Clinical Research

Clinical Orthopaedics and Related Research®

, Volume 470, Issue 5, pp 1431-1435

First online:

Periprosthetic Bone Remodeling after 12 Years Differs in Cemented and Uncemented Hip Arthroplasties

  • Prakash ChandranAffiliated withTrauma and Orthopaedics, Scarborough General Hospital Email author 
  • , Mohammed AzzabiAffiliated withTrauma and Orthopaedics, Scarborough General Hospital
  • , Mark AndrewsAffiliated withTrauma and Orthopaedics, Scarborough General Hospital
  • , John G. BradleyAffiliated withTrauma and Orthopaedics, Scarborough General Hospital

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Abstract

Background

Different patterns of stress shielding may lead to differences in periprosthetic bone preservation around cemented and uncemented hips in the long term?

Questions/purposes

The purpose of this study is to compare the difference in periprosthetic bone density between cemented Charnley total hip and uncemented hydroxyapatite-coated Furlong® THAs at a minimum followup of 12 years (mean, 16 years; range, 12–24 years).

Methods

We studied a cohort of 17 patients who had bilateral THAs with a cemented Charnley THA on one side and an uncemented Furlong® hydroxyapatite-coated THA on the other side. At a minimum followup of 12 years, Harris and Oxford hip scores were used to determine the function, and dual-energy x-ray absorptiometry was used to quantify bone mineral density adjacent to the prosthesis. The results of the dual-energy x-ray absorptiometry scan for cemented and uncemented hips were analyzed using paired-sample two-tailed t-tests. To compare the Harris hip scores, a nonparametric Wilcoxon test was used.

Results

Bone mineral density was higher on the uncemented Furlong® side in Gruen Zones 2, 3, 5, and 6 of the proximal femur and DeLee and Charnley Zone 1 of the acetabulum. In all other zones, there was no difference. Comparison of Harris and Oxford hip scores showed no differences between the two hips.

Conclusion

Bone density is better preserved around the uncemented hydroxyapatite-coated Furlong® stem compared with the Charnley cemented stem.

Level of Evidence

Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.