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

Abstract Background: Bone stock preservation in total hip replacement is essential to allow for later revisions in an increasingly younger and fitter index patient population. While contemporary modular press-fit acetabular cups lead to rigid fixation with equatorial stress and central osteolysis, more elastic fixation may cause different peri-acetabular bone remodelling. The purpose of this study was to investigate changes in peri-acetabular bone mineral density (BMD) in uncemented elastic fixation with monoblock press-fit cups.Methods: This prospective observational study included 45 patients with monoblock cups. We evaluated peri-acetabular BMD using dual-energy X-ray absorptiometry and reported functional outcomes and complications.Results: At a mean follow-up of 24.2 ± 2.2 months, we found that BMD stabilised in DeLee and Charnley zones I and III and recovered to baseline value in zone II. The mean Harris Hip Scores improved significantly from 56.9 ± 20.0 to 97.2 ± 4.0 (p < 0001). Other than one peri-operative dislocation, we saw no post-operative complications.Conclusions: We found favourable adaptive bone changes with BMD stabilisation in the equatorial zones and recovery to pre-operative values in the central zone. Additionally, excellent clinical outcomes and few prosthesis-related complications strengthened the favourable results of monoblock acetabular cups.Trial registration: Registration number DRKS00017076.

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

10.21203/rs.3.rs-19063/v1 ◽

2020 ◽

Author(s):

Conrad Anderl ◽

Georg Mattiassich New ◽

Reinhold Ortmaier New ◽

Martin Steinmair New ◽

Josef Hochreiter New

Keyword(s):

Observational Study ◽

Bone Remodelling ◽

Central Zone ◽

Rigid Fixation ◽

Mineral Density ◽

Acetabular Bone ◽

Total Hip ◽

Press Fit ◽

Uncemented Total Hip Arthroplasty ◽

Elastic Fixation

Abstract Background: Bone stock preservation in total hip replacement is essential to allow for later revisions in an increasingly younger and fitter index patient population. While contemporary modular press-fit acetabular cups lead to rigid fixation with equatorial stress and central osteolysis, more elastic fixation may cause different peri-acetabular bone remodelling. The purpose of this study was to investigate changes in peri-acetabular bone mineral density (BMD) in uncemented elastic fixation with monoblock press-fit cups.Methods: This prospective observational study included 45 patients with monoblock cups. We evaluated peri-acetabular BMD using dual-energy X-ray absorptiometry and reported functional outcomes and complications.Results: At a mean follow-up of 24.2 ± 2.2 months, we found that BMD stabilised in DeLee and Charnley zones I and III and recovered to baseline value in zone II. The mean Harris Hip Scores improved significantly from 56.9 ± 20.0 to 97.2 ± 4.0 (p < 0001). Other than one peri-operative dislocation, we saw no post-operative complications.Conclusions: We confirmed favourable adaptive bone changes with BMD stabilisation in the equatorial zones and recovery to pre-operative values in the central zone. Additionally, excellent clinical outcomes and few prosthesis-related complications confirmed the favourable results of monoblock acetabular cups.

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

10.21203/rs.3.rs-19063/v2 ◽

2020 ◽

Author(s):

Conrad Anderl ◽

Georg Mattiassich ◽

Reinhold Ortmaier ◽

Martin Steinmair ◽

Josef Hochreiter

Keyword(s):

Observational Study ◽

Bone Remodelling ◽

Central Zone ◽

Rigid Fixation ◽

Mineral Density ◽

Acetabular Bone ◽

Total Hip ◽

Press Fit ◽

Uncemented Total Hip Arthroplasty ◽

Elastic Fixation

Abstract Background: Bone stock preservation in total hip replacement is essential to allow for later revisions in an increasingly younger and fitter index patient population. While contemporary modular press-fit acetabular cups lead to rigid fixation with equatorial stress and central osteolysis, more elastic fixation may cause different peri-acetabular bone remodelling. The purpose of this study was to investigate changes in peri-acetabular bone mineral density (BMD) in uncemented elastic fixation with monoblock press-fit cups.Methods: This prospective observational study included 45 patients with monoblock cups. We evaluated peri-acetabular BMD using dual-energy X-ray absorptiometry and reported functional outcomes and complications.Results: At a mean follow-up of 24.2 ± 2.2 months, we found that BMD stabilised in DeLee and Charnley zones I and III and recovered to baseline value in zone II. The mean Harris Hip Scores improved significantly from 56.9 ± 20.0 to 97.2 ± 4.0 (p < 0001). Other than one peri-operative dislocation, we saw no post-operative complications.Conclusions: We found favourable adaptive bone changes with BMD stabilisation in the equatorial zones and recovery to pre-operative values in the central zone. Additionally, excellent clinical outcomes and few prosthesis-related complications strengthened the favourable results of monoblock acetabular cups.Trial registration: Registration number DRKS00017076.

