Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
International Orthopaedics
Published in: International Orthopaedics 2/2008

01-04-2008 | Original Paper

Changes of bone mineral density after cementless total hip arthroplasty with two different stems

Authors: Keiji Sano, Kouji Ito, Kengo Yamamoto

Published in: International Orthopaedics | Issue 2/2008

Login to get access

Abstract

Cementless total hip arthroplasty has achieved reliable long-term results since porous coatings were developed, but postoperative changes around the stem remain poorly documented. In this study, changes of the bone mineral density (BMD) were compared between two types of cementless stem. In group B (28 patients with 31 hips), a straight tapered stem with porous plasma spray coating on the proximal 1/4 was used, while group S (24 patients with 26 hips) was given a fluted, tri-slot stem with porous hydroxyapatite coating on the proximal 1/3. In group B, there was an early decrease of BMD, which recovered after 12 months, indicating that stress shielding was minimal. In group S, however, BMD continued to decrease without recovery. The stem shape and radiological findings suggested that the cause of stress shielding in group S was distal fixation.
Literature
1.
Bobyn JD, Glassman AH, Goto H, Krygier JJ, Miller JE, Brooks CE (1990) The effect of stem stiffness on femoral bone resorption after canine porous-coated total hip arthroplasty. Clin Orthop 261:196–213PubMed
2.
Bobyn JD, Mortimer ES, Glassman AH, Engh CA, Miller JE, Brooks CE (1992) Producing and avoiding stress shielding. Laboratory and clinical observations of noncemented total hip arthroplasty. Clin Orthop 274:79–96PubMed
3.
Charnley J, Cupic Z (1973) The nine- and ten-year results of the low-friction arthroplasty of the hip. Clin Orthop 95:9–25PubMed
4.
Cohen B, Rushton N (1995) Accuracy of DEXA measurement of bone mineral density after total hip arthroplasty. J Bone Joint Surg 77B:479–483
5.
Engh CA, Bobyn JD (1988) The influence of stem size and extent of porous coating on femoral bone resorption after primary cementless hip arthroplasty. Clin Orthop 231:7–28PubMed
6.
Frost HM (1973) The origin and nature of transients in human bone remodeling dynamics. In: Frame B, Parfitt, AM, Duncan H (eds) Clinical aspects of metabolic bone disease. Excerpta Medica, Amsterdam, pp 124–137
7.
Graeter JH, Nevins R (1998) Early osteolysis with Hylamer acetabular liners. J Arthroplasty 13:464–466PubMedCrossRef
8.
Gruen TA, McNeice GM, Amstutz HC (1979) Modes of failure of cemented stem-type femoral components. Clin Orthop 141:17–27PubMed
9.
Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. J Bone Joint Surg 51A:737–755
10.
Huiskes R (1990) The various stress patterns of press-fit, ingrown, and cemented femoral stems. Clin Orthop 261:27–36PubMed
11.
Kilgus DJ, Shimaoka EE, Tipton JS, Eberle RW (1996) Dual-energy X-ray absorptiometry measurement of bone mineral density around porous-coated cementless femoral implants. J Bone Joint Surg 75B:279–287
12.
Kiratli BJ, Checovich MM, Mcbeath AA, Wilson MA (1996) Measurement of bone mineral density by dual-energy X-ray absorptiometry in patients with the Wisconsin hip, an uncemented femoral stem. J Arthroplasty 11:184–193PubMedCrossRef
13.
Kroger H, Miettinen H, Arnala I, Koski E, Rushton N, Suomalainen O (1996) Evaluation of periprosthetic bone using dual-energy X-ray absorptiometry: precision of the method and effect of operation on bone mineral density. J Bone Miner Res 11:1526–1530PubMedCrossRef
14.
Manley MT, D’Antonio JA, Capello WN, Edidin AA (2002) Osteolysis: a disease of access to fixation interfaces. Clin Orthop 405:129–137PubMedCrossRef
