Top

International Orthopaedics

Published in:

01-06-2012 | Original Paper

Periprosthetic bone mineral density with a cementless triple tapered stem is dependent on daily activity

Authors: Shinya Hayashi, Takayuki Nishiyama, Takaaki Fujishiro, Noriyuki Kanzaki, Shingo Hashimoto, Masahiro Kurosaka

Published in: International Orthopaedics | Issue 6/2012

Abstract

Purpose

Periprosthetic bone loss around the femoral stem is frequently found after total hip arthroplasty. We have shown that periprosthetic bone mineral density (BMD) loss using the triple tapered stem is consistently much less in comparison with the straight type component. In this study, we compared periprosthetic BMD change with clinical factors.

Methods

Postoperative dual-energy X-ray absorptiometry was evaluated at follow-up. BMD was determined based on seven Gruen zones. We further compared BMD with clinical examination: body mass index (BMI), age, Harris hip score (HHS) or University of California at Los Angeles (UCLA) activity rating score.

Results

Periprosthetic BMD loss of the triple tapered stem was maintained. Especially, BMD in Gruen zone 1 which was maintained at 96% in comparison with the straight tapered stem. We compared the BMD change with clinical factors. There is no correlation between BMD and BMI, age or HHS. However, we found significant correlation between BMD and UCLA activity rating score in Gruen zones 1 and 2 of the triple tapered stem. Further, the correlation coefficient was increased at 48 months in comparison with 24 months.

Conclusion

The cementless triple tapered stem maintains periprosthetic bone mineral density. Activity may reflect improving periprosthetic bone quality after THA using a triple tapered stem.

Available only for authorised users

Huiskes R, Weinans H, van Rietbergen B (1992) The relationship between stress shielding and bone resorption around total hip stems and the effects of flexible materials. Clin Orthop Relat Res 274:124–134PubMed

Niinimäki T, Junila J, Jalovaara P (2001) A proximal fixed anatomic femoral stem reduces stress shielding. Int Orthop 25:85–88PubMedCrossRef

Sychterz CJ, Engh CA (1996) The influence of clinical factors on periprosthetic bone remodeling. Clin Orthop Relat Res 322:285–292PubMedCrossRef

Bodén HS, Sköldenberg OG, Salemyr MO, Lundberg HJ, Adolphson PY (2006) Continuous bone loss around a tapered uncemented femoral stem: a long-term evaluation with DEXA. Acta Orthop 77:877–885PubMedCrossRef

Spittlehouse AJ, Smith TW, Eastell R (1998) Bone loss around 2 different types of hip prostheses. J Arthroplasty 13:422–427PubMedCrossRef

Kilgus DJ, Shimaoka EE, Tipton JS, Eberle RW (1993) Dual-energy X-ray absorptiometry measurement of bone mineral density around porous-coated cementless femoral implants. Methods and preliminary results. J Bone Joint Surg Br 75:279–287PubMed

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

Hayashi S, Nishiyama T, Fujishiro T, Kanzaki N, Hashimoto S, Takebe K, Kurosaka M (2011) Maintenance of periprosthetic bone mineral density with a cementless three dimensional straight tapered stem. Hip Int 21:163–167PubMedCrossRef

Wroblewski BM, Siney PD, Fleming PA (2001) Triple taper polished cemented stem in total hip arthroplasty: rationale for the design, surgical technique, and 7 years of clinical experience. J Arthroplasty 16(8 Suppl 1):37–41PubMedCrossRef

10.

Gruen TA (1987) Radiographic criteria for the clinical performance of uncemented total joint replacements. In: Lemmons JE (ed) Quantitative characterization and performance of porous implants for hard tissue applications. ASTM, Philadelphia, pp 207–218CrossRef

11.

Engh CA, McGovern TF, Bobyn JD, Harris WH (1992) A quantitative evaluation of periprosthetic bone-remodeling after cementless total hip arthroplasty. J Bone Joint Surg Am 74:1009–1020PubMed

12.

Wixson RL, Stulberg SD, Mehlhoff M (1991) Total hip replacement with cemented, uncemented, and hybrid prostheses. A comparison of clinical and radiographic results at two to four years. J Bone Joint Surg Am 73:257–270PubMed

13.

