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Archives of Orthopaedic and Trauma Surgery

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01-01-2016 | Hip Arthroplasty

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

Authors: Tobias Freitag, Marie-Anne Hein, Dirk Wernerus, Heiko Reichel, Ralf Bieger

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 1/2016

Abstract

Introduction

Short stem prostheses have been developed to preserve proximal femoral bone stock. This prospective, randomized study compared periprosthetic bone remodelling following short and straight stem implantation 1 year after surgery.

Materials and methods

One hundred and forty-four consecutive patients undergoing total hip arthroplasty were randomized to either a Fitmore short or a cementless straight stem (both Zimmer, Winterthur, Switzerland). Periprosthetic bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry performed the day before surgery and at 7 days, 3 months and 1 year postoperatively. Furthermore, the HHS and the WOMAC were obtained.

Results

One hundred and thirty-eight patients completed 1-year follow-up. Periprosthetic BMD changes at 1 year were most pronounced in the proximal medial region of interest (ROI) 7 with −17.2 % after short stem and −16.7 % after straight implantation (p = 0.67). However, there was significantly less BMD reduction in ROI 6 following short (−4.7 %) versus straight stem (−10.8 %) implantation (p = 0.01). There were no significant differences between the two groups in terms of the HHS and the WOMAC either before or after surgery.

Conclusion

One year after surgery, both stems showed an implant-specific periprosthetic bone remodelling. Nevertheless, proximal load transfer was more pronounced after short stem implantation than with a straight stem.

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Title: Bone remodelling after femoral short stem implantation in total hip arthroplasty: 1-year results from a randomized DEXA study
Authors: Tobias Freitag
Marie-Anne Hein
Dirk Wernerus
Heiko Reichel
Ralf Bieger
Publication date: 01-01-2016
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 1/2016
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-015-2370-z

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

Abstract

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Materials and methods

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Conclusion

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