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Preoperative bone quality as a factor in dual-energy X-ray absorptiometry analysis comparing bone remodelling between two implant types

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Abstract

Recently it was shown that the design changes from the ABG-I to ABG-II hip stem resulted in a better, although not significant, proximal bone preservation. Our hypothesis was that by matching patients for preoperative bone quality, statistical power would increase and that the trend of better proximal bone preservation in ABG-II might become significant. Twenty-four ABG-II patients were compared to two different ABG-I groups: (1) 25 patients from our earlier prospective study and (2) a group of 24 patients selected to perfectly match the ABG-II group regarding gender, age and preoperative bone quality. Postoperative changes in periprosthetic bone mineral density (BMD) were quantified at 2 years postoperatively using DEXA scanning. Bone preservation (less BMD loss) was better for the ABG-II than the ABG-I (all two groups) in the proximal zones 1 and 7. In Gruen zone 7, a statistically significant difference was found for group B (p = 0.03). By matching patients for preoperative bone quality and gender, a statistical significant difference was found in proximal bone preservation in favour of ABG-II. In future comparative bone remodelling studies using DEXA, patients should be matched for preoperative bone quality and gender.

Résumé

Il a été démontré, récemment, que le changement de la pièce fémorale entre l’ABG-1 et l’ABG-2 entraînait une amélioration de la préservation du stock osseux mais ceci n’était pas significatif. En étudiant une série de patients, nous avons souhaité démontrer l’inverse. 24 patients avec une prothèse ABG-2 ont été comparés à différents groupes de patients avec une prothèse ABG-1: (1) 25 patients de notre étude prospective et (2) un groupe de 24 patients sélectionnés, avec une série parfaitement cohérente en termes de sexe, d’âge et de qualité osseuse préopératoire. Les modifications de la densité minérale osseuse (BMD) ont été mesurées à deux ans post opératoires en utilisant la technique DEXA. La préservation du capital osseux est meilleure dans l’ABG-2 que dans l’ABG-1 (y compris dans les deux groupes) au niveau de la partie proximale en zones 1 et 7. Dans la zone 7 de Gruen une différence significative a été trouvée pour le groupe B (p = 0.03). Cette étude montre qu’avec une bonne sélection de patients on peut mettre en évidence que la conservation osseuse est meilleure pour l’ABG-2. Dans une étude ultérieure, nous essayerons d’évaluer, selon la technique DEXA le capital osseux en sélectionnant des patients en préopératoire selon la qualité de l’os et le sexe.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Atrium Medical Center, P.O. Box 4446, 6401 CX, Heerlen, The Netherlands

    Bart Cornelis Hendrikus van der Wal, Bernd Grimm, Ide Heyligers & Alphons Tonino

  2. Department of Nuclear Medicine, Atrium Medical Center, 6401 CX, Heerlen, The Netherlands

    Ali Rahmy

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  1. Bart Cornelis Hendrikus van der Wal
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  2. Ali Rahmy
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  3. Bernd Grimm
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  4. Ide Heyligers
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  5. Alphons Tonino
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Correspondence to Bart Cornelis Hendrikus van der Wal.

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van der Wal, B.C.H., Rahmy, A., Grimm, B. et al. Preoperative bone quality as a factor in dual-energy X-ray absorptiometry analysis comparing bone remodelling between two implant types. International Orthopaedics (SICO 32, 39–45 (2008). https://doi.org/10.1007/s00264-006-0279-4

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  • DOI: https://doi.org/10.1007/s00264-006-0279-4

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