Venesmaa PK, Kroger HP, Jurvelin JS, Miettinen HJ, Suomalainen OT, Alhava EM (2003) Periprosthetic bone loss after cemented total hip arthroplasty: a prospective 5-year dual energy radiographic absorptiometry study of 15 patients. Acta Orthop Scand 74:31–36PubMedCrossRef

14.

Dan D, Germann D, Burki H, Hausner P, Kappeler U, Meyer RP, Klaghofer R, Stoll T (2006) Bone loss after total hip arthroplasty. Rheumatol Int 26:792–798PubMedCrossRef

15.

Sabo D, Reiter A, Simank HG, Thomsen M, Lukoschek M, Ewerbeck V (1998) Periprosthetic mineralization around cementless total hip endoprosthesis: longitudinal study and cross-sectional study on titanium threaded acetabular cup and cementless Spotorno stem with DEXA. Calcif Tissue Int 62:177–182PubMedCrossRef

16.

Goldsmith AA, Dowson D, Wroblewski BM, Siney PD, Fleming PA, Lane JM (2001) The effect of activity levels of total hip arthroplasty patients on socket penetration. J Arthroplasty 16:620–627PubMedCrossRef

17.

Ohta H, Kobayashi S, Saito N, Nawata M, Horiuchi H, Takaoka K (2003) Sequential changes in periprosthetic bone mineral density following total hip arthroplasty: a 3-year follow-up. J Bone Miner Metab 21:229–233PubMed

18.

Digas G, Karrholm J (2009) Five-year DEXA study of 88 hips with cemented femoral stem. Int Orthop 33:1495–1500PubMedCrossRef

19.

Pitto RP, Hayward A, Walker C, Shim VB (2010) Femoral bone density changes after total hip arthroplasty with uncemented taper-design stem: a five year follow-up study. Int Orthop 34:783–787PubMedCrossRef

20.

Korovessis P, Piperos G, Michael A, Baikousis A, Stamatakis M (1997) Changes in bone mineral density around a stable uncemented total hip arthroplasty. Int Orthop 21:30–34PubMedCrossRef

21.

Kärrholm J, Anderberg C, Snorrason F, Thanner J, Langeland N, Malchau H, Herberts P (2002) Evaluation of a femoral stem with reduced stiffness. A randomized study with use of radiostereometry and bone densitometry. J Bone Joint Surg Am 84:1651–1658PubMed

22.

May H, Murphy S, Khaw K-T (1994) Aged-associated bone loss in men and women and its relationship to weight. Age Ageing 23:235–240

23.

Yamauchi M, Sugimoto T, Yamaguchi T, Nakaoka D, Kanzawa M, Yano S et al (2001) Plasma leptin concentrations are associated with bone mineral density and the presence of vertebral fractures in postmenopausal women. Clin Endocrinol 55:341–347CrossRef

Title: Periprosthetic bone mineral density with a cementless triple tapered stem is dependent on daily activity
Authors: Shinya Hayashi
Takayuki Nishiyama
Takaaki Fujishiro
Noriyuki Kanzaki
Shingo Hashimoto
Masahiro Kurosaka
Publication date: 01-06-2012
Publisher: Springer-Verlag
Published in: International Orthopaedics / Issue 6/2012
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-011-1407-3

At a glance: The STEP trials

Springer Medicine

Periprosthetic bone mineral density with a cementless triple tapered stem is dependent on daily activity

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 6/2012

The sex specificity of hip-joint muscles offers an explanation for better results in men after total hip arthroplasty

Epidemiological survey of idiopathic scoliosis and sequence alignment analysis of multiple candidate genes

Bone mineral density is not related to heterotopic ossification after total hip arthroplasty

Retrograde dynamic locked nailing for valgus knee correction: a revised technique

Percutaneous interface biopsy in dry-aspiration cases of chronic periprosthetic joint infections: A technique for preoperative isolation of the infecting organism

Geometrical values of the normal and arthritic hip and knee detected with the EOS imaging system