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Bone density adjacent to press-fit acetabular components. A prospective analysis with quantitative computed
J M Wright1, P M Pellicci, E A Salvati
1The Hospital for Special Surgery, New York, NY 10021, USA.
The Journal of Bone and Joint Surgery. American Volume
|April 24, 2001
Summary
Periprosthetic pelvic bone density significantly decreased after total hip arthroplasty, indicating a remodeling response to altered stress patterns. This study evaluated short-term changes in bone-mineral density following hip implants.
Area of Science:
- Orthopedic surgery
- Biomedical engineering
- Bone biology
Background:
- Periprosthetic bone stock is critical for revision hip arthroplasty.
- Femoral stress-shielding after hip arthroplasty is well-documented.
- Pelvic bone remodeling post-hip arthroplasty remains less defined.
Purpose of the Study:
- To evaluate the short-term changes in periacetabular bone-mineral density after primary total hip arthroplasty.
- To assess the natural history of pelvic bone density around acetabular implants.
Main Methods:
- Prospective study of 26 patients undergoing hybrid total hip arthroplasty.
- Quantitative computed tomography (QCT) assessed bone-mineral density in the ilium.
- Serial measurements compared pre-operative and average 1.28-year post-operative density, using contralateral ilium as internal control.
Main Results:
- Significant decrease in bone-mineral density on the operated side (p<0.001).
- Density reduction was greatest adjacent to the acetabular implant and extended 10 mm cephalad.
- Relative density decline ranged from 20-33% of baseline; no osteolysis detected.
Conclusions:
- Observed bone density decline suggests a remodeling response to altered pelvic stress from the acetabular implant.
- Findings support finite element analysis and remodeling theory predictions.
- Long-term implications for press-fit acetabular component stability require further investigation.