15.
McCarthy CK, Steinberg GG, Agren M, Leahey D, Wyman E, Baran DT (1991) Quantifying bone loss from the proximal femur after total hip arthroplasty. J Bone Joint Surg 73B:774–778
16.
Nakamura Y, Katano H, Kudo Y, Okada H, Hirakawa H, Matutani K, Matumoto K (1994) A clinical study of AML cementless femoral stem. J Joint Surg Jpn 13:1075–1081
17.
Niinimaki T, Junila J, Jalovaara P (2001) A proximal fixed anatomic femoral stem reduces stress shielding. Int Orthop 25:85–88PubMedCrossRef
18.
Nishii T, Sugano N, Masuhara K (1997) Longitudinal evaluation of time related bone remodeling after cementless total hip arthroplasty. Clin Orthop 339:123–131
19.
Richmond BJ, Bauer TW, Stulberg BN (1990) Bone mineral density in patients undergoing uncemented total hip arthroplasty. Calcif Tissue Int 46:145
20.
Rosenthall L, Bobyn JD, Brooks CE (1999) Temporal changes of periprosthetic bone density in patients with a modular noncemented femoral prosthesis. J Arthroplasty 14:71–76PubMedCrossRef
21.
Schmidt R, Muller L, Nowak TE, Pitto RP (2003) Clinical outcome and periprosthetic bone remodeling of an uncemented femoral component with taper design. Int Orthop 27:204–207PubMedCrossRef
22.
Schmidt R, Nowak TE, Muller L, Pitto RP (2004) Osteodensitometry after total hip replacement with uncemented taper-design stem. Int Orthop 28:74–77PubMedCrossRef
23.
Skinner HB, Kim AS, Keyak JH, Keyak JH, Mote CD (1994) Femoral prosthesis induces changes in bone stress that depend on the extent of porous coating. J Orthop Res 12:553–563PubMedCrossRef
24.
Sochart D (1999) Relationship of acetabular wear to osteolysis and loosening in total hip arthroplasty. Clin Orthop 363:135–150PubMed
25.
Spittlehouse AJ, Smith TW, Eastell R (1998) Bone loss around two different types of hip prostheses. J Arthroplasty 13:422–427PubMedCrossRef
26.
Tunner TM, Sumner DR, Urban RM, Igroria R, Galante JO (1997) Maintenance of proximal cortical bone with use of a less stiff femoral component in hemiarthroplasty of the hip without cement. J Bone Joint Surg 79A:1381–1390
27.
Wilson CR, Fogelman I, Blake GM, Rodin A (1991) The effect of positioning on dual-energy X-ray bone densitometry of the proximal femur. Bone Miner 13:69–76PubMedCrossRef
28.
Wixson RL, Stulberg D, Van Flandern GJ, Puri L (1997) Maintenance of proximal bone mass with an uncemented femoral stem: analysis with dual-energy X-ray absorptiometry. J Arthroplasty 12:365–372PubMedCrossRef
Metadata
Title
Changes of bone mineral density after cementless total hip arthroplasty with two different stems
Authors
Keiji Sano
Kouji Ito
Kengo Yamamoto
Publication date
01-04-2008
Publisher
Springer-Verlag
Published in
International Orthopaedics / Issue 2/2008
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-006-0298-1

Other articles of this Issue 2/2008

International Orthopaedics 2/2008 Go to the issue

Original Paper

Accuracy of direct magnetic resonance arthrography in the diagnosis of triangular fibrocartilage complex tears of the wrist

Original Paper

Long-term results after a triple arthrodesis of the hindfoot: function and satisfaction in 36 patients

Original Paper

The dynamic vacuum orthosis: a functional and economical benefit?

Original Paper

Minimum ten year results of total hip arthroplasty with the acetabular reinforcement ring in avascular osteonecrosis

Original Paper

Hip resurfacing: why does it fail? Early results and critical analysis of our first 60 cases

Original Paper

The treatment of transtrochanteric fractures of the femur with a minimally invasive technique using an extramedullary implant MINUS System