This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowReprints and Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Wright, J. M.
Right arrow Articles by Koh, J. L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Wright, J. M.
Right arrow Articles by Koh, J. L.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Technorati  
What's this?
The Journal of Bone and Joint Surgery 83:529 (2001)
© 2001 The Journal of Bone and Joint Surgery, Inc.

Bone Density Adjacent to Press-Fit Acetabular Components

A Prospective Analysis with Quantitative Computed Tomography

John M. Wright, MD, Paul M. Pellicci, MD, Eduardo A. Salvati, MD, Bernard Ghelman, MD, Mathew M. Roberts, MD and Jason L. Koh, MD

Investigation performed at The Hospital for Special Surgery, New York, NY
John M. Wright, MD The Steadman-Hawkins Clinic, 181 West Meadow Drive, Suite 400, Vail, CO 81657
Paul M. Pellicci, MD Eduardo A. Salvati, MD Bernard Ghelman, MD Mathew M. Roberts, MD Jason L. Koh, MD The Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. No funds were received in support of this study.

Background:

The status of periprosthetic bone stock is an important concern when revision total hip arthroplasty is undertaken. Remodeling of periprosthetic femoral bone after total hip arthroplasty has been studied extensively, and the phenomenon of femoral stress-shielding has been well characterized. Finite element analysis and computer-simulated remodeling theory have predicted that retroacetabular bone-mineral density decreases after total hip arthroplasty; however, remodeling of periprosthetic pelvic bone in this setting has yet to be well defined. This study was conducted to evaluate the short-term natural history of periacetabular bone-mineral density following primary total hip arthroplasty.

Methods:

Periacetabular bone-mineral density was studied prospectively in a group of twenty-six patients who underwent primary hybrid total hip arthroplasty for the treatment of advanced osteoarthritis. Density within the central part of the ilium (directly cephalad to a press-fit acetabular component) was assessed with serial quantitative computed tomography. Baseline density was measured within the first five days following the total hip arthroplasty. Ipsilateral density measurements were repeated at an average of 1.28 years postoperatively. Density values at corresponding levels of the contralateral ilium were obtained at both time-points in all patients to serve as internal controls.

Results:

Bone-mineral density decreased significantly (p £ 0.001) between the two time-points on the side of the operation. The mean absolute magnitude of the interval density reduction (75 mg/cc) was greatest immediately adjacent to the implant (p < 0.001), but it was also significantly reduced (by 35 mg/cc) at a distance of 10 mm cephalad to the implant (p = 0.001). Relative declines in mean density ranged from 33% to 20% of the baseline values. No focal bone resorption (osteolysis) was detected at the time of this short-term follow-up study. With the numbers available, no significant interval alteration in bone-mineral density was found on the untreated (internal control) side (p 0.07).

Conclusions:

We suggest that the observed decline in bone-mineral density represents a remodeling response to an altered stress pattern within the pelvis that was induced by the presence of the acetabular implant. This finding corroborates the predictions of finite element analysis and computer-simulated remodeling theory. It remains to be seen whether this trend of atrophy of retroacetabular bone stock will continue with longer follow-up or will ultimately affect the long-term stability of press-fit acetabular components.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Technorati Technorati    What's this?


This article has been cited by other articles:


Home page
 J Am Acad Orthop SurgHome page
I. C. Clarke and M. T. Manley
How do alternative bearing surfaces influence wear behavior?
J. Am. Acad. Ortho. Surg., July 1, 2008; 16(suppl_1): S86 - S93.
[Abstract] [Full Text] [PDF]

Home page
 J Bone Joint Surg BrHome page
N. R. Shetty, A. J. Hamer, R. M. Kerry, I. Stockley, R. Eastell, and J. M. Wilkinson
Bone remodelling around a cemented polyethylene cup: A LONGITUDINAL DENSITOMETRY STUDY
J Bone Joint Surg Br, April 1, 2006; 88-B(4): 455 - 459.
[Abstract] [Full Text] [PDF]

Home page
 J Bone Joint Surg BrHome page
G. P. Grobler, I. D. Learmonth, B. P. Bernstein, and B. J. Dower
Ten-year results of a press-fit, porous-coated acetabular component
J Bone Joint Surg Br, June 1, 2005; 87-B(6): 786 - 789.
[Abstract] [Full Text] [PDF]