Leiss, Franziska and Goetz, Julia Sabrina and Schindler, Melanie and Reinhard, Jan and Mueller, Karolina and Grifka, Joachim and Greimel, Felix and Meyer, Matthias (2024) Influence of bone mineral density on femoral stem subsidence after cementless THA. ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY, 144. pp. 451-458. ISSN 0936-8051, 1434-3916
Full text not available from this repository. (Request a copy)Abstract
IntroductionFemoral stem subsidence can lead to aseptic loosening after total hip arthroplasty (THA). Low bone mineral density (BMD) is a risk factor for stem subsidence as it can affect the initial stability and osteointegration. We evaluated whether reduced bone mineral density is related to higher subsidence of the femoral stem after primary cementless THA with enhanced recovery rehabilitation.Methods79 patients who had undergone primary cementless THA with enhanced recovery rehabilitation were analyzed retrospectively. Subsidence of the femoral stem was measured on standing pelvic anterior-posterior radiographs after 4-6 weeks and one year. Patient individual risk factors for stem subsidence (stem size, canal flare index, canal fill ratio, body mass index (BMI), demographic data) were correlated. Dual X-ray absorptiometry (DXA) scans were performed of the formal neck and the lumbar spine including the calculation of T-score and Z-score. Patient-reported outcome measures were evaluated 12 months postoperatively.ResultsStem subsidence appeared regardless of BMD (overall collective 2.3 & PLUSMN; 1.64 mm). Measure of subsidence was even higher in patients with normal BMD (2.8 & PLUSMN; 1.7 mm vs. 2.0 & PLUSMN; 1.5 mm, p = 0.05). High BMI was correlated with increased stem subsidence (p = 0.015). Subsidence had no impact on improvement of patient-related outcome measures (WOMAC, EQ-5D-5L and EQ-VAS) after THA. Patients with low BMD reported lower quality of life 12 month postoperatively compared to patients with normal BMD (EQ-5D-5L 0.82 vs. 0.91, p = 0.03).ConclusionStable fixation of a cementless stem succeeds also in patients with reduced BMD. Regarding stem subsidence, enhanced recovery rehabilitation can be safely applied in patients with low BMD.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | TOTAL HIP-ARTHROPLASTY; RISK-FACTORS; FIXATION; OSSEOINTEGRATION; MICROMOTION; PROSTHESES; MIGRATION; STABILITY; WOMEN; BMD; Subsidence; Bone mineral density; Total hip arthroplasty; Enhanced recovery |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Orthopädie Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Klinische Studien |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 07 May 2024 05:04 |
| Last Modified: | 04 Mar 2025 10:00 |
| URI: | https://pred.uni-regensburg.de/id/eprint/59802 |
Actions (login required)
 |
View Item |
