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Hydroxyapatite-coated compaction short stem represents a characteristic pattern of peri-prosthetic bone remodelling after total hip arthroplasty

  • Hip Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

We aimed to investigate the differences in peri-prosthetic bone remodelling between the full hydroxyapatite (HA)-collared compaction short stem and the short tapered-wedge stem.

Methods

This retrospective cohort study enrolled 159 consecutive patients (159 joints) undergoing total hip arthroplasty (THA) using the full HA compaction short (n = 64) and short tapered-wedge (n = 95) stems. Body mass index (BMI), peri-prosthetic bone mineral density (BMD), and clinical factors, including the Japanese Orthopaedic Association score and the University of California Los Angeles (UCLA) activity score were assessed and compared.

Results

Stem related complications were seen in three cases. Both groups showed similar peri-prosthetic BMD changes. Peri-prosthetic BMD was almost maintained in the distal femur and Gruen zone 6 with both type of stems, but significant BMD loss was found in zones 1 and 7 in both groups and in zone 2 of the full HA compaction stem group. No significant correlations were found between the proximal femoral BMD changes and the age, BMI, and UCLA score in both the full HA compaction and tapered-wedge stem groups. Femoral bone shape affected the peri-prosthetic BMD changes in the tapered-wedge stem group but not in the full HA compaction group. The stem collar of the full HA compaction stem did not affect peri-prosthetic BMD, but unique bone remodelling in the calcar region was observed in 27.6% cases. A significant difference in the peri-prosthetic BMD changes at Gruen zone 2 was found in patients with or without thigh pain.

Conclusion

Peri-prosthetic bone remodelling remained unaffected by clinical and radiographic factors after THA with the new short full HA compaction stem. Therefore, this new stem may be useful in a variety of cases.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan

    Shinya Hayashi, Shingo Hashimoto, Yuichi Kuroda, Naoki Nakano, Tomoyuki Matsumoto, Tomoyuki Kamenaga, Takahiro Niikura & Ryosuke Kuroda

Authors
  1. Shinya Hayashi
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  2. Shingo Hashimoto
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  3. Yuichi Kuroda
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  4. Naoki Nakano
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  5. Tomoyuki Matsumoto
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  6. Tomoyuki Kamenaga
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  7. Takahiro Niikura
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  8. Ryosuke Kuroda
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Correspondence to Shinya Hayashi.

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This research was approved by the institutional review board of the authors’ institution, and the study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki.

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Informed consent for participation in the study was obtained from all participants.

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Hayashi, S., Hashimoto, S., Kuroda, Y. et al. Hydroxyapatite-coated compaction short stem represents a characteristic pattern of peri-prosthetic bone remodelling after total hip arthroplasty. Arch Orthop Trauma Surg 142, 2903–2910 (2022). https://doi.org/10.1007/s00402-021-04140-3

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  • DOI: https://doi.org/10.1007/s00402-021-04140-3

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