scholarly journals An evaluation of proximal femur bone density in young, active patients undergoing total hip arthroplasty at one year postoperatively

2018 ◽  
Vol 29 (1) ◽  
pp. 51-57
Author(s):  
Denis Nam ◽  
Rondek Salih ◽  
Robert L Barrack ◽  
Ryan M Nunley
Keyword(s):  
Bone Density ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Proximal Femur ◽  
Mineral Density ◽  
Stem Design ◽  
Ucla Activity Score ◽  
Total Hip ◽  
The Mean ◽  
Active Patients

Background: Prior investigations have shown a decrease in periprosthetic bone mineral density (BMD) of the calcar following total hip arthroplasty (THA). The purpose of this investigation was to study proximal femur BMD in a cohort of young, active patients following THA at 1 year postoperatively using a recently introduced stem design. Methods: This was a prospective, IRB-approved investigation of patients with an age <65 years, BMI <35 kg/m2, and presymptomatic UCLA score of >6 undergoing a primary THA for a diagnosis of osteoarthritis. All patients received a titanium, proximally coated, tapered cementless femoral stem (ACCOLADE II, Stryker Inc, Mahwah, NJ, USA). Dual energy X-ray absorptiometry scans were performed at 6 weeks, 6 months, and 1 year postoperatively. Bone density was analyzed for 7 traditional Gruen zones with BMD ratios calculated for change in BMD compared with the baseline. Results: 31 patients (mean age of 52.6 + 6.5 years, BMI of 27.9 + 3.9 kg/m2, and UCLA activity score of 7.3 + 1.9) were included. The mean BMD ratio decreased at the 6 months and 1 year interval in zones 1 and 2. However, the mean BMD ratio was maintained in Gruen zones 3 thru 7 with zone 7 (medial calcar) demonstrating 100% maintenance of the baseline BMD at 1 year. Conclusion: This study demonstrates the maintenance of medial calcar bone density at 1 year postoperatively in young, active patients undergoing THA. Further longitudinal analysis of this stem design is necessary to elucidate the significance of this finding.

Proximal Femur Bone Density Decreases up to 5 Years After Total Hip Arthroplasty in Young, Active Patients

2016 ◽  
Vol 31 (12) ◽  
pp. 2825-2830 ◽  
Author(s):  
Denis Nam ◽  
Robert L. Barrack ◽  
John C. Clohisy ◽  
Ryan M. Nunley
Keyword(s):  
Bone Density ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Proximal Femur ◽  
Total Hip ◽  
Femur Bone ◽  
Active Patients

Measuring bone mineral density of the pelvis and proximal femur after total hip arthroplasty

2001 ◽  
Vol 83-B (2) ◽  
pp. 283-288 ◽  
Author(s):  
J. M. Wilkinson ◽  
N. F. A. Peel ◽  
R. A. Elson ◽  
I. Stockley ◽  
R. Eastell
Keyword(s):  
Bone Mineral Density ◽  
Total Hip Arthroplasty ◽  
Bone Mineral ◽  
Hip Arthroplasty ◽  
Proximal Femur ◽  
Mineral Density ◽  
Total Hip

Modular dual mobility total hip arthroplasty is a viable option for young, active patients

2021 ◽  
Vol 103-B (7 Supple B) ◽  
pp. 73-77
Author(s):  
Charles Murray Lawrie ◽  
Robert L. Barrack ◽  
Ryan M. Nunley
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Metal Ion ◽  
Femoral Stem ◽  
Dual Mobility ◽  
Total Hip ◽  
The Mean ◽  
Active Patients ◽  
Cobalt Chrome

Aims Dual mobility (DM) implants have been shown to reduce the dislocation rate after total hip arthroplasty (THA), but there remain concerns about the use of cobalt chrome liners inserted into titanium shells. The aim of this study was to assess the clinical outcomes, metal ion levels, and periprosthetic femoral bone mineral density (BMD) at mid-term follow-up in young, active patients receiving a modular DM THA. Methods This was a prospective study involving patients aged < 65 years, with a BMI of < 35 kg/m2, and University of California, Los Angeles activity score of > 6 who underwent primary THA with a modular cobalt chrome acetabular liner, highly cross-linked polyethylene mobile bearing, and a cementless titanium femoral stem. Patient-reported outcome measures, whole blood metal ion levels (μg/l), and periprosthetic femoral BMD were measured at baseline and at one, two, and five years postoperatively. The results two years postoperatively for this cohort have been previously reported. Results A total of 43 patients were enrolled. At minimum follow-up of five years, 23 (53.4%) returned for clinical and radiological review, 25 (58.1%) had metal ion analysis performed, 19 (44.2%) underwent dual energy x-ray absorptiometry scans, and 25 (58%) completed a pain-drawing questionnaire. The mean modified Harris Hip Scores improved significantly from 54.8 (SD 19) preoperatively to 93.08 (SD 10.5) five years postoperatively (p < 0.001). One patient was revised for aseptic acetabular loosening. The mean cobalt levels increased from 0.065 μg/l (SD 0.03) to 0.08 (SD 0.05) and the mean titanium levels increased from 0.35 (SD 0.13) to 0.78 (SD 0.29). The femoral BMD ratio decreased in Gruen Zone 1 (91.9%) at five years postoperatively compared with the baseline scores at six weeks potoperatively. The femoral BMD ratio was maintained in Gruen zones 2 to 7. Conclusion The use of a modular DM component and a cementless, tapered femoral stem shows excellent mid-term survivorship with minimal concerns for corrosion and metal ion release in a cohort of young, active patients undergoing primary THA. Cite this article: Bone Joint J 2021;103-B(7 Supple B):73–77.

