Bone remodeling after total hip arthroplasty using an uncemented anatomic femoral stem: a three-year prospective study using bone densitometry.

Department of Orthopedic Surgery, Miguel Servet University Hospital, Zaragoza, Spain.
Journal of orthopaedic surgery (Hong Kong) (Impact Factor: 0.7). 05/2006; 14(1):32-7.
Source: PubMed


To evaluate the clinical, radiological, and densitometric changes in the bone-remodelling patterns of femoral stems aligned in neutral, valgus, or varus positions.
Between February and October 2000, 70 patients underwent unilateral total hip arthroplasty for primary osteoarthritis using an uncemented Anatomique Benoist Girard (ABG) II stem. 69 patients (30 males and 39 females) with a mean age of 59 years (range, 38-76 years) and a mean body weight of 79.3 kg (range, 29-110 kg) completed 3 years' follow-up on bone remodelling. The clinical, radiological, and densitometric changes of the neutral, valgus, and varus groups were evaluated, and the difference in bone-remodelling patterns between the 3 groups was analysed.
54 patients had neutrally placed stems, while varus and valgus malalignment occurred in 6 and 9 patients, respectively. Clinical and radiological evaluations were very similar among the 3 groups. Only densitometry could detect traceable changes resulting from the differing biomechanics of the neutral, varus, and valgus stem alignments.
The ABG II stem design made moderate errors in alignment biomechanically tolerable. Alignment defects had no clinical consequences and resulted in minimal differences in bone remodelling.

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    • "The results showed that bone loss around the implant is linked to the elastic modulus of the implant; the higher the elastic modulus, the higher the bone loss. In another investigation, Panisello and co-authors evaluated bone-remodeling after unilateral THA in a number of patients [5]. By assessing bone densitometry, they found that stress shielding provoked proximal cortical atrophy. "
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    • "hetic bone loss ( Sköldenberg et al . 2006 ) but , on the other hand , stability can be improved by larger stems , thus eliminating distal bone loss seen with smaller ABG II stems ( van der Wal et al . 2006 ) . A larger stem may also help to avoid malalignment of the stem , which appears to cause periprosthetic bone loss in ABG II arthroplasties ( Panisello et al . 2006 ) ."
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