Preoperative Factors Predicting the Severity of BMD Loss Around the Implant After Total Hip Arthroplasty

Overview

Journal BMC Musculoskelet Disord

Publisher Biomed Central

Specialties Orthopedics
Physiology

Date 2021 Mar 20

PMID 33740931

Citations 6

Authors

Akira Morita

Naomi Kobayashi

Hyonmin Choe

Taro Tezuka

Shota Higashihira

Yutaka Inaba

Affiliations

Soon will be listed here.

Abstract

Background: Stress shielding after total hip arthroplasty (THA) leads to loss of bone mineral density (BMD) around the femoral implants, particularly in the proximal area. Loss of BMD around the implant is likely to occur within 1 year after THA; however, its severity depends on patient characteristics. This study evaluated preoperative factors correlated with the severity of zone 7 BMD loss after THA.

Methods: This retrospective cohort study included 48 patients who underwent primary THA from October 2011 to December 2015. All patients underwent implantation of a Zweymüller-type femoral component without any postoperative osteoporosis medications. The objective variable was a change in zone 7 BMD after 1 year. Factors evaluated included age, body mass index, Japanese Orthopaedic Association score, Harris Hip Score, Canal Flare Index (CFI), and lumbar BMD on the frontal and lateral sides. Univariate and multivariate regression analyses identified factors correlated with loss of zone 7 BMD.

Results: Univariate regression analysis identified CFI (P = 0.003) and preoperative lumbar BMD on the anterior-posterior (P = 0.003) and lateral (P < 0.001) sides as being correlated with loss of zone 7 BMD. Multivariate regression analysis identified CFI (P = 0.014) and lumbar BMD on the lateral side (P < 0.001) as being correlated independently with loss of zone 7 BMD.

Conclusion: Lower preoperative lumbar BMD on the lateral side and lower CFI were correlated with zone 7 BMD loss after THA. Patients with these characteristics should be monitored carefully for severe BMD loss after THA.

Citing Articles

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The assessment of canal flare index and proximal femoral bone density can improve stem selection for peri-prosthetic bone maintenance after total hip arthroplasty.

Hayashi S, Kuroda Y, Nakano N, Matsumoto T, Kamenaga T, Tsubosaka M Arch Orthop Trauma Surg. 2024; 144(6):2881-2887.

PMID: 38771361 DOI: 10.1007/s00402-024-05378-3.

Preoperative prediction for periprosthetic bone loss and individual evaluation of bisphosphonate effect after total hip arthroplasty using artificial intelligence.

Morita A, Iida Y, Inaba Y, Tezuka T, Kobayashi N, Choe H Bone Joint Res. 2024; 13(4):184-192.

PMID: 38631686 PMC: 11023718. DOI: 10.1302/2046-3758.134.BJR-2023-0188.R1.

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Soma D, Ichiseki T, Ueda S, Sakurai M, Kawahara N J Clin Med. 2023; 12(24).

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Advancement in the Treatment of Osteoporosis and the Effects on Bone Healing.

Kushchayeva Y, Pestun I, Kushchayev S, Radzikhovska N, Lewiecki E J Clin Med. 2022; 11(24).

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