Effect of a stemless femoral implant for total hip arthroplasty on the bone mineral density of the proximal femur

1997 ◽  
Vol 12 (4) ◽  
pp. 373-379 ◽  
Author(s):  
E. Munting ◽  
P. Smitz ◽  
N. Van Sante ◽  
C.Nagant de Deuxchaisnes ◽  
A. Vincent ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Total Hip Arthroplasty ◽  
Bone Mineral ◽  
Hip Arthroplasty ◽  
Proximal Femur ◽  
Mineral Density ◽  
Total Hip

scholarly journals Bone density measurements adjacent to acetabular cups in total hip arthroplasty using dual-energy CT: an in vivo reliability and agreement study

2018 ◽  
Vol 7 (9) ◽  
pp. 205846011879653 ◽  
Author(s):  
Bo Mussmann ◽  
Poul Erik Andersen ◽  
Trine Torfing ◽  
Søren Overgaard
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Intraclass Correlation ◽  
Dual Energy ◽  
Dual Energy Ct ◽  
Mineral Density ◽  
Metal Artifacts ◽  
Total Hip ◽  
Complex Anatomy ◽  
The Mean

Background Measuring bone mineral density (BMD) around acetabular prosthetic components with computed tomography (CT) is challenged by the complex anatomy and metal artifacts. Three-dimensional (3D) segmentation is required for the analysis, but it is usually not practically applicable on current CT workstations Purpose To test the between-scan agreement and reliability of custom segmentation software for BMD measurements adjacent to cemented and uncemented acetabular cups in dual-energy CT (DECT). Material and Methods Twenty-four male patients with total hip arthroplasty were scanned and rescanned using 130-keV virtual monochromatic DECT images. Hemispherical regions of interest were defined slice-by-slice and BMD was calculated around the acetabular cup using custom segmentation software. Results In the uncemented cup, the mean BMD was 153 mg/cm3 with a between-scan difference of 10 mg/cm3 ( P < 0.0001). In the cemented cup, the mean BMD was 186 mg/cm3 with a between-scan difference of 6 mg/cm3 ( P = 0.15). In both uncemented and cemented cups the intraclass correlation coefficient between repeated measurements was >0.95 and narrow Bland–Altman Limits of Agreement. Conclusion BMD can be measured with high absolute between-scan agreement and good reliability adjacent to acetabular cemented and uncemented cups using DECT and segmentation software.

Bipolar hemiarthroplasty versus total hip arthroplasty in allograft-prosthesis composite reconstruction of the proximal femur following primary bone tumour resection

2020 ◽  
Vol 102-B (4) ◽  
pp. 524-529
Author(s):  
Khodamorad Jamshidi ◽  
Masoud Mirkazemi ◽  
Mohammad Gharedaghi ◽  
Azra Izanloo ◽  
Mehdi Mohammadpour ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Functional Outcome ◽  
Hip Arthroplasty ◽  
Proximal Femur ◽  
Primary Tumour ◽  
Tumour Resection ◽  
Bipolar Hemiarthroplasty ◽  
Total Hip ◽  
The Mean ◽  
Primary Tumour Resection

Aims The consensus is that bipolar hemiarthroplasty (BHA) in allograft-prosthesis composite (APC) reconstruction of the proximal femur following primary tumour resection provides more stability than total hip arthroplasty (THA). However, no comparative study has been performed. In this study, we have compared the outcome and complication rates of these two methods. Methods In a retrospective study, 57 patients who underwent APC reconstruction of proximal femur following the primary tumour resection, either using BHA (29) or THA (28), were included. Functional outcome was assessed using the Musculoskeletal Tumour Society (MSTS) scoring system and Harris Hip Score (HHS). Postoperative complications of the two techniques were also compared. Results The mean follow-up of the patients was 8.3 years (standard deviation (SD) 5.5) in the BHA and 6.9 years (SD 4.7) in the THA group. The mean HHS was 65 (SD 16.6) in the BHA group and 88 (SD 11.9) in the THA group (p = 0.036). The mean MSTS score of the patients was 73.3% (SD 16.1%) in the BHA and 86.7% (SD 12.2%) in the THA group (p = 0.041). Limping was recorded in 19 patients (65.5%) of the BHA group and five patients (17.8%) of the THA group (p < 0.001). Dislocation occurred in three patients (10.3%) of the BHA group and two patients (7.1%) of the THA group. Conclusion While the dislocation rate was not higher in THA than with BHA, the functional outcome was significantly superior. Based on our results, we recommend THA in APC reconstruction of the proximal femur. Cite this article: Bone Joint J 2020;102-B(4):524–529.

