AI Article Synopsis
- The study compared initial fixation and changes in bone mineral density (BMD) after total hip arthroplasty (THA) using two types of fully HA-coated stems: traditional (T-HA) and newly introduced (N-HA) stems.
- The research involved 66 patients, measuring changes in BMD over two years and evaluating stem-bone contact areas using advanced imaging techniques.
- Results showed that the N-HA group had larger contact areas but experienced a decrease in BMD, while the T-HA group preserved BMD better, suggesting that the type of HA-coated stem chosen may impact long-term outcomes in THA.
Article Abstract
Aims: The aim of this study was to compare the pattern of initial fixation and changes in periprosthetic bone mineral density (BMD) between patients who underwent total hip arthroplasty (THA) using a traditional fully hydroxyapatite (HA)-coated stem (T-HA group) and those with a newly introduced fully HA-coated stem (N-HA group).
Methods: The study included 36 patients with T-HA stems and 30 with N-HA stems. Dual-energy X-ray absorptiometry was used to measure the change in periprosthetic BMD, one and two years postoperatively. The 3D contact between the stem and femoral cortical bone was evaluated using a density-mapping system, and clinical assessment, including patient-reported outcome measurements, was recorded.
Results: There were significantly larger contact areas in Gruen zones 3, 5, and 6 in the N-HA group than in the T-HA group. At two years postoperatively, there was a significant decrease in BMD around the proximal-medial femur (zone 6) in the N-HA group and a significant increase in the T-HA group. BMD changes in both groups correlated with BMI or preoperative lumbar BMD rather than with the extent of contact with the femoral cortical bone.
Conclusion: The N-HA-coated stem showed a significantly larger contact area, indicating a distal fixation pattern, compared with the traditional fully HA-coated stem. The T-HA-coated stem showed better preservation of periprosthetic BMD, two years postoperatively. Surgeons should consider these patterns of fixation and differences in BMD when selecting fully HA-coated stems for THA, to improve the long-term outcomes.
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| http://dx.doi.org/10.1302/0301-620X.106B6.BJJ-2023-1157.R2 | DOI Listing |
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