of Implanted Femurs Based on Stress Distribution

2013 ◽  
Vol 459 ◽  
pp. 524-529
Author(s):  
Koki Ouchi ◽  
Gang Deng ◽  
Go Yamako ◽  
Etsuo Chosa ◽  
Tsutomu Nakanishi
Keyword(s):  
Total Hip Arthroplasty ◽  
Stress Distribution ◽  
Hip Arthroplasty ◽  
Stress Shielding ◽  
Stress Distributions ◽  
The Finite Element Method ◽  
Gruen Zone ◽  
Total Hip ◽  
Method Analysis ◽  
Thrust Plate Prosthesis

This research investigates the stress distribution of the three types of implanted femurs using the finite element method analysis. The comparisons of the stress distribution between the implanted femursand the healthy femur were performed and the characteristics in the stress shielding of each casewere clarified. Since the load is transferred on the contact surface between the implant and the inner surface of the femur in the case of the total hip arthroplasty, the stress in the intertrochanteric zone (Gruen zone 7) become very small, and the phenomenon of the stress shielding is confirmed obviously. The stress distributions of the femurs afterthe resurfacing hiparthroplasty and the thrust plate prosthesis are about the same with that of the healthy femur, so, the possibility of the stress shielding is considered lower compared with the femur after the total hip arthroplasty. However, considering the stress concentration thatwill increase the risk of femoral fracture caused by the screws for the fixation of the implant in the thrust plate prosthesis, the resurfacing hiparthroplastymay beconcluded as the best method among these three types of implants to avoid stress shielding.

scholarly journals Periprosthetic fragility fracture of the femur after primary cementless total hip arthroplasty

2021 ◽  
Author(s):  
Masanobu Hirao ◽  
Kazumasa Miyatake ◽  
Ryohei Takada ◽  
Tetsuya Tachibana ◽  
Atsushi Okawa ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Fragility Fracture ◽  
Survival Rates ◽  
Stress Shielding ◽  
Epidemiological Data ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty ◽  
End Point ◽  
Significant Difference

ABSTRACT Objectives Periprosthetic bone fragility due to stress shielding (SS) can be a risk factor of periprosthetic fracture after cementless total hip arthroplasty (THA). We aimed to obtain epidemiological information on periprosthetic fragility fracture of the femur (PPFF) after THA. Methods We retrospectively reviewed the medical records of 1062 hips that had undergone cementless THA. We evaluated the epidemiological data as well as the features of PPFFs. Results Of the 1062 hips, 8 (0.8%) were diagnosed with PPFFs. The survival rates, with the occurrence of PPFF as the end point, were 99.2% and 97.6% at 10 and 16 years postoperatively, respectively. When patients were classified as having either mild or severe SS on radiographs 5 years postoperatively, there was no significant difference in the survival rate, with PPFF as the end point. Conclusions In our cases, the incidence of PPFF after cementless THA was 0.8%.

scholarly journals Excellent Functional Outcome and Quality of Life after Primary Cementless Total Hip Arthroplasty (THA) Using an Enhanced Recovery Setup

2021 ◽  
Vol 10 (4) ◽  
pp. 621
Author(s):  
Franziska Leiss ◽  
Julia Sabrina Götz ◽  
Günther Maderbacher ◽  
Matthias Meyer ◽  
Jan Reinhard ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Patient Satisfaction ◽  
Total Hip Arthroplasty ◽  
Functional Outcome ◽  
Hip Arthroplasty ◽  
Enhanced Recovery ◽  
Harris Hip Score ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty

Background: Total hip arthroplasty combined with the concept of enhanced recovery is of continued worldwide interest, as it is reported to improve early functional outcome and treatment quality without increasing complications. The aim of the study was to investigate functional outcome and quality of life 4 weeks and 12 months after cementless total hip arthroplasty in combination with an enhanced recovery concept. Methods: A total of 109 patients underwent primary cementless Total Hip Arthroplasty (THA) in an enhanced recovery concept and were retrospectively analyzed. After 4 weeks and 12 months, clinical examination was analyzed regarding function, pain and satisfaction; results were evaluated using Harris Hip score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), EQ-5D-5L, EQ-VAS and subjective patient-related outcome measures (PROMs). Preoperatively, HADS (Hospital Anxiety and Depression Scale) was collected. A correlation analysis of age, American Society of Anesthesiologists (ASA), HADS and comorbidities (diabetes mellitus, art. hypertension, cardiovascular disease) with WOMAC, Harris Hip score (HHS) and EQ-5D was performed. Results: Patients showed a significant improvement in Harris Hip score 4 weeks and 12 months postoperatively (p < 0.001). WOMAC total score, subscale pain, subscale stiffness and subscale function improved significantly from preoperative to 12 months postoperative (p < 0.001). EQ-5D showed a significant improvement preoperative to postoperative (p < 0.001). The influence of anxiety or depression (HADS-A or HADS-D) on functional outcome could not be determined. There was a high patient satisfaction postoperatively, and almost 100% of patients would choose enhanced recovery surgery again. Conclusion: Cementless THA with the concept of enhanced recovery improves early clinical function and quality of life. PROMs showed a continuous improvement over a follow-up of 12 months after surgery. PROMs can help patients and surgeons to modify expectations and improve patient satisfaction.

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