Dual X-ray absorptiometry for the evaluation of bone density from the proximal femur after total hip arthroplasty: Analysis protocols and reproducibility

1993 ◽  
Vol 53 (3) ◽  
pp. 158-161 ◽  
Author(s):  
Carlo Trevisan ◽  
Marco Bigoni ◽  
Roberto Cherubini ◽  
Peter Steiger ◽  
Gianni Randelli ◽  
...  
Keyword(s):  
Bone Density ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Proximal Femur ◽  
X Ray ◽  
Total Hip

Periprosthetic Femoral Bone Loss in Total Hip Arthroplasty: Systematic Analysis of the Effect of Stem Design

2016 ◽  
Vol 27 (1) ◽  
pp. 26-34 ◽  
Author(s):  
Ashleen R. Knutsen ◽  
Nicole Lau ◽  
Donald B. Longjohn ◽  
Edward Ebramzadeh ◽  
Sophia N. Sangiorgio
Keyword(s):  
Total Hip Arthroplasty ◽  
Bone Loss ◽  
Hip Arthroplasty ◽  
Femoral Stem ◽  
Fixation Method ◽  
Mineral Density ◽  
Periprosthetic Bone ◽  
Stem Design ◽  
Total Hip ◽  
Press Fit

Introduction Periprosthetic bone loss may lead to major complications in total hip arthroplasty (THA), including loosening, migration, and even fracture. This study analysed the influence of femoral implant designs on periprosthetic bone mineral density (BMD) after THA. Methods The results of all previous published studies reporting periprosthetic femoral BMD following THA were compiled. Using these results, we compared percent changes in bone loss as a function of: femoral stem fixation, material, and geometry. Results The greatest bone loss was in the calcar region (Gruen Zone 7). Overall, cemented stems had more bone loss distally than noncemented stems, while noncemented stems had more proximal bone loss than cemented stems. Within noncemented stems, cobalt-chromium (CoCr) stems had nearly double the proximal bone loss compared to titanium (Ti) alloy stems. Finally, within noncemented titanium alloy group, straight stems had less bone loss than anatomical, tapered, and press-fit designs. Discussion The findings from the present study quantified percent changes in periprosthetic BMD as a function of fixation method, alloy, and stem design. While no one stem type was identified as ideal, we now have a clearer understanding of the influence of stem design on load transfer to the surrounding bone.

scholarly journals Hydroxyapatite-Coated Compaction Short Stem Represents a Characteristic Pattern of Peri-Prosthetic Bone Remodelling After Total Hip Arthroplasty

2021 ◽  
Author(s):  
Shinya Hayashi ◽  
Shingo Hashimoto ◽  
Yuichi Kuroda ◽  
Naoki Nakano ◽  
Tomoyuki Matsumoto ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Bone Remodelling ◽  
Japanese Orthopaedic Association ◽  
Short Stem ◽  
Clinical Factors ◽  
Mineral Density ◽  
Ucla Activity Score ◽  
Total Hip ◽  
Stem Group

Abstract Purpose: We aimed to investigate the differences in peri-prosthetic bone remodelling between the full hydroxyapatite (HA)-collared compaction short stem and the short tapered-wedge stem.Methods: This retrospective cohort study enrolled 159 consecutive patients (159 joints) undergoing total hip arthroplasty (THA) using the full HA compaction short (n=64) and short tapered-wedge (n=95) stems. Body mass index (BMI), peri-prosthetic bone mineral density (BMD), and clinical factors, including the Japanese Orthopaedic Association score and the University of California Los Angeles (UCLA) activity score, were assessed and compared.Results: Both groups showed similar peri-prosthetic BMD changes. Peri-prosthetic BMD was almost maintained in the distal femur and Gruen zone 6 with both type of stems, but significant BMD loss was found in zones 1 and 7 in both groups and in zone 2 of the full HA compaction stem group. Significant positive correlations were found between the proximal femoral BMD changes and the UCLA score in the tapered-wedge stem group but not between BMD changes and clinical factors in the full HA compaction stem group. Femoral bone shape affected the peri-prosthetic BMD changes in the tapered-wedge stem but not in the full HA compaction group. The stem collar of the full HA compaction stem did not affect peri-prosthetic BMD, but unique bone remodelling in the calcar region was observed in 27.6% cases.Conclusion: Peri-prosthetic bone remodelling remained unaffected by clinical and radiographic factors after THA with the new short full HA compaction stem. Therefore, the new stem may be useful in a variety of cases.

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