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Periacetabular bone changes after uncemented total hip arthroplasty evaluated by quantitative computed tomography.

Lutz Arne Mueller1, Alexander Kress, Tobias Nowak

  • 1Department of Orthopaedic Surgery, University of Erlangen-Nuremberg, Erlangen, Germany. ltzmll@aol.com

Acta Orthopaedica
|July 5, 2006
PubMed
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This study shows that hemispherical titanium alloy hip implants cause significant cancellous bone loss and alter stress patterns. Computed tomography-assisted osteodensitometry effectively measures these periacetabular bone density changes.

Area of Science:

  • Orthopedic surgery
  • Biomaterials science
  • Medical imaging

Background:

  • Limited dual X-ray absorptiometry (DXA) data exists on periacetabular bone density post-hip cup implantation.
  • This study investigates load transfer and stress distribution in bone surrounding a titanium alloy press-fit cup.
  • A novel computed tomography (CT)-assisted osteodensitometry method was employed.

Purpose of the Study:

  • To analyze periacetabular bone density changes after hemispherical titanium alloy press-fit cup implantation.
  • To assess the load-transfer mechanism and stress patterns in cortical and cancellous bone.
  • To evaluate the efficacy of CT-assisted osteodensitometry for in vivo bone density measurement.

Main Methods:

  • 26 hip osteoarthritis patients received hemispherical titanium alloy press-fit cups.

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  • Sequential CT scans were performed within 10 days and at a mean of 1.1 years post-surgery.
  • Bone density (mgCaHA/mL) of full, cancellous, and cortical bone was measured.

    • Main Results:

    • Cortical bone density cranial to the cup increased by 3.6% (p=0.03).
    • Cancellous bone density decreased by 18%, with greater loss ventral (-35%) than dorsal (-30%).
    • Ventral cortical bone density decreased by 6.4% (p<0.05).

    Conclusions:

    • CT-assisted osteodensitometry is effective for measuring periacetabular bone density changes after total hip arthroplasty.
    • The rigid implant causes stress shielding of cancellous bone and increased load transfer to cranial cortical bone.
    • These findings provide insights into the long-term performance and prognosis of this type of hip implant.