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Preserved periprosthetic bone stock at 5 years post-operatively with uncemented short hip stem in both collared and collarless version

Belfrage, Ola LU ; Weber, Erik LU ; Sundberg, Martin LU orcid and Flivik, Gunnar LU (2022) In Archives of Orthopaedic and Trauma Surgery 142(11). p.3489-3496
Abstract

Introduction: Previous bone density studies have generally shown bone resorption around both cemented and uncemented total hip arthroplasty (THA) stems. This is presumed to be due to stress shielding. Short stems have been introduced partly to preserve bone in the proximal femur by a more physiological loading of the bone. The purpose of this study was to evaluate bone remodeling around a short, fully hydroxyapatite-coated titanium stem that comes in a collared and collarless version. Patients and methods: A prospective cohort of 50 patients included in a study evaluating the Furlong Evolution stem has been followed for 5 years. Examination was done with dual energy X-ray absorptiometry (DXA) postoperatively, at 1, 2 and 5 years.... (More)

Introduction: Previous bone density studies have generally shown bone resorption around both cemented and uncemented total hip arthroplasty (THA) stems. This is presumed to be due to stress shielding. Short stems have been introduced partly to preserve bone in the proximal femur by a more physiological loading of the bone. The purpose of this study was to evaluate bone remodeling around a short, fully hydroxyapatite-coated titanium stem that comes in a collared and collarless version. Patients and methods: A prospective cohort of 50 patients included in a study evaluating the Furlong Evolution stem has been followed for 5 years. Examination was done with dual energy X-ray absorptiometry (DXA) postoperatively, at 1, 2 and 5 years. Clinical outcome was followed with radiography and both general and hip specific outcome measures. Results: The two versions of the stem behaved similarly regarding bone remodeling. After an initial decrease up to 1 year, bone mineral density (BMD) increased in all Gruen zones up to 2 years and at 5 years bone stock was still preserved compared with postoperatively (net BMD + 1.2% (95% CI − 0.4 to 2.8)). Increase in BMD occurred mainly in the greater trochanter and distally around the stem with a decrease in the calcar area. Both versions showed excellent clinical outcome up to 5 years. Conclusion: This short stem seems to preserve proximal bone stock up to 5 years, exhibiting similar behaviour both with and without a collar. Trial registration number and date of registration: ClinicalTrials.gov, (identifier: NCT01894854). July 10, 2013.

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Please use this url to cite or link to this publication:
author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bone density, DXA, Short stem THA, THA
in
Archives of Orthopaedic and Trauma Surgery
volume
142
issue
11
pages
8 pages
publisher
Springer
external identifiers
  • scopus:85120060170
  • pmid:34841462
ISSN
0936-8051
DOI
10.1007/s00402-021-04225-z
language
English
LU publication?
yes
id
74a05955-528a-48d1-a496-59f0c0382c13
date added to LUP
2021-12-14 13:56:58
date last changed
2024-06-15 22:40:51
@article{74a05955-528a-48d1-a496-59f0c0382c13,
  abstract     = {{<p>Introduction: Previous bone density studies have generally shown bone resorption around both cemented and uncemented total hip arthroplasty (THA) stems. This is presumed to be due to stress shielding. Short stems have been introduced partly to preserve bone in the proximal femur by a more physiological loading of the bone. The purpose of this study was to evaluate bone remodeling around a short, fully hydroxyapatite-coated titanium stem that comes in a collared and collarless version. Patients and methods: A prospective cohort of 50 patients included in a study evaluating the Furlong Evolution stem has been followed for 5 years. Examination was done with dual energy X-ray absorptiometry (DXA) postoperatively, at 1, 2 and 5 years. Clinical outcome was followed with radiography and both general and hip specific outcome measures. Results: The two versions of the stem behaved similarly regarding bone remodeling. After an initial decrease up to 1 year, bone mineral density (BMD) increased in all Gruen zones up to 2 years and at 5 years bone stock was still preserved compared with postoperatively (net BMD + 1.2% (95% CI − 0.4 to 2.8)). Increase in BMD occurred mainly in the greater trochanter and distally around the stem with a decrease in the calcar area. Both versions showed excellent clinical outcome up to 5 years. Conclusion: This short stem seems to preserve proximal bone stock up to 5 years, exhibiting similar behaviour both with and without a collar. Trial registration number and date of registration: ClinicalTrials.gov, (identifier: NCT01894854). July 10, 2013.</p>}},
  author       = {{Belfrage, Ola and Weber, Erik and Sundberg, Martin and Flivik, Gunnar}},
  issn         = {{0936-8051}},
  keywords     = {{Bone density; DXA; Short stem THA; THA}},
  language     = {{eng}},
  number       = {{11}},
  pages        = {{3489--3496}},
  publisher    = {{Springer}},
  series       = {{Archives of Orthopaedic and Trauma Surgery}},
  title        = {{Preserved periprosthetic bone stock at 5 years post-operatively with uncemented short hip stem in both collared and collarless version}},
  url          = {{http://dx.doi.org/10.1007/s00402-021-04225-z}},
  doi          = {{10.1007/s00402-021-04225-z}},
  volume       = {{142}},
  year         = {{2022}},
}