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Changes in periprosthetic bone remodelling after redesigning an anatomic cementless stem

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Abstract

The aim of this prospective cohort study was to determine the densitometric relevance of minor design modifications of a cementless stem designed to improve proximal load transfer. We used a prospective cohort study with densitometric analysis over a five-year period of two groups of patients with primary osteoarthritis. The first group, 56 hips, received the first version of the ABG stem (ABG-I); the second group, 54 hips, had the ABG-II stem. The results obtained with the ABG-I stem showed a decrease of bone density in proximal areas that ranged from 13% to 37%. However, the new design had a decrease of the same areas that ranged from 9% to 23%. These differences were noted at the end of the first post-operative year and remained stable, except in zone 7, where they were progressive. There is little evidence that the modified stem reduces femoral bone density loss.

Résumé

Nous avons revu de façon rétrospective 68 hanches chez 62 patients présentant une dysplasie acétabulaire et ayant bénéficié d’une ostéotomie péri-acétabulaire. Parmi ces 68 hanches, 33 avaient en préopératoire une rétroversion acétabulaire (groupe rétroversion) et 35 une antéversion (groupe contrôle). Toutes les hanches ont été évaluées selon le score de Harris. L’évaluation radiographique de la rétroversion acétabulaire et du mur postérieur déficient ont été basées sur le signe du croisement et le signe du mur extérieur. Les scores cliniques des deux groupes au suivi final était semblable. Dans le groupe rétroversion, 12 hanches avaient antéversé leur acétabulum en post-opératoire le signe du mur postérieur disparaissant, mais celui-ci restant présent dans 21 hanches avec un acétabulum en rétroversion post-opératoire. Parmi les 21 hanches avec acétabulum rétroversé une coxarthrose postérieure s’est développée à 5 ans post-opératoire. Lorsque l’on réalise une correction par ostéotomie pour une hanche dysplasique avec un acétabulum rétroversé, il est important de corriger cette rétroversion de façon à prévenir une coxarthrose secondaire due à la déficience du mur postérieur.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University Hospital Miguel Servet, 1–3 Isabel la Católica Avenue, 50009, Zaragoza, Spain

    Juan J. Panisello, Vicente Canales, Luis Herrero, Antonio Herrera, Jesús Mateo & María J. Caballero

  2. Urb. Vallesverdes, 19. Crta. de Logroño Km 5, 50011, Zaragoza, Spain

    Juan J. Panisello

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  1. Juan J. Panisello
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  2. Vicente Canales
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  3. Luis Herrero
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  4. Antonio Herrera
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  5. Jesús Mateo
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  6. María J. Caballero
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Correspondence to Juan J. Panisello.

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Panisello, J.J., Canales, V., Herrero, L. et al. Changes in periprosthetic bone remodelling after redesigning an anatomic cementless stem. International Orthopaedics (SICOT) 33, 373–379 (2009). https://doi.org/10.1007/s00264-007-0501-z

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  • DOI: https://doi.org/10.1007/s00264-007-0501-z

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