Influence of Femoral Component Design on Proximal Femoral Bone Mass After Total Hip Replacement: A Randomized Controlled Trial
| Autor: | Mohit M Mahatma, George Grammatopoulos, Paul E. Beaulé, J. Mark Wilkinson, Mohsen Farzi, Pablo A Slullitel |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Bone density medicine.medical_treatment Arthroplasty Replacement Hip Periprosthetic Dentistry Osteoarthritis Prosthesis Design Prosthesis Osteoarthritis Hip Bone remodeling Absorptiometry Photon Bone Density medicine Humans Orthopedics and Sports Medicine Femur Patient Reported Outcome Measures Bone Resorption Aged Hip surgery business.industry General Medicine Middle Aged medicine.disease Arthroplasty Surgery Female Bone Remodeling Hip Prosthesis business |
| Zdroj: | The Journal of bone and joint surgery. American volume. 103(1) |
| ISSN: | 1535-1386 |
| Popis: | In this randomized controlled trial (RCT), we compared bone remodeling and bone turnover between 2 total hip arthroplasty implants-the short, proximally porous-coated Tri-Lock Bone-Preservation Stem and a conventional, fully-coated Corail prosthesis-over a 2-year postoperative period.Forty-six participants received the Tri-Lock prosthesis and 40 received the Corail prosthesis. At baseline, the 2 groups had similar demographics, proximal femoral bone mineral density (BMD), bone turnover markers, radiographic canal flare index, and patient-reported outcome measure (PROM) scores. Outcomes were measured at weeks 26, 52, and 104.Loss of periprosthetic bone, measured by high-sensitivity dual x-ray absorptiometry region-free analysis (DXA-RFA), was identified at the calcar and proximal-lateral aspect of the femur in both prosthesis groups (p0.05). However, the conventional prosthesis was associated with a smaller reduction in BMD compared with the bone-preservation prosthesis (p0.001). This effect was most prominent in the region of the femoral calcar and greater trochanter. A small gain in BMD was also identified in some areas, and this gain was greater with the conventional than the bone-preservation prosthesis (p0.001). The 2 groups had similar changes in bone turnover markers and improvement in PROM scores over the study period (p0.05). The adverse-event rate was also similar between the groups (p0.05).This RCT shows that prostheses intended to preserve proximal femoral bone do not necessarily perform better in this regard than conventional cementless designs. DXA-RFA is a sensitive tool for detecting spatially complex patterns of periprosthetic bone remodeling.Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence. |
| Databáze: | OpenAIRE |
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