Periprosthetic femoral bone loss in total hip arthroplasty: systematic analysis of the effect of stem design
Hip Int 2017; 27(1): 26 - 34
Article Type: ORIGINAL RESEARCH ARTICLE
AuthorsAshleen R. Knutsen, Nicole Lau, Donald B. Longjohn, Edward Ebramzadeh, Sophia N. Sangiorgio
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.
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.
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.
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.
- • Accepted on 22/04/2016
- • Available online on 03/08/2016
- • Published in print on 21/02/2017
This article is available as full text PDF.
- Knutsen, Ashleen R. [PubMed] [Google Scholar] 1, 2
- Lau, Nicole [PubMed] [Google Scholar] 1, 3
- Longjohn, Donald B. [PubMed] [Google Scholar] 3
- Ebramzadeh, Edward [PubMed] [Google Scholar] 1, 2
- Sangiorgio, Sophia N. [PubMed] [Google Scholar] 1, 2, * Corresponding Author (firstname.lastname@example.org)
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