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.

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.

Bone remodelling after femoral short stem implantation in total hip arthroplasty: 1-year results from a randomized DEXA study

2015 ◽  
Vol 136 (1) ◽  
pp. 125-130 ◽  
Author(s):  
Tobias Freitag ◽  
Marie-Anne Hein ◽  
Dirk Wernerus ◽  
Heiko Reichel ◽  
Ralf Bieger
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Bone Remodelling ◽  
Short Stem ◽  
Total Hip

The effect of femoral stem collar on implant migration and clinical outcomes following direct anterior approach total hip arthroplasty

2020 ◽  
Vol 102-B (12) ◽  
pp. 1654-1661
Author(s):  
Maxwell E. Perelgut ◽  
Jennifer S. Polus ◽  
Brent A. Lanting ◽  
Matthew G. Teeter
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Short Form ◽  
Femoral Stem ◽  
Ucla Activity Score ◽  
Total Hip ◽  
Implant Migration ◽  
Post Surgery ◽  
Stem Group ◽  
Patient Reported

Aims The direct anterior (DA) approach has been associated with rapid patient recovery after total hip arthroplasty (THA) but may be associated with more frequent femoral complications including implant loosening. The objective of this study was to determine whether the addition of a collar to the femoral stem affects implant migration, patient activity, and patient function following primary THA using the DA approach. Methods Patients were randomized to either a collared (n = 23) or collarless (n = 26) cementless femoral stem implanted using the DA approach. Canal fill ratio (CFR) was measured on the first postoperative radiographs. Patients underwent a supine radiostereometric analysis (RSA) exam postoperatively on the day of surgery and at two, four, six, 12, 26, and 52 weeks postoperatively. Patient-reported outcome measures (Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index, the 12-item Short Form Health Survey Mental and Physical Score, and University of California, Los Angeles (UCLA) Activity Score) were measured preoperatively and at each post-surgery clinic visit. Activity and function were also measured as the weekly average step count recorded by an activity tracker, and an instrumented timed up-and-go (TUG) test in clinic, respectively. Results Comparing the RSA between the day of surgery baseline exam to two weeks postoperatively, subsidence was significantly lower (mean difference 2.23 mm (SD 0.71), p = 0.023) with collared stems, though these patients had a greater CFR (p = 0.048). There was no difference (p = 0.426) in subsidence between stems from a two-week baseline through to one year postoperatively. There were no clinically relevant differences in PROMs; and there was no difference in the change in activity (p = 0.078) or the change in functional capacity (p = 0.664) between the collared stem group and the collarless stem group at any timepoint. Conclusion Presence of a collar on the femoral stem resulted in reduced subsidence during the first two postoperative weeks following primary THA using the DA approach. However, the clinical implications are unclear, and larger studies examining patient activity and outcomes are required. Cite this article: Bone Joint J 2020;102-B(12):1654–1661.

scholarly journals Bone remodelling around the Metha short stem in total hip arthroplasty: a prospective dual-energy X-ray absorptiometry study

2011 ◽  
Vol 36 (3) ◽  
pp. 533-538 ◽  
Author(s):  
Matthias Lerch ◽  
Annelene von der Haar-Tran ◽  
Henning Windhagen ◽  
Bernd A. Behrens ◽  
Patrick Wefstaedt ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Bone Remodelling ◽  
Dual Energy ◽  
Short Stem ◽  
X Ray ◽  
Total Hip

Periprosthetic bone remodelling of short-stem total hip arthroplasty: a systematic review

2017 ◽  
Vol 42 (9) ◽  
pp. 2077-2086 ◽  
Author(s):  
Shuang G. Yan ◽  
Patrick Weber ◽  
Arnd Steinbrück ◽  
Xingyi Hua ◽  
Volkmar Jansson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Bone Remodelling ◽  
Short Stem ◽  
Periprosthetic Bone ◽  
Total Hip

scholarly journals Preoperative factors predicting the severity of BMD loss around the implant after Total hip Arthroplasty

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Akira Morita ◽  
Naomi Kobayashi ◽  
Hyonmin Choe ◽  
Taro Tezuka ◽  
Shota Higashihira ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Multivariate Regression ◽  
Japanese Orthopaedic Association ◽  
Harris Hip Score ◽  
Lateral Side ◽  
Mineral Density ◽  
Total Hip ◽  
Preoperative Factors

Abstract Background Stress shielding after total hip arthroplasty (THA) leads to loss of bone mineral density (BMD) around the femoral implants, particularly in the proximal area. Loss of BMD around the implant is likely to occur within 1 year after THA; however, its severity depends on patient characteristics. This study evaluated preoperative factors correlated with the severity of zone 7 BMD loss after THA. Methods This retrospective cohort study included 48 patients who underwent primary THA from October 2011 to December 2015. All patients underwent implantation of a Zweymüller-type femoral component without any postoperative osteoporosis medications. The objective variable was a change in zone 7 BMD after 1 year. Factors evaluated included age, body mass index, Japanese Orthopaedic Association score, Harris Hip Score, Canal Flare Index (CFI), and lumbar BMD on the frontal and lateral sides. Univariate and multivariate regression analyses identified factors correlated with loss of zone 7 BMD. Results Univariate regression analysis identified CFI (P = 0.003) and preoperative lumbar BMD on the anterior-posterior (P = 0.003) and lateral (P < 0.001) sides as being correlated with loss of zone 7 BMD. Multivariate regression analysis identified CFI (P = 0.014) and lumbar BMD on the lateral side (P < 0.001) as being correlated independently with loss of zone 7 BMD. Conclusion Lower preoperative lumbar BMD on the lateral side and lower CFI were correlated with zone 7 BMD loss after THA. Patients with these characteristics should be monitored carefully for severe BMD loss after THA.

scholarly journals Abductor Muscle Force after Straight-Stem Compared to Short-Stem Total Hip Arthroplasty through a Modified Direct Lateral Approach: Functional Assessment of 70 Consecutive Patients of a Randomized Controlled Clinical Trial

2021 ◽  
Vol 10 (6) ◽  
pp. 1235
Author(s):  
Michael Fuchs ◽  
Marie-Anne Hein ◽  
Martin Faschingbauer ◽  
Mirco Sgroi ◽  
Ralf Bieger ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Muscle Strength ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Lateral Approach ◽  
Short Stem ◽  
Abductor Muscle ◽  
Total Hip ◽  
Straight Stem ◽  
Direct Lateral Approach

Because of preservation of proximal femoral bone stock and minimized soft tissue trauma, short-stem implants are becoming increasingly important in total hip arthroplasty (THA). The postulated advantage regarding the functional outcome has not been verified. We hypothesized an increased abductor muscle strength by the use of a short-stem design. Seventy consecutive patients of a randomized clinical trial were included. Of these, 67 patients met the inclusion criteria after 12 months. Thirty-five patients received a standard straight stem and 32 patients a short-stem femoral component. All surgeries were performed by a modified direct lateral approach. Isometric muscle strength of the hip abductors was evaluated preoperatively 3 and 12 months after surgery. Harris hip score (HHS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were evaluated. After three months, there were no differences between the two groups; the abductor force was comparable to the preoperative initial values. After 12 months, a significant increase in muscle strength for the short stem patient group compared to preoperative baseline values was measured (straight-stem THA, 0.09 Nm/kg ± 0.4, p = 0.32; short-stem THA, 0.2 Nm/kg ± 0.3, p = 0.004). Comparison of the 12-month postoperative total HHS and WOMAC revealed no significant differences between both groups. A significant increase in hip abductor muscle strength 12 months after short-stem THA compared to conventional-stem THA was observed.

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