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Five-year DEXA study of 88 hips with cemented femoral stem

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Abstract

We performed repeated dual-energy X-ray absorptiometry (DEXA) measurements over five years in a homogeneous patient population to study the effect of a cemented stem on proximal femoral bone remodelling. Data from 88 patients (88 hips) implanted with total hip arthroplasty (THA) prostheses were extracted from three randomised studies. Femoral bone mineral density (BMD) was measured using a Lunar DPX-IQ densitometer for five years postoperatively. At one year the BMD changes had decreased between −2.0% [region of interest (ROI) 1] and −11.5% (ROI 7). During the follow-up period the BMD initially increased during the second year and thereafter decreased again in ROIs 5, 6 and 7. The loss of BMD at five years was more pronounced in region 7 (12.9%) and decreased with increasing age, total hip replacement (THR) on the right side and decreasing weight of the patient. We found that after the initial phase of early bone loss a period of recovery follows. Thereafter the BMD decreases again, which probably reflects the normal ageing of bone after uncomplicated cemented THA.

Résumé

Nous avons réalisé des examens avec des mesures répétées de densité osseuse (DEXA) sur une période de 5 ans dans une population homogène de patients ayant bénéficié de la mise en place d’une prothèse fémorale cimentée avec évaluation de remodelage osseux. Nous avons extrait les données de 88 patients (88 hanches) de trois études randomisées. La densité minérale osseuse fémorale a été mesurée par densitomètre Lunar DPX-IQ durant les cinq années post-opératoires. A un an, la densité minérale osseuse diminue de −2% (zone 1) et de −11,5% (zone 7). Durant la période d’observation la densité minérale osseuse augmente au cours de la deuxième année et puis diminue à nouveau en zones 5, 6 et 7. La perte de densité osseuse à cinq ans est moins importante en zone 7 (12,9%) et diminue lorsque l’âge augmente notamment du côté droit et en fonction du poids des patients. Nous avons ainsi montré, qu’après une phase initiale de déminéralisation osseuse il existe une phase de reminéralisation puis la densité minérale osseuse diminue à nouveau ceci étant probablement dans les prothèses totales de hanches non compliquées le reflet de l’âge.

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Acknowledgements

The institution of the authors has received funding from the Swedish Research Council (Project nr.K2002-73X-0741-16D), the Göteborg Medical Society, Centerpulse, Switzerland and Zimmer, USA.

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Authors and Affiliations

  1. Department of Orthopaedics, Institute of Surgical Science, Sahlgrenska University Hospital, Göteborg University, 41345, Göteborg, Sweden

    Georgios Digas & Johan Kärrholm

  2. Department of Orthopaedics, General Hospital, 67100, Xanthi, Greece

    Georgios Digas

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  1. Georgios Digas
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  2. Johan Kärrholm
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Correspondence to Georgios Digas.

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Digas, G., Kärrholm, J. Five-year DEXA study of 88 hips with cemented femoral stem. International Orthopaedics (SICOT) 33, 1495–1500 (2009). https://doi.org/10.1007/s00264-008-0699-4

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  • DOI: https://doi.org/10.1007/s00264-008-0699-4

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