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Comparison study of periprosthetic bone remodeling between simultaneous bilateral total hip arthroplasty and unilateral total hip arthroplasty: a matched cohort study

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A Letter to the Editor to this article was published on 09 September 2023

Abstract

Purpose

The load-bearing pattern of periprosthetic bone may differ between patients who underwent simultaneous bilateral and unilateral total hip arthroplasty (THA). We investigated the differences in periprosthetic bone remodeling after simultaneous bilateral total hip arthroplasty and unilateral total hip arthroplasty.

Methods

This retrospective cohort study enrolled 154 consecutive patients undergoing THA using full hydroxyapatite (HA) compaction short stems. Patient characteristics including age, body mass index, University of California Los Angeles (UCLA) activity score, and bone shape of the proximal femur were adjusted by propensity score matching. Subsequently, periprosthetic bone mineral density changes were compared between simultaneous bilateral and unilateral THA.

Results

We found that bone mineral density loss in the simultaneous bilateral THA group was significantly higher in zones 6 and 7 at 24 months after THA (zone 6, p = 0.019; zone 7, p = 0.041). Periprosthetic bone mineral density loss was not associated with clinical factors, including age, body mass index, and daily activity. Additionally, we demonstrated that periprosthetic bone mineral density loss was higher in zones 1, 4, 6, and 7 of patients with a normal hip on the contralateral side after unilateral THA (zone 1, p = 0.041; zone 4, p = 0.041; zone 6, p = 0.037; zone7, p = 0.019).

Conclusions

The postoperative periprosthetic bone remodeling was lower in patients who underwent simultaneous bilateral THA than in those who underwent unilateral THA, even though patient characteristics were adjusted by propensity matching. Further observation of periprosthetic bone mineral density loss is needed to clarify the differences between the groups.

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Data availability

All data generated or analyzed during this study are included in this published article.

Abbreviations

THA:

Total hip arthroplasty

BMD:

Bone mineral density

BMI:

Body mass index

DEXA:

Dual-energy X-ray absorptiometry

UCLA:

University of California Los Angeles

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan

    Shinya Hayashi, Yuichi Kuroda, Naoki Nakano, Tomoyuki Matsumoto, Shotaro Tachibana & Ryosuke Kuroda

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  1. Shinya Hayashi
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  2. Yuichi Kuroda
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  6. Ryosuke Kuroda
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Contributions

SH participated in the study design, drafting of the manuscript, and data collection. YK carried out data collection and drafting of the manuscript. NN participated in the data collection and drafting of the manuscript. TM participated in the study design and helped to revise the manuscript. ST participated in the data collection and drafting of the manuscript. RK participated in the study design and helped to revise the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Shinya Hayashi.

Ethics declarations

Ethics approval

The study protocol was approved by our institutional ethics committee on September 8, 2011 (No 1219).

Consent to participate

Informed consent for participation in the study was obtained from all participants. The study protocol was approved by the Institutional Review Board on September 8, 2011 (No. 1220).

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Not applicable.

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The authors declare no competing interests.

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Hayashi, S., Kuroda, Y., Nakano, N. et al. Comparison study of periprosthetic bone remodeling between simultaneous bilateral total hip arthroplasty and unilateral total hip arthroplasty: a matched cohort study. International Orthopaedics (SICOT) 47, 2767–2772 (2023). https://doi.org/10.1007/s00264-023-05918-3

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