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Preservation of femoral bone mass after total hip replacements with a lateral flare stem

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Abstract

Uncemented, porous-coated femoral stems rely on bone in-growth to achieve stable, long-lasting fixation. The loss of proximal femoral bone mass around hip stems has been traditionally termed “stress shielding” and has been linked to the transfer of loads to the diaphysis and the relative unloading of the proximal femur. A total of 10 total hip arthroplasties with a proximally coated lateral flare device designed to engage both cortices at the metaphyseal level were evaluated with dual-energy X-ray (DEXA) absorptiometry and qualitative radiographic changes 3 weeks after surgery and at 12, 24 and 52 weeks thereafter. All hips were radiologically stable. The DEXA measurements revealed an overall increase in the bone mineral density (BMD) at 52 weeks of 3%. Greater gains were observed at or below the lateral flare of the stem in the metaphyseal femur.

Résumé

Les tiges fémorales poreuses recouvertes comptent sur la réhabitation osseuse pour obtenir une fixation stable et durable. La perte osseuse fémorale proximale autour des tiges a été appelée traditionnellement détournement de contrainte et été lié au transfert de charges du fémur proximal vers la diaphyse. Dix arthroplasties totales avec une tige comportant un évasement latéral proximal pour mettre en jeu les deux corticales au niveau métaphysaire ont été évaluées avec une absorptiomčtrie biphotonique et les changements radiographiques qualitatifs à 3, 12, 24 et 52 semaines aprčs la chirurgie. Toutes les hanches étaient stables radiographiquement. Les examens d’absorptiomčtrie ont révélé une augmentation totale de la DMO à 52 semaines de 3%. Les plus grands gains ont été observés au niveau oů en dessous de l’évasement latéral de la tige dans le fémur métaphysaire.

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Acknowledgement

The authors wish to thank Ms. Sandra La Vende for her assistance with the DEXA scanning.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, New York, NY, USA

    Alex Leali & Joseph F. Fetto

  2. 530 1st Ave, Suite 5B, New York, NY, 10016, USA

    Alex Leali

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  1. Alex Leali
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  2. Joseph F. Fetto
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Correspondence to Alex Leali.

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Statement on conflict of interest: Although none of the authors has received or will receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this article, benefits have been or will be received but will be directed solely to a research fund, foundation, educational institution, or other non-profit organisation with which one or more of the authors are associated.

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Leali, A., Fetto, J.F. Preservation of femoral bone mass after total hip replacements with a lateral flare stem. International Orthopaedics (SICOT) 28, 151–154 (2004). https://doi.org/10.1007/s00264-004-0554-1

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