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Changes of bone mineral density after cementless total hip arthroplasty with two different stems

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Abstract

Cementless total hip arthroplasty has achieved reliable long-term results since porous coatings were developed, but postoperative changes around the stem remain poorly documented. In this study, changes of the bone mineral density (BMD) were compared between two types of cementless stem. In group B (28 patients with 31 hips), a straight tapered stem with porous plasma spray coating on the proximal 1/4 was used, while group S (24 patients with 26 hips) was given a fluted, tri-slot stem with porous hydroxyapatite coating on the proximal 1/3. In group B, there was an early decrease of BMD, which recovered after 12 months, indicating that stress shielding was minimal. In group S, however, BMD continued to decrease without recovery. The stem shape and radiological findings suggested that the cause of stress shielding in group S was distal fixation.

Résumé

Les prothèses totales de hanche sans ciment ont de bons résultats à long terme, notamment depuis qu’ont été développées les techniques de revêtement poreux, mais les modifications post opératoires autour de la pièce fémorale, ont été jusqu’à présent peu documentées. Dans cette étude, nous avons souhaité étudier les modifications de la densité osseuse (BMD) en comparant deux types de prothèses sans ciment. Dans le groupe B (28 patients, 31 hanches) une pièce fémorale droite avec un plasma spray proximal pour le groupe S (24 patients, 26 hanches) la pièces fémorale a été recouverte d’hydroxyapatite sur le tiers proximal. Les patients du groupe B ont présenté une diminution précoce de la BMD indiquant un stress shielding minime et dans le groupe S, la BMD diminue sans récupération alors que cette BMB réaugmente dans le groupe B. Ceci nous indique que la cause du stress shielding dans le groupe S est secondaire à la fixation distale.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Tokyo Medical University Hachioji Medical Center, 1163, Tate-machi, Hachioji-shi, Tokyo, 193-0998, Japan

    Keiji Sano & Kouji Ito

  2. Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan

    Kengo Yamamoto

Authors
  1. Keiji Sano
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  2. Kouji Ito
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  3. Kengo Yamamoto
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Correspondence to Keiji Sano.

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Sano, K., Ito, K. & Yamamoto, K. Changes of bone mineral density after cementless total hip arthroplasty with two different stems. International Orthopaedics (SICO 32, 167–172 (2008). https://doi.org/10.1007/s00264-006-0298-1

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  • DOI: https://doi.org/10.1007/s00264-006-0298-1

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