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Archives of Orthopaedic and Trauma Surgery
Published in: Archives of Orthopaedic and Trauma Surgery 8/2012

01-08-2012 | Orthopaedic Surgery

Stress-related femoral cortical and cancellous bone density loss after collum femoris preserving uncemented total hip arthroplasty: a prospective 7-year follow-up with quantitative computed tomography

Authors: Alexander M. Kress, Rainer Schmidt, Tobias E. Nowak, Melanie Nowak, Lothar Haeberle, Raimund Forst, Lutz A. Mueller

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 8/2012

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Abstract

Purpose

Bone loss around uncemented femoral components is suspected to precede implant loosening and contribute to problems in revision surgery. Short-stemmed cementless femoral components are designed to preserve proximal femoral bone stock and ultimately the longevity of the prosthesis.

Methods

With quantitative computed tomography-assisted osteodensitometry, we prospectively analyzed femoral cortical and cancellous bone density (BD) and contact area changes of an uncemented collum femoris preserving stem (n = 38) 10 days, 1, 3 and 7 years post-operatively.

Results

Seven years post-operatively, cancellous BD (mg CaHA/mL) had decreased by as much as −66 % and cortical BD by up to −27 % at the metaphyseal portion of the femur; the decrease was progressive between the 1- and 3-year examinations and halted thereafter. Contact area (in % out of a possible 100 %) decreased proximally between the 1- and 3-year follow-up.

Conclusion

Proximal cortical and cancellous bone density loss and decrease of contact area indicate that metaphyseal fixation cannot be achieved. The lack of cortical BD loss and increase of contact area values below the trochanter minor suggest diaphyseal fixation.
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Metadata
Title
Stress-related femoral cortical and cancellous bone density loss after collum femoris preserving uncemented total hip arthroplasty: a prospective 7-year follow-up with quantitative computed tomography
Authors
Alexander M. Kress
Rainer Schmidt
Tobias E. Nowak
Melanie Nowak
Lothar Haeberle
Raimund Forst
Lutz A. Mueller
Publication date
01-08-2012
Publisher
Springer-Verlag
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 8/2012
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-012-1537-0

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