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Peri-acetabular bone mineral density in total hip replacement

Bone and Joint Research ◽

10.1302/2046-3758.28.2000173 ◽

2013 ◽

Vol 2 (8) ◽

pp. 140-148 ◽

Cited By ~ 5

Author(s):

L. Gauthier ◽

L. Dinh ◽

P. E. Beaulé

Keyword(s):

Bone Mineral Density ◽

Total Hip Replacement ◽

Bone Mineral ◽

Hip Replacement ◽

Mineral Density ◽

Acetabular Bone ◽

Total Hip

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Quantitative CT-assisted osteodensitometry of femoral adaptive bone remodelling after uncemented total hip arthroplasty

International Orthopaedics ◽

10.1007/s00264-007-0389-7 ◽

2007 ◽

Vol 32 (5) ◽

pp. 589-595 ◽

Cited By ~ 13

Author(s):

Rocco P. Pitto ◽

Aknaksha Bhargava ◽

Salil Pandit ◽

Cameron Walker ◽

Jacob T. Munro

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Bone Remodelling ◽

Quantitative Ct ◽

Total Hip ◽

Uncemented Total Hip Arthroplasty

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Changes in bone mineral density around a stable uncemented total hip arthroplasty

International Orthopaedics ◽

10.1007/s002640050113 ◽

1997 ◽

Vol 21 (1) ◽

pp. 30-34 ◽

Cited By ~ 16

Author(s):

P. Korovessis ◽

G. Piperos ◽

A. Michael ◽

A. Baikousis ◽

M. Stamatakis

Keyword(s):

Bone Mineral Density ◽

Total Hip Arthroplasty ◽

Bone Mineral ◽

Hip Arthroplasty ◽

Mineral Density ◽

Total Hip ◽

Uncemented Total Hip Arthroplasty

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Changes in periacetabular bone mineral density five years after resurfacing hip arthroplasty versus conventional total hip arthroplasty

Hip International ◽

10.1177/1120700018808023 ◽

2018 ◽

Vol 29 (2) ◽

pp. 153-160 ◽

Cited By ~ 1

Author(s):

Davey MJM Gerhardt ◽

José MH Smolders ◽

Elisabeth A Roovers ◽

Ton AJM Rijnders ◽

Job LC van Susante

Keyword(s):

Bone Mineral Density ◽

Total Hip Arthroplasty ◽

Bone Mineral ◽

Hip Arthroplasty ◽

Controlled Trial ◽

Small Diameter ◽

Mineral Density ◽

Total Hip ◽

Press Fit ◽

Resurfacing Hip Arthroplasty

Introduction: We studied whether acetabular bone mineral density (BMD) is better preserved after resurfacing hip arthroplasty (RHA) versus small diameter metal-on-metal total hip arthroplasty (THA). Methods: This randomised controlled trial included 82 patients. BMD was measured in 5 periprosthetic regions of interest (ROI) with dual-energy absorptiometry (DEXA) preoperatively, at 3 and 6 months, 1, 2, 3 and 5 years postoperative. 34 RHA and 26 THA had a complete 5 years follow-up. 1 RHA and 1 THA were revised due to pseudotumour formation, 2 THA were revised because of recurrent dislocations and 1 RHA for avascular necrosis. Results: Overall an initial decrease in BMD was observed for both implants, stabilising after 2 years. 5 years after RHA a BMD change of +1% in upper cranial, –4% ( p < 0.01) in cranial, –8% ( p < 0.01) in craniomedial, –7% ( p < 0.01) in medial and +4% in caudal ROI compared to baseline values was seen. 5 years after THA a BMD change of –3% ( p = 0.01), –13% ( p < 0.01), –21% ( p < 0.01), –11% ( p < 0.01) and –2% for each respective ROI. The observed BMD decrease in different regions was structurally favouring the RHA-cup, with significantly higher levels in the cranial and craniomedial ROI. Conclusion: Acetabular BMD is better preserved behind a rigid press-fit convex cup in RHA compared to a titanium threaded cup in conventional THA in the cranial and craniomedial ROI. Despite of a theoretical higher stress-shielding behind the stiff acetabular component in RHA, compared to the more elastic threaded titanium THA-cup, bone depletion behind the RHA component does not seem to be of major concern. Registration: EudraCT (2006-005610-12)

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