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Increase in physical activity after resurfacing hip arthroplasty is associated with calcar and acetabular bone mineral density changes

Increase in physical activity after resurfacing hip arthroplasty is associated with calcar and acetabular bone mineral density changes

Post author correction

Article Type: ORIGINAL RESEARCH ARTICLE

Article Subject: Hip replacement

DOI:10.5301/hipint.5000433

Authors

Davey M.J.M. Gerhardt, Gerjon Hannink, Ton Rijnders, Job L.C. van Susante

Abstract

Purpose

Bone preservation is an important advantage of the resurfacing hip arthroplasty (RHA) concept. We hypothesised that patients’ increase in physical activity level after RHA would positively relate with periprosthetic bone mineral density (BMD) changes and thus facilitate bone preservation.

Methods

BMD-changes were prospectively recorded in 38 patients after RHA. Dual-energy absorptiometry was used to quantify BMD-changes in 6 periprosthetic regions of interest preoperatively, at 6 months, 1, 2 and 3 years postoperative. The effect estimates of patients’ physical activity, according to their Harris Hip Score (HHS) and University of California at Los Angeles (UCLA) Activity Score, on these BMD changes were assessed in linear mixed models.

Results

The UCLA (coefficient = 0.02 (95% CI, 0.010-0.034); p<0.001) and HHS (coefficient = 0.002 (95% CI, 0.001-0.003); p<0.001) were associated with the BMD in the calcar region. As for BMD changes in the femoral neck only the HHS was associated (coefficient = 0.0006 (95% CI, <0.0001-0.001); p = 0.04). Both the UCLA and the HHS were inversely associated with BMD in the medial acetabular region (UCLA: coefficient = -0.02 (95% CI, -0.038 to -0.007); p = 0.005, HHS: coefficient = -0.002 (95% CI, -0.003 to -0.001), the same accounted for the HHS to BMD-change cranial to the acetabulum (-0.001 [95% CI, -0.0018 to -0.0001]; p = 0.03). For the caudal acetabular and femoral subtrochanteric region no relation with BMD-changes was found.

Conclusions

The increase in activity scores after RHA was indeed associated with an increase in BMD in the calcar region, however unexpectedly also with a BMD decrease on the acetabular side. Stress shielding from the implant is the most likely causative factor.

Article History

Disclosures

Financial support: None.
Conflict of interest: None.

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Authors

Affiliations

  •  Department of Orthopaedics, Rijnstate Hospital, Arnhem - The Netherlands
  •  Department of Orthopaedics, Radboud University Medical Centre, Nijmegen - The Netherlands
  •  Department of Radiology and Nuclear Medicine, Rijnstate Hospital, Arnhem - The Netherlands

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