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Femoral bone density changes after total hip arthroplasty with uncemented taper-design stem: a five year follow-up study

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Abstract

We measured bone density (BD) changes to assess adaptive bone remodelling five years after uncemented total hip arthroplasty with taper-design femoral component using quantitative computed-tomography-assisted osteodensitometry (qCT). Nineteen consecutive patients (21 hips) with degenerative joint disease were enrolled in the study. A press-fit cup and a tapered uncemented stem ceramic−ceramic pairing were used in all patients. Serial clinical, radiological and qCT osteodensitometry assessments were performed after the index operation and at the one, two and five year follow-ups. At the latest follow-up, the clinical outcome was rated satisfactory in all hips. The radiological assessment showed signs of osteointegration with stable fixation of all cups and stems. Overall, there was evidence of a BD loss at year five (p = 0.004). We estimate that BD loss was between 2.2% and 12.1% in comparison with baseline postoperative values. Progressive loss of BD in the metaphyseal region was observed in all hips. We found unremarkable BD changes of diaphyseal cortical BD throughout the five year follow-up period. qCT osteodensitometry technology allows differentiation of cortical and cancellous BD changes over time. Periprosthetic BD changes at the five year follow-up are suggestive of stable stem osteointegration with proximal femoral diaphysis load transfer and metaphyseal stress shielding.

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Acknowledgments

The authors thank Mr. Garnet Tregonning, Dr. Jacob Munro, Dr. Lyndon Bradley, Dr. Godwyn Choy, Dr. Andrew Graydon, Dr. Melissa Rossaak and Dr. Keryn Reilly for their assistance during the clinical follow-ups.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Auckland, Auckland, New Zealand

    Rocco P. Pitto & Annabel Hayward

  2. Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand

    Cameron Walker & Vickie B. Shim

  3. Department of Orthopaedic Surgery, Middlemore Hospital, P.O. Box 91133, Otahuhu, Auckland, New Zealand

    Rocco P. Pitto

Authors
  1. Rocco P. Pitto
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  2. Annabel Hayward
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  3. Cameron Walker
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  4. Vickie B. Shim
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Corresponding author

Correspondence to Rocco P. Pitto.

Additional information

This study was supported by an educational grant from the Stevenson Charitable Trust, New Zealand, and was partially funded by DePuy Int., Leeds, UK

This study was approved by the local Ethical Board Review Committee

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Pitto, R.P., Hayward, A., Walker, C. et al. Femoral bone density changes after total hip arthroplasty with uncemented taper-design stem: a five year follow-up study. International Orthopaedics (SICOT) 34, 783–787 (2010). https://doi.org/10.1007/s00264-009-0884-0

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  • DOI: https://doi.org/10.1007/s00264-009-0884-0

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