Bone remodelling and integration of two different types of short stem: a dual-energy X-ray - absorptiometry study

Int Orthop. 2020 May;44(5):839-846. doi: 10.1007/s00264-020-04545-6. Epub 2020 Mar 26.

Abstract

Purpose: Different kinds of bone preserving hip stems have been created to assure a more physiological distribution of the strengths on the femur. The aim of this research is to evaluate the density reaction of the periprosthetic bone while changing the conformation of the prosthetic implant on dual-energy X-ray - absorptiometry (DXA).

Methods: This is a prospective, single-centre study assessing bone remodelling changes after implantation of two short hip stems, dividing the patients in two groups according to the implant used: 20 in group A, Metha (B-Braun), and 16 in group B, SMF (Smith and Nephew). All participants had a pre-operative and a post-operative (24 months) DXA evaluating the changes in bone mass density (BMD) occurred in the five Gruen's zones.

Results: Compared to the pre-operative value, differences in BMD percentage were statistically significant only in ROI 4 (p < 0.05), with an increase in both groups (9 and 18%, respectively). The average increase in BMD was of 7.3% and 7.2% in the 2 groups.

Conclusion: According to our study, both stems have proved able to provide good load distribution across the metaphyseal region favouring proper system integration. Nonetheless, is certainly needed to perform other studies with longer follow-up and bigger populations to give strength to these conclusions.

Keywords: Bone remodelling; DXA; Hip arthroplasty; Short stem; Tissue-sparing surgery.

MeSH terms

  • Absorptiometry, Photon
  • Arthroplasty, Replacement, Hip* / adverse effects
  • Bone Density
  • Bone Remodeling
  • Femur / diagnostic imaging
  • Femur / surgery
  • Follow-Up Studies
  • Hip Prosthesis*
  • Humans
  • Prospective Studies
  • X-Rays