Preoperative BMD does not influence femoral stem subsidence of uncemented THA when the femoral T-score is > –2.5
Background and purpose — It is believed that in uncemented primary total hip arthroplasty (THA) the anchorage of the stem is dependent on the level of bone mineral density (BMD) of the femoral bone. This is one of the reasons for the widely accepted agreement that a cemented solution should be selec...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Medical Journals Sweden
2021-10-01
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| Series: | Acta Orthopaedica |
| Online Access: | http://dx.doi.org/10.1080/17453674.2021.1920163 |
| _version_ | 1818333967390081024 |
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| author | Karen Dyreborg Michala S Sørensen Gunnar Flivik Søren Solgaard Michael M Petersen |
| author_facet | Karen Dyreborg Michala S Sørensen Gunnar Flivik Søren Solgaard Michael M Petersen |
| author_sort | Karen Dyreborg |
| collection | DOAJ |
| description | Background and purpose — It is believed that in uncemented primary total hip arthroplasty (THA) the anchorage of the stem is dependent on the level of bone mineral density (BMD) of the femoral bone. This is one of the reasons for the widely accepted agreement that a cemented solution should be selected for people with osteoporosis or age > 75 years. We evaluated whether preoperative BMD of the femur bone is related to femoral stem migration in uncemented THA. Patients and methods — We enrolled 62 patients (mean age 64 years (range 49–74), 34 males) scheduled for an uncemented THA. Before surgery we undertook DEXA scans of the proximal femur including calculation of the T- and Z-scores for the femoral neck. Evaluation of stem migration by radiostereometric analysis (RSA) was performed with 24 months of follow-up. In 56 patients both preoperative DEXA data and RSA data were available with 24 months of follow-up. Results — None of the patients had a T-score below –2.5. We found no statistically significant relationship between preoperative BMD and femoral stem subsidence after 3 or 24 months. When comparing the average femoral stem subsidence between 2 groups with T-score > –1 and T-score ≤ –1, respectively, we found no statistically significant difference after either 3 or 24 months when measured with RSA. Interpretation — In a cohort of people ≤ 75 years of age and with local femur T-score > –2.5 we found no relationship between preoperative BMD and postoperative femoral stem subsidence of a cementless THA. |
| first_indexed | 2024-12-13T14:00:03Z |
| format | Article |
| id | doaj.art-2d2e5fb8432f429ab5f951b2d2eabda3 |
| institution | Directory Open Access Journal |
| issn | 1745-3674 1745-3682 |
| language | English |
| last_indexed | 2024-12-13T14:00:03Z |
| publishDate | 2021-10-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Orthopaedica |
| spelling | doaj.art-2d2e5fb8432f429ab5f951b2d2eabda32022-12-21T23:42:45ZengMedical Journals SwedenActa Orthopaedica1745-36741745-36822021-10-0192553854310.1080/17453674.2021.19201631920163Preoperative BMD does not influence femoral stem subsidence of uncemented THA when the femoral T-score is > –2.5Karen Dyreborg0Michala S Sørensen1Gunnar Flivik2Søren Solgaard3Michael M Petersen4Department of Orthopaedic SurgeryDepartment of Orthopaedic SurgeryDepartment of Orthopaedics, Skåne University HospitalDepartment of Hip and Knee Surgery, Herlev-Gentofte HospitalDepartment of Orthopaedic SurgeryBackground and purpose — It is believed that in uncemented primary total hip arthroplasty (THA) the anchorage of the stem is dependent on the level of bone mineral density (BMD) of the femoral bone. This is one of the reasons for the widely accepted agreement that a cemented solution should be selected for people with osteoporosis or age > 75 years. We evaluated whether preoperative BMD of the femur bone is related to femoral stem migration in uncemented THA. Patients and methods — We enrolled 62 patients (mean age 64 years (range 49–74), 34 males) scheduled for an uncemented THA. Before surgery we undertook DEXA scans of the proximal femur including calculation of the T- and Z-scores for the femoral neck. Evaluation of stem migration by radiostereometric analysis (RSA) was performed with 24 months of follow-up. In 56 patients both preoperative DEXA data and RSA data were available with 24 months of follow-up. Results — None of the patients had a T-score below –2.5. We found no statistically significant relationship between preoperative BMD and femoral stem subsidence after 3 or 24 months. When comparing the average femoral stem subsidence between 2 groups with T-score > –1 and T-score ≤ –1, respectively, we found no statistically significant difference after either 3 or 24 months when measured with RSA. Interpretation — In a cohort of people ≤ 75 years of age and with local femur T-score > –2.5 we found no relationship between preoperative BMD and postoperative femoral stem subsidence of a cementless THA.http://dx.doi.org/10.1080/17453674.2021.1920163 |
| spellingShingle | Karen Dyreborg Michala S Sørensen Gunnar Flivik Søren Solgaard Michael M Petersen Preoperative BMD does not influence femoral stem subsidence of uncemented THA when the femoral T-score is > –2.5 Acta Orthopaedica |
| title | Preoperative BMD does not influence femoral stem subsidence of uncemented THA when the femoral T-score is > –2.5 |
| title_full | Preoperative BMD does not influence femoral stem subsidence of uncemented THA when the femoral T-score is > –2.5 |
| title_fullStr | Preoperative BMD does not influence femoral stem subsidence of uncemented THA when the femoral T-score is > –2.5 |
| title_full_unstemmed | Preoperative BMD does not influence femoral stem subsidence of uncemented THA when the femoral T-score is > –2.5 |
| title_short | Preoperative BMD does not influence femoral stem subsidence of uncemented THA when the femoral T-score is > –2.5 |
| title_sort | preoperative bmd does not influence femoral stem subsidence of uncemented tha when the femoral t score is 2 5 |
| url | http://dx.doi.org/10.1080/17453674.2021.1920163 |
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