title: Dual energy X-ray absorptiometry analysis of peri-prosthetic stress shielding in the Birmingham resurfacing hip replacement.
abstract: BACKGROUND
  Numerous reports in the literature refer to the femoral neck fracture rate in hip resurfacing. The aim of this study was to determine the bone mineral density and evidence of stress shielding around the femoral component of the Birmingham resurfacing prosthesis.
  
  
  METHODS
  Twenty-eight patients with primary unilateral osteoarthritis had a Birmingham resurfacing prosthesis. DEXA analysis of the proximal femur and femoral neck was performed and compared with the opposite unaffected side.
  
  
  RESULTS
  Total periprosthetic bone mineral density was 0.49% greater than the control, but this did not achieve statistical significance. Although the BMD of the femoral neck was slightly increased on the prosthetic side (1.002 g/cm2) as opposed to the control side, this difference did not reach statistical significance.
  
  
  CONCLUSIONS
  The Birmingham resurfacing prosthesis does not appear to reduce femoral neck bone mineral density in comparison to the normal femoral neck bone density. We conclude that femoral neck fractures are unlikely to be due to stress shielding related to the prosthesis.
authors.affiliation: Department of Orthopaedic Surgery, Cork University Hospital, The Mews, 61 Serpentine Ave, Ballsbridge, Dublin 4, Ireland. jaharty@hotmail.com
authors.forename: J A
authors.initials: JA
authors.lastname: Harty
authors.forename: B
authors.initials: B
authors.lastname: Devitt
authors.forename: L C
authors.initials: LC
authors.lastname: Harty
authors.forename: M
authors.initials: M
authors.lastname: Molloy
authors.forename: A
authors.initials: A
authors.lastname: McGuinness
mesh_terms: D015502:Absorptiometry, Photon; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D015519:Bone Density; D005270:Femur Head / Q000000981:diagnostic imaging; D005272:Femur Neck / Q000000981:diagnostic imaging; D006622:Hip Prosthesis; D006801:Humans; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000295:instrumentation*; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000601:surgery; D013314:Stress, Mechanical