Advertisement

Periprosthetic femoral bone loss in total hip arthroplasty: systematic analysis of the effect of stem design

Abstract

Introduction

Periprosthetic bone loss may lead to major complications in total hip arthroplasty (THA), including loosening, migration, and even fracture. This study analysed the influence of femoral implant designs on periprosthetic bone mineral density (BMD) after THA.

Methods

The results of all previous published studies reporting periprosthetic femoral BMD following THA were compiled. Using these results, we compared percent changes in bone loss as a function of: femoral stem fixation, material, and geometry.

Results

The greatest bone loss was in the calcar region (Gruen Zone 7). Overall, cemented stems had more bone loss distally than noncemented stems, while noncemented stems had more proximal bone loss than cemented stems. Within noncemented stems, cobalt-chromium (CoCr) stems had nearly double the proximal bone loss compared to titanium (Ti) alloy stems. Finally, within noncemented titanium alloy group, straight stems had less bone loss than anatomical, tapered, and press-fit designs.

Discussion

The findings from the present study quantified percent changes in periprosthetic BMD as a function of fixation method, alloy, and stem design. While no one stem type was identified as ideal, we now have a clearer understanding of the influence of stem design on load transfer to the surrounding bone.

Hip Int 2017; 27(1): 26 - 34

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/hipint.5000413

Authors

Ashleen R. Knutsen, Nicole Lau, Donald B. Longjohn, Edward Ebramzadeh, Sophia N. Sangiorgio

Article History

Disclosures

Financial support: Partial funding provided by an ISS Grant from Amgen, Inc.
Conflict of interest: None.

This article is available as full text PDF.

  • If you are a Subscriber, please log in now.

  • Article price: Eur 36,00
  • You will be granted access to the article for 72 hours and you will be able to download any format (PDF or ePUB). The article will be available in your login area under "My PayPerView". You will need to register a new account (unless you already own an account with this journal), and you will be guided through our online shop. Online purchases are paid by Credit Card through PayPal.
  • If you are not a Subscriber you may:
  • Subscribe to this journal
  • Unlimited access to all our archives, 24 hour a day, every day of the week.

Authors

Affiliations

  • J. Vernon Luck, Sr., M.D. Orthopaedic Research Center Orthopaedic Institute for Children, Los Angeles, California - USA
  • University of California, Los Angeles, California - USA
  • University of Southern California, Los Angeles, California - USA

Article usage statistics

The blue line displays unique views in the time frame indicated.
The yellow line displays unique downloads.
Views and downloads are counted only once per session.

No supplementary material is available for this article.