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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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.
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The study protocol was approved by our institutional ethics committee on September 8, 2011 (No 1219).
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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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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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DOI: https://doi.org/10.1007/s00264-023-05918-3