Bone Preservation in Total Hip Arthroplasty
Conrad Anderl1, Martin Steinmair1, Josef Hochreiter1
1Department of Orthopaedic Surgery, Ordensklinikum Barmherzige Schwestern, Vinzenz Gruppe, Center of Orthopaedic Excellence, Teaching Hospital of the Paracelsus Medical University Salzburg, Linz, Austria.
The Journal of Arthroplasty
|February 5, 2022
Summary
Short-stem total hip arthroplasty (THA) with an isoelastic cup preserves bone stock and improves function. This 5-year follow-up shows stable bone mineral density and excellent clinical outcomes, with minimal complications.
Area of Science:
- Orthopedic surgery
- Biomaterials science
- Bone physiology
Background:
- Preserving bone stock is crucial for younger, active patients undergoing total hip arthroplasty (THA) to facilitate future revisions.
- Short femoral stems and isoelastic acetabular cups are innovative prosthesis designs aimed at maximizing bone preservation.
- Limited long-term data exists on bone remodeling following short-stem THA with isoelastic monoblock acetabular cups.
Purpose of the Study:
- To evaluate bone preservation after THA using short-stem femoral prostheses and isoelastic monoblock acetabular cups.
- To assess long-term bone remodeling and functional outcomes at a 5-year follow-up.
- To determine the safety and efficacy of this prosthesis combination in primary osteoarthritis patients.
Main Methods:
- Prospective observational study with a 5-year follow-up of 45 patients with primary osteoarthritis.
- Patients received a calcar-guided femoral short-stem prosthesis and a monoblock press-fit acetabular cup.
- Bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry; functional outcomes and complications were recorded.
Main Results:
- BMD remained comparable to 24-month levels in most Gruen zones (3-7) at 5 years, with significant differences noted in zones 1 and 2.
- Acetabular BMD stabilized across all DeLee and Charnley zones between 24 and 60 months.
- Significant improvements in all clinical outcomes were observed (P < .001), with one perioperative dislocation reported.
Conclusions:
- Total hip arthroplasty using a calcar-guided femoral short-stem prosthesis and an isoelastic monoblock acetabular cup effectively preserves bone stock.
- This approach yields excellent clinical outcomes and a low complication rate over a 5-year follow-up period.
- The findings support the use of these prostheses for bone preservation in THA patients.
