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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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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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Correspondence to M. B. Laursen.

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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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