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Bone remodelling around HA-coated acetabular cups

A DEXA study with a 3-year follow-up in a randomised trial

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Abstract

This study was designed to investigate bone remodelling around the cup in cementless THA. Previous studies indicate an advantage of better sealing of the bone-prosthesis interface by HA/TCP coating of implants, inhibiting polyethylene-induced osteolysis. One hundred patients gave informed consent to participate in a controlled randomized study between porous coated Trilogy versus Trilogy Calcicoat (HA/TCP coated). The cup was inserted in press-fit fixation. The femoral component was a cementless porous coated titanium alloy stem (Bi-Metric), with a modular 28-mm CrCo head. The Harris Hip Score (HHS) and bone mineral density (BMD) determined by DEXA scanning were used to study the effect. Measurements revealed no difference between the two groups after 3 years either in the clinical outcome or in terms of periprosthetic bone density. Patients with a body mass index above normal regained more bone mineral than patients with normal weight. This finding supports the assumption that load is beneficial to bone remodelling.

Résumé

Cette étude a pour but d’analyser le remodelage osseux autour des cupules sans ciment dans l’arthroplastie totale de hanche. Cent patients ont accepté de participer à une étude randomisée utilisant une cupule trilogie « porous coated versus calcicoat » (avec revêtement HAP). La cupule a été mise en place en press-fit. Le composant fémoral était un composant sans ciment en titane (bi métric) avec une tête CrCo de 28 mm. Les résultats ont été analysés avec le score de Harris et une étude de la densité osseuse déterminée par scanner Dexa. Les mesures n’ont pas montré de différence entre les deux groupes pendant 3 ans, ni de différence dans le devenir clinique de ces patients en terme de densité osseuse. Les patients présentant une surcharge pondérale ont une densité osseuse supérieure aux patients sans surcharge pondérale. Cette attitude nous montre que la charge est le facteur principal du remodelage osseux.

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References

  1. Aldinger PR, Sabo D, Pritsch M, Thomsen M, Mau H, Ewerbeck V, Breusch SJ (2003) Pattern of periprosthetic bone remodeling around stable uncemented tapered hip stems: a prospective 84-month follow-up study and a median 156-month cross-sectional study with DXA. Calcif Tissue Int 73:115–121

    Article  PubMed  CAS  Google Scholar 

  2. Bauer TW, Stulberg BN, Ming J, Geesink RG (1993) Uncemented acetabular components. Histologic analysis of retrieved hydroxyapatite-coated and porous implants. J Arthroplasty 8:167–177

    PubMed  CAS  Google Scholar 

  3. Boden H, Adolphson P (2004) No adverse effects of early weight bearing after uncemented total hip arthroplasty: a randomized study of 20 patients. Acta Orthop Scand 75:21–29

    PubMed  Google Scholar 

  4. Engh CA Jr, Sychterz C, Engh C Sr (1999) Factors affecting femoral bone remodeling after cementless total hip arthroplasty. J Arthroplasty 14:637–644

    Article  PubMed  Google Scholar 

  5. Gehrchen PM (1999) Quantitative measurements of adaptive bone remodeling in the proximal femur following uncemented total hip arthroplasty using dual energy X-ray absorptiometry. Ph.D.-thesis. Danish National Hospital, University of Copenhagen

  6. Havelin LI, Engesaeter LB, Espehaug B, Furnes O, Lie SA, Vollset SE (2000) The Norwegian arthroplasty register: 11 years and 73,000 arthroplasties. Acta Orthop Scand 71:337–353

    Article  PubMed  CAS  Google Scholar 

  7. Ibrahim T, Hobson S, Beiri A, Esler CN (2005) No influence of body mass index on early outcome following total hip arthroplasty. Int Orthop 29:359–361

    Article  PubMed  CAS  Google Scholar 

  8. Karrholm J, Malchau H, Snorrason F, Herberts P (1994) Micromotion of femoral stems in total hip arthroplasty. A randomized study of cemented, hydroxyapatite-coated, and porous-coated stems with roentgen stereophotogrammetric analysis. J Bone Joint Surg Am 76:1692–1705

    PubMed  CAS  Google Scholar 

  9. Laursen MB, Nielsen PT, Soballe K (2006) Detection of bony defects around cementless acetabular components in total hip arthroplasty. A DEXA study on ten human cadavers. Acta Orthop Scand 77(2):209–217

    Google Scholar 

  10. Laursen MB, Nielsen PT, Soballe K (2005) DXA scanning of acetabulum in patients with cementless total hip arthroplasty. J Clin Densitom 8:476–483

    Article  PubMed  Google Scholar 

  11. Levenston ME, Beaupre GS, Schurman DJ, Carter DR (1993) Computer simulations of stress-related bone remodeling around noncemented acetabular components. J Arthroplasty 8:595–605

    Article  PubMed  CAS  Google Scholar 

  12. Rahbek O, Kold S, Zippor B, Overgaard S, Soballe K (2005) Particle migration and gap healing around trabecular metal implants. Int Orthop 29:368–374

    Article  PubMed  CAS  Google Scholar 

  13. Rohrl SM, Nivbrant B, Strom H, Nilsson KG (2004) Effect of augmented cup fixation on stability, wear, and osteolysis: a 5-year follow-up of total hip arthroplasty with RSA. J Arthroplasty 19:962–971

    PubMed  Google Scholar 

  14. 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 62:177–182

    Article  PubMed  CAS  Google Scholar 

  15. Schmalzried TP, Wessinger SJ, Hill GE, Harris WH (1994) The Harris-Galante porous acetabular component press-fit without screw fixation. Five-year radiographic analysis of primary cases. J Arthroplasty 9:235–242

    Article  PubMed  CAS  Google Scholar 

  16. Soballe K, Hansen ES, Brockstedt RH, Pedersen CM, Bunger C (1990) Hydroxyapatite coating enhances fixation of porous coated implants. A comparison in dogs between press fit and noninterference fit. Acta Orthop Scand 61:299–306

    Article  PubMed  CAS  Google Scholar 

  17. Soballe K, Toksvig-Larsen S, Gelineck J, Fruensgaard S, Hansen ES, Ryd L, Lucht U, Bunger C (1993) Migration of hydroxyapatite coated femoral prostheses. A Roentgen Stereophotogrammetric study. J Bone Joint Surg Br 75:681–687

    PubMed  CAS  Google Scholar 

  18. Thanner J, Karrholm J, Herberts P, Malchau H (1999) Porous cups with and without hydroxylapatite-tricalcium phosphate coating: 23 matched pairs evaluated with radiostereometry. J Arthroplasty 14:266–271

    Article  PubMed  CAS  Google Scholar 

  19. Thanner J, Karrholm J, Herberts P, Malchau H (2000) Hydroxyapatite and tricalcium phosphate-coated cups with and without screw fixation: a randomized study of 64 hips. J Arthroplasty 15:405–412

    Article  PubMed  CAS  Google Scholar 

  20. Wilkinson JM, Hamer AJ, Rogers A, Stockley I, Eastell R (2003) Bone mineral density and biochemical markers of bone turnover in aseptic loosening after total hip arthroplasty. J. Orthop Res. 21:691–696

    Article  PubMed  CAS  Google Scholar 

  21. Wilkinson JM, Peel NF, Elson RA, Stockley I, Eastell R (2001) Measuring bone mineral density of the pelvis and proximal femur after total hip arthroplasty. J Bone Joint Surg Br 83:283–288

    Article  PubMed  CAS  Google Scholar 

  22. Wright JM, Pellicci PM, Salvati EA, Ghelman B, Roberts MM, Koh JL (2001) Bone density adjacent to press-fit acetabular components. A prospective analysis with quantitative computed tomography. J Bone Joint Surg Am 83-A:529–536

    PubMed  CAS  Google Scholar 

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Acknowledgements

The authors were awarded consultancy from the Research society for Western Danish Health Sciences. They introduced us to Associate Professor Malene Højbjerre and Associate Professor Søren Lundbye-Christensen, Statistical Laboratory, Institute of Mathematical Sciences, Department of Mathematical Sciences, Aalborg University, Denmark; we wish to thank both of them for invaluable statistical guidance.

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Authors and Affiliations

  1. Department of Hip and Knee Arthroplasty Northern Ortopaedic Division, Aarhus University Hospital, Sdr. Skovvej 11, 9000, Aalborg, Denmark

    M. B. Laursen & P. T. Nielsen

  2. Department of Orthopaedics, Aarhus University Hospital, 9100, Aalborg, Denmark

    K. Søballe

Authors
  1. M. B. Laursen
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  2. P. T. Nielsen
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  3. K. Søballe
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Corresponding author

Correspondence to M. B. Laursen.

Additional information

This work was supported by Zimmer Scandinavia, who produced the Trilogy Calcicoat prostheses.

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Laursen, M.B., Nielsen, P.T. & Søballe, K. Bone remodelling around HA-coated acetabular cups. International Orthopaedics (SICOT) 31, 199–204 (2007). https://doi.org/10.1007/s00264-006-0148-1

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  • DOI: https://doi.org/10.1007/s00264-006-0148-1

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