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International Orthopaedics

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27.11.2017 | Review Article

Periprosthetic bone remodelling of short-stem total hip arthroplasty: a systematic review

verfasst von: Shuang G. Yan, Patrick Weber, Arnd Steinbrück, Xingyi Hua, Volkmar Jansson, Florian Schmidutz

Erschienen in: International Orthopaedics | Ausgabe 9/2018

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Abstract

Purpose

Short-stem hip arthroplasty (SHA) was designed to preserve bone stock and provide an improved load transfer. To gain more evidence regarding the load transfer, this review analysed the periprosthetic bone remodelling of SHA in comparison to standard hip arthroplasty (THA).

Methods

PubMed and ScienceDirect were screened to extract dual-energy X-ray absorptiometry (DXA) studies evaluating the periprosthetic bone remodelling of SHA and two proven THA designs. From the studies included, the postoperative change in periprosthetic bone mineral density (BMD) after one year and the trend over two years was determined.

Results

Fifteen studies with four SHAs (CFP, Metha, Nanos, Fitmore) and two THAs (CLS and Bicontact) designs were included. All SHA and THA stems revealed an initial decrease at the calcar and major trochanter (Gruen 1 and 7) with the Metha, Nanos and Fitmore showing a smaller and more balanced remodelling compared to THA. The pattern after one year and the trend over two years argue for a methaphyseal anchorage of the Metha and Nanos, whereas the Fitmore and CFP seem to anchor metha-diaphyseal. Clearly different pattern of bone remodelling were observed between all four SHAs.

Conclusions

Periprosthetic bone remodelling is also present in SHA, with the main bone reduction observed proximally. However, certain SHA stems show a more balanced remodelling compared to THA, arguing for a favourable load transfer. Also, the femoral length where bone remodelling occurs is clearly shorter in SHA. As distinctively different pattern between the SHA designs were observed, they should not be judged as a single implant group.

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Titel: Periprosthetic bone remodelling of short-stem total hip arthroplasty: a systematic review
verfasst von: Shuang G. Yan
Patrick Weber
Arnd Steinbrück
Xingyi Hua
Volkmar Jansson
Florian Schmidutz
Publikationsdatum: 27.11.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: International Orthopaedics / Ausgabe 9/2018
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-017-3691-z

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Periprosthetic bone remodelling of short-stem total hip arthroplasty: a systematic review

Abstract

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Results

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