Bone mineral density changes in the graft after acetabular impaction bone grafting in primary and revision hip surgery

Autor:	Job L C van Susante, Berend W. Schreurs, Enrico de Visser, Davey M J M Gerhardt, Baudewijn W Hendrickx
Rok vydání:	2018
Předmět:	musculoskeletal diseases Bone stock Visual analogue scale medicine.medical_treatment Dentistry Oxford hip score Bone grafting Bone remodeling 03 medical and health sciences All institutes and research themes of the Radboud University Medical Center 0302 clinical medicine Medicine Orthopedics and Sports Medicine 030212 general & internal medicine GeneralLiterature_REFERENCE(e.g. dictionaries encyclopedias glossaries) Orthopedic surgery Bone mineral Hip surgery 030222 orthopedics business.industry Impaction General Medicine Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10] Surgery business RD701-811
Zdroj:	Acta Orthopaedica Scandinavica, 89, 302-307 Acta Orthopaedica, Vol 89, Iss 3, Pp 302-307 (2018) Acta Orthopaedica Scandinavica, 89, 3, pp. 302-307
ISSN:	1745-3682 1745-3674
DOI:	10.1080/17453674.2018.1460776
Popis:	Background and purpose — Impaction bone grafting (IBG) is an established method in hip revision surgery to reconstruct loss of bone stock. There is limited knowledge concerning the actual bone remodelling process within the allograft. We investigated with repeated bone mineral density (BMD) measurements the biological process of bone remodelling in the allograft in vivo. We hypothesized that an initial decrease in BMD would be followed by an increase towards baseline values. Patients and methods — Dual-energy X-ray absorptiometry (DXA) was used to measure BMD values in 3 regions of interest (ROI) in 20 patients (average age at surgery 70 years, 11 males) after an acetabular reconstruction with IBG and a cemented cup. A postoperative DXA was used as baseline and DXA was repeated at 3 and 6 months and at 1 and 2 years. The Oxford Hip Score (OHS), the 12-Item Short Form Health Survey (SF12), and a 0 to 100 mm visual analogue scale (VAS) for pain and satisfaction were obtained simultaneously. Results — The overall mean BMD in the IBG regions increased significantly by 9% (95% CI 2–15) at 2 years’ follow-up. In the cranial ROI BMD increased 14% (CI 6–22), whereas the BMD in the medial and caudal ROI showed an increase of 10% (CI 1–18) and 4% (CI –6–16), respectively. The OHS, SF12-mental, and VAS for pain all improved statistically significantly 2 years after surgery, with a mean VAS for satisfaction of 77 (CI 63–90) out of 100 points. The SF12-physical showed non-significant improvement. Interpretation — The BMD in the allograft gradually increased after IBG for acetabular reconstruction arthroplasties, particularly in the cranial ROI. An initial decrease in the BMD was not encountered. These BMD changes, as proxy measurements for bone remodeling, may indicate progressive apposition of vital new host bone in the grafted area.
Databáze:	OpenAIRE
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