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

  • Clinical Research
  • Published:
Clinical Orthopaedics and Related Research®

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.

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Acknowledgment

We thank Dr Jeremy Miles, senior lecturer in biostatistics, University of York, for assistance with the statistical analysis.

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Authors and Affiliations

  1. Trauma and Orthopaedics, Scarborough General Hospital, Scarborough, West Yorkshire, UK

    Prakash Chandran MS, FRCS (Ortho), Mohammed Azzabi MRCS, Mark Andrews FRCS (Ortho) & John G. Bradley FRCS

  2. 15, Cresswell Close, Callands, Warrington, North Cheshire, WA5 9UA, UK

    Prakash Chandran MS, FRCS (Ortho)

Authors
  1. Prakash Chandran MS, FRCS (Ortho)
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  2. Mohammed Azzabi MRCS
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  3. Mark Andrews FRCS (Ortho)
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  4. John G. Bradley FRCS
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Corresponding author

Correspondence to Prakash Chandran MS, FRCS (Ortho).

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Each author certifies that he or she, or a member of their immediate family, has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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Chandran, P., Azzabi, M., Andrews, M. et al. Periprosthetic Bone Remodeling after 12 Years Differs in Cemented and Uncemented Hip Arthroplasties. Clin Orthop Relat Res 470, 1431–1435 (2012). https://doi.org/10.1007/s11999-011-2134-1

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  • DOI: https://doi.org/10.1007/s11999-011-2134-1

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