Peri-prosthetic bone density after implantation of a custom-made femoral component. A five-year follow-up.
Peri-prosthetic bone loss caused by stress shielding may be associated with aseptic loosening of femoral components. In order to increase primary stability and to reduce stress shielding, a three-dimensional, cementless individual femoral (Evolution K) component was manufactured using pre-operative CT scans. Using dual energy x-ray absorptiometry, peri-prosthetic bone density was measured in 43 patients, three months, six months, 3.6 and 4.6 years after surgery. At final follow-up there was a significant reduction in mean bone density in the proximal Gruen zones of -30.3% (zone 7) and -22.8% (zone 1). The density in the other zones declined by a mean of between -4% and -16%. We conclude that the manufacture of a three-dimensional, custom-made femoral component could not prevent a reduction in peri-prosthetic bone density.
Department