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Stress-related femoral cortical and cancellous bone density loss after collum femoris preserving uncemented total hip arthroplasty: a prospective 7-year follow-up with quantitative computed tomography

  • Orthopaedic Surgery
  • Published:
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Abstract

Purpose

Bone loss around uncemented femoral components is suspected to precede implant loosening and contribute to problems in revision surgery. Short-stemmed cementless femoral components are designed to preserve proximal femoral bone stock and ultimately the longevity of the prosthesis.

Methods

With quantitative computed tomography-assisted osteodensitometry, we prospectively analyzed femoral cortical and cancellous bone density (BD) and contact area changes of an uncemented collum femoris preserving stem (n = 38) 10 days, 1, 3 and 7 years post-operatively.

Results

Seven years post-operatively, cancellous BD (mg CaHA/mL) had decreased by as much as −66 % and cortical BD by up to −27 % at the metaphyseal portion of the femur; the decrease was progressive between the 1- and 3-year examinations and halted thereafter. Contact area (in % out of a possible 100 %) decreased proximally between the 1- and 3-year follow-up.

Conclusion

Proximal cortical and cancellous bone density loss and decrease of contact area indicate that metaphyseal fixation cannot be achieved. The lack of cortical BD loss and increase of contact area values below the trochanter minor suggest diaphyseal fixation.

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Acknowledgments

The study was sponsored by Waldemar LINK GmbH & Co. KG, Hamburg, Germany.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Friedrich-Alexander-University of Erlangen-Nuremberg, Rathsberger Str. 57, 91054, Erlangen, Germany

    Alexander M. Kress, Rainer Schmidt, Raimund Forst & Lutz A. Mueller

  2. Department of Trauma Surgery, Johannes-Gutenberg-University, Langenbeckstrasse 1, 55131, Mainz, Germany

    Tobias E. Nowak & Melanie Nowak

  3. Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-University of Erlangen-Nuremberg, Waldstr. 6, 91054, Erlangen, Germany

    Lothar Haeberle

Authors
  1. Alexander M. Kress
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  2. Rainer Schmidt
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  3. Tobias E. Nowak
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  4. Melanie Nowak
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  5. Lothar Haeberle
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  6. Raimund Forst
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  7. Lutz A. Mueller
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Corresponding author

Correspondence to Lutz A. Mueller.

Additional information

A. M. Kress and R. Schmidt contributed equally to this paper.

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Kress, A.M., Schmidt, R., Nowak, T.E. et al. Stress-related femoral cortical and cancellous bone density loss after collum femoris preserving uncemented total hip arthroplasty: a prospective 7-year follow-up with quantitative computed tomography. Arch Orthop Trauma Surg 132, 1111–1119 (2012). https://doi.org/10.1007/s00402-012-1537-0

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