Changes of Periprosthetic Bone Density after Implantation of an Anatomical Femoral Stem with Cemented and Cementless Fixation

2011 ◽  
Vol 21 (3) ◽  
pp. 317-324 ◽  
Author(s):  
Ralf Bieger ◽  
Franz Martini ◽  
Heiko Reichel ◽  
Ralf Decking
Keyword(s):  
Bone Density ◽  
Femoral Stem ◽  
Cementless Fixation ◽  
Periprosthetic Bone

Immediate Changes of Bone Density Caused by the Implantation of a Femoral Stem - A Dexa Study

2011 ◽  
Vol 21 (6) ◽  
pp. 706-712 ◽  
Author(s):  
Ulf G. Leichtle ◽  
Jeremi Leasure ◽  
Franz Martini ◽  
Carmen I. Leichtle
Keyword(s):  
Bone Density ◽  
Bone Loss ◽  
Femoral Stem ◽  
Periprosthetic Bone ◽  
Experimental Conditions ◽  
Press Fit ◽  
Custom Made ◽  
Femoral Stems ◽  
Cementless Prosthesis ◽  
Post Implantation

Considerable immediate periprosthetic bone density changes after implantation of femoral stems have been observed comparing DEXA measurements taken pre- and post-operatively. This is important in relation to the interpretation of DEXA studies. We analysed these density changes under standardised experimental conditions. Five human femora were implanted with a custom made femoral stem and ten femora with a standard cementless prosthesis. Densitometry was performed at various stages of implantation. Following rasping only slight density changes were noted (–2.7% to +0.7%). Comparing post-implantation and pre-operative measurements, all custom made stems with a proximal press-fit demonstrated clear increases in proximal periprosthetic bone density of +11% and +14%. In contrast, the standard prosthesis with a distal press-fit showed a loss of –5% and –2% in the proximal zones. Measurements following removal of the implants demonstrated hardly any density changes (0% to –4%) compared to the pre-operative measurements. We concluded that compacting of trabecular bone or bone loss due to rasping are not the main causes of density changes. Substantial measuring errors exist. For examination of periprosthetic bone density changes, pre-operative initial measurements should not be used as a baseline for comparison. Studies should commence with an immediate postoperative measurement.

Periprosthetic Bone Density Around Fully Hydroxyapatite Coated Femoral Stem

1997 ◽  
Vol 340 ◽  
pp. 109-117 ◽  
Author(s):  
Carlo Trevisan ◽  
Marco Bigoni ◽  
Gianni Randelli ◽  
Edoardo Carlo Marinoni ◽  
Giovanni Peretti ◽  
...  
Keyword(s):  
Bone Density ◽  
Femoral Stem ◽  
Periprosthetic Bone

BIOMECHANICAL RATIONALE FOR CHOICE OF CEMENT MANTLE THICKNESS AROUND A FEMORAL STEM

2018 ◽  
Vol 18 (06) ◽  
pp. 1850064
Author(s):  
IEVGEN LEVADNYI ◽  
JAN AWREJCEWICZ ◽  
OLGA SZYMANOWSKA ◽  
DARIUSZ GRZELCZYK ◽  
JOSÉ EDUARDO GUBAUA ◽  
...  
Keyword(s):  
Bone Density ◽  
Femoral Stem ◽  
Peak Stress ◽  
Proximal Part ◽  
Cement Mantle ◽  
Bone Adaptation ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
High Reduction ◽  
Hip Arthroplasties

The change in mechanical properties of the femoral bone tissue surrounding hip endoprosthesis stems during the post-operative period is one of the causes of implant instability, and the mathematical description of this phenomenon is the subject of much research. In the present study, a model of bone adaptation, based on isotropic Stanford theory, is created for further computer investigation. The results of implementation of such a mathematical model are presented regarding the choice of cement mantle rational thickness in cemented hip arthroplasties. The results show that for cement mantle thicknesses ranging from 1–1.5[Formula: see text]mm, a peak stress value in the proximal part of the mantle exceeds the limit of durability of bone cement. Moreover, results show that high reduction in the bone density of distal and proximal regions was observed in cases of cement mantle thicknesses varying from 1–3[Formula: see text]mm. No significant changes in bone density of the abovementioned regions were obtained for 4[Formula: see text]mm and 5[Formula: see text]mm. The outcome of numerical investigations can be treated as valuable and will lead to the improvement of cemented hip replacement surgery results.

scholarly journals PERIPROSTHETIC BONE DENSITY CHANGES EVALUATION USING COMPUTED TOMOGRAPHY

2005 ◽  
pp. 072-076
Author(s):  
Fidele Likibi ◽  
Michel Assad ◽  
Christine Coillard ◽  
Gilles Chabot ◽  
Charles-H. . Rivard
Keyword(s):  
Computed Tomography ◽  
Bone Density ◽  
Computer Tomography ◽  
Lumbar Fusion ◽  
Titanium Implant ◽  
Density Variation ◽  
Periprosthetic Bone ◽  
Sheep Model ◽  
Post Implantation

The aim of this study was to examine the effect of the presence of two types of metallic intervertebral lumbar fusion implants (a porous nitinol and a hollow titanium cylindrical implants) in the implant peripheral tissue after 3, 6 and 12 months post-implantation in a lumbar sheep model in order to evaluate and compare the biofunctionality and biocompatibility of both implants. 19 sheep were used to evaluate this bone density variation using computer tomography (CT). 16 of them received both implants at either level L2–L3 or L4–L5 and 3 other non-treated animals were used as controls. Results indicated that PNT obtained a superior biofunctionality that the conventional titanium implant. However, the biocompatibility of porous nitinol seemed comparable to that of titanium – a well-known long-term implant material.

Locally administered bisphosphonate in hip stem revisions using the bone impaction grafting technique: a randomised, placebo-controlled study with DXA and five-year RSA follow-up

2018 ◽  
Vol 29 (1) ◽  
pp. 26-34
Author(s):  
Ola Belfrage ◽  
Magnus Tägil ◽  
Martin Sundberg ◽  
Uldis Kesteris ◽  
Gunnar Flivik
Keyword(s):  
Bone Density ◽  
Femoral Stem ◽  
Controlled Study ◽  
First Year ◽  
Allograft Bone ◽  
Impaction Grafting ◽  
Hip Revision ◽  
Grafting Technique ◽  
Bone Impaction Grafting

Background: Bisphosphonates have previously been shown to increase the density of impacted graft bone. In the present study we hypothesise that bisphosphonates also reduce early stem subsidence. We examined the effect of locally applied bisphosphonate to allografts on prosthetic micromotion and bone density in femoral stem revision with impaction grafting. Methods: 37 patients were randomised to either clodronate or saline as local adjunct to the morsellised allograft bone. 24 patients were finally analysed per protocol and evaluated by dual-energy x-ray absorptiometry (DXA) during the first year and with radiostereometric analysis (RSA) for 5 years. Results: There were no significant differences neither in bone density, nor in migratory behaviour between the groups. The femoral stems had subsided 3.6 mm in both groups (p = 0.99) at 5 years and there was no difference as measured over time with mixed models analysis. The clinical outcome was good in both groups. Conclusion: Clodronate as a local addendum to allograft bone in hip revision did not increase bone density or reduce micromotion of the implant.

scholarly journals Short to Midterm Follow-Up of Periprosthetic Bone Mineral Density after Total Hip Arthroplasty with the Ribbed Anatomic Stem

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Xiang-Dong Wu ◽  
Mian Tian ◽  
Yao He ◽  
Hong Chen ◽  
Yu Chen ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Femoral Stem ◽  
Mineral Density ◽  
Periprosthetic Bone ◽  
Gruen Zone ◽  
X Ray ◽  
Periprosthetic Bone Mineral Density

Background. Femoral bone remodeling around hip prosthesis after total hip arthroplasty (THA) is definite but unpredictable in time and place. This study aimed to investigate the implant-specific remodeling and periprosthetic bone mineral density (BMD) changes after implantation of the Ribbed anatomic cementless femoral stem. Methods. After power analysis, 41 patients who had undergone primary unilateral THA with the Ribbed anatomic cementless stem were included. BMD of the seven Gruen zones was measured by dual-energy X-ray absorptiometry, and the contact, fitness, and fixation of the femoral stem and proximal femur were analyzed by X-ray. Additional clinical outcome parameters were also recorded. Results. Compared with the contralateral unoperated side, significant reductions of BMD were detected in the distal zone (Gruen zone 4: 1.665±0.198 versus 1.568±0.242 g/cm2, P=0.001) and middle distal zone (Gruen zone 5: 1.660±0.209 versus 1.608±0.215 g/cm2, P=0.026) on the prosthetic side, but no significant differences in BMD were detected in other zones (Gruen zones 1, 2, 3, 6, and 7). Subgroups analyses indicated no significant correlation between periprosthetic BMD changes and clinical factors including primary disease and body mass index. Visible areas of bone ingrowth indicated solid fixation of the femoral stem and there was no case of loosening. Clinical and functional outcome scores were excellent with mean HHS of 93.13 points and mean WOMAC score of 5.20 points, and three patients described intermittent mild thigh pain at the final follow-up. Conclusions. For the Ribbed femoral stem, the periprosthetic BMD was well maintained in the proximal femur, while periprosthetic BMD was significantly reduced in the distal and middle distal zones of the femur. Further clinical investigations are required to examine the efficacy of the Ribbed stem, particularly with regard to long-term survival. This trial is registered with ChiCTR1800017750.

Comparison Between DEXA and Finite Element Studies in the Long-Term Bone Remodeling of an Anatomical Femoral Stem

2009 ◽  
Vol 131 (4) ◽  
Author(s):  
A. Herrera ◽  
J. J. Panisello ◽  
E. Ibarz ◽  
J. Cegoñino ◽  
J. A. Puértolas ◽  
...  
Keyword(s):  
Finite Element ◽  
Bone Density ◽  
Bone Mass ◽  
Simulation Model ◽  
Load Transfer ◽  
Fe Simulation ◽  
Femoral Stem ◽  
Mineral Density ◽  
Biomechanical Behavior

The implantation of a cemented or cementless femoral stem changes the physiological load transfer on the femur producing an effect on the bone called adaptative remodeling. The patterns of this remodeling are attributed to mechanical and biological factors, and those changes in bone mineral density have been determined in long-term densitometry studies. This technique has proved to be a useful tool able to quantify small changes in bone density in different femoral areas, and it is considered to be ideal for long-term studies. On the other hand, the finite element (FE) simulation allows the study of the biomechanical changes produced in the femur after the implantation of a femoral stem. The aim of this study was to contrast the findings obtained from a 5 year follow-up densitometry study that used a newly designed femoral stem (73 patients were included in this study), with the results obtained using a finite element simulation that reproduces the pattern of load transfer that this stem causes on the femur. In this study we have obtained a good comparison between the results of stress of FE simulation and the bone mass values of the densitometry study establishing a ratio between the increases in stress (%) versus the increases in bone density (%). Hence, the changes in bone density in the long term, compared with the healthy femur, are due to different load transfers after stem implantation. It has been checked that in the Gruen zone 7 at 5 years, the most important reduction in stress (7.85%) is produced, which coincides with the highest loss of bone mass (23.89%). Furthermore, the simulation model can be used with different stems with several load conditions and at different time periods to carry out the study of biomechanical behavior in the interaction between the stem and the femur, explaining the evolution of bone density in accordance to Wolff’s law, which validates the simulation model.

scholarly journals Periprosthetic bone loss after insertion of an uncemented, customized femoral stem and an uncemented anatomical stem

2011 ◽  
Vol 82 (4) ◽  
pp. 410-416 ◽  
Author(s):  
Mona Nysted ◽  
Pål Benum ◽  
Jomar Klaksvik ◽  
Olav Foss ◽  
Arild Aamodt
Keyword(s):  
Bone Loss ◽  
Femoral Stem ◽  
Periprosthetic Bone ◽  
Periprosthetic Bone Loss
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