Periprosthetic proximal bone loss after uncemented hip arthroplasty is related to stem size: DXA measurements in 138 patients followed for 2–7 years
Olof G Sköldenberg, Henrik S G Bodén, Mats O F Salemyr, Torbjörn E Ahl & Per Y AdolphsonHip
Background Periprosthetic bone loss occurs around uncemented femoral stems and may be influenced by the stem size.
Patients and methods We studied 138 consecutive patients, 3 (2–7) years on average after a total hip arthroplasty operation (THA) for unilateral osteoarthritis with the Bi-Metric uncemented femoral stem. We analyzed Harris hip score and bone mineral density.
Results The mean Harris hip score was 97 at follow-up. Bone mineral density decreased proximally by 19% in both Gruen zones 1 and 7. Bone loss in zones 1, 2, 6, and 7 was significantly associated with stem size. Distally, a small gain in bone mass was found in zones 3 and 5 for medium femoral sizes.
Interpretation We found a marked proximal BMD loss, especially for the larger stems, which may be specific for this particular implant. Long-term studies should reveal whether this proximal bone loss will affect the longevity of the THA.
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