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Stem anteversion affects periprosthetic bone mineral density after total hip arthroplasty
Shinya Hayashi1, Shingo Hashimoto1, Noriyuki Kanzaki1
1Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe - Japan.
Summary
Periprosthetic bone mineral density (BMD) around cementless short tapered-wedge stems in total hip arthroplasty (THA) is maintained proximally. Stem anteversion and varus alignment significantly impact BMD changes, particularly in specific Gruen zones.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Radiology
Background:
- Total hip arthroplasty (THA) aims to restore function and alleviate pain.
- Cementless stems are widely used, and their effect on periprosthetic bone mineral density (BMD) is crucial for long-term implant survival.
- Understanding periprosthetic BMD changes is vital for optimizing implant design and surgical technique.
Purpose of the Study:
- To evaluate periprosthetic BMD changes around a cementless short tapered-wedge stem after THA.
- To determine the correlation between BMD changes and stem alignment parameters (anteversion, varus, anterior tilt).
Main Methods:
- A prospective study involving 21 patients undergoing THA with a TriLock stem.
- Dual-energy X-ray absorptiometry (DXA) was used to assess BMD in 7 Gruen zones at baseline and 24 months postoperatively.
- Statistical analysis correlated BMD changes with measured stem alignment.
Main Results:
- Minimal BMD changes were observed in the distal femur (zones 3, 4, 5).
- Significant BMD loss occurred in Gruen zone 7, with temporary loss in zone 1 that later recovered.
- Negative correlations were found between BMD changes and stem anteversion and varus in zone 1, while positive correlations were found with varus in zone 7.
Conclusions:
- Periprosthetic BMD is generally well-maintained in the proximal femur following THA with this short tapered-wedge stem.
- Stem anteversion and varus alignment are significant factors influencing periprosthetic BMD changes around the implant.
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