Analyse der periprothetischen femoralen Knochenreaktion nach zementfreier Hüftendoprothetik mittels computertomographiegestützter Osteodensitometriein vivo: 6-Jahres-Follow-up / Analysis of the periprosthetic femoral bone reaction after uncemented total hip arthroplasty with computertomography assisted osteodensitometryin vivo: 6-year follow-up

Autor:	Stephan Eichinger, Tobias E. Nowak, David Pfander, Rocco P. Pitto, Michael Völk, Rainer Schmidt, Lutz Müller, Raimund Forst
Rok vydání:	2006
Předmět:	Bone density business.industry Biomedical Engineering Periprosthetic Diaphysis medicine.anatomical_structure In vivo Harris Hip Score medicine Cortical bone Implant Nuclear medicine business Cancellous bone
Zdroj:	Biomedizinische Technik/Biomedical Engineering. 51:139-144
ISSN:	1862-278X 0013-5585
Popis:	AIMS We prospectively analyzed the cancellous and cortical periprosthetic femoral bone reaction after implantation of a cementless total hip arthroplasty with computertomography assisted osteodensitometry after a mean of 1 and 6 years. MATERIALS AND METHODS Twenty-one patients (O age at implantation: 52 years) with osteoarthrits of the hip joint received 21 cementless hip prostheses with a three-dimensionally tapered design. All patients were analyzed clinically, with CT-osteodensitometry and plain radiography after a mean of 10 days, at 1 and 6 years postoperatively. Cancellous and cortical bone density was evaluated automatically using a special software tool. RESULTS The proximal region of the stem showed progessive cortical (O -15% 1 year, -25% 6 years post-OP) and cancellous (O -26% 1 year, -49% 6 years post-OP) bone density loss. Cortical bone density loss was lower and non-progressive at the diaphysis (O -7% 1 year, -9% 6 years post-OP) and the distal region (O -6% 1 year, -4% 6 years post-OP) of the stem. All stems showed no signs of loosening on plain radiography and good clinical results according to the Harris hip score. CONCLUSION Computertomography assisted osteodensitometry is the only method which allows discrimination between periprosthetic cortical and cancellous bone density changes in vivo. The analyzed uncemented stem fixates at the diaphysis and distal region. Due to the changed biomechanical loading after stem implantation, progressive proximal cancellous bone density loss was measured for the first time in vivo. Its role in the pathogenesis of implant loosening is still unknown and needs to be further elucidated.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::b07186e13bdd62369648f224116f83e4 https://doi.org/10.1515/bmt.2006.023 Zobrazit plný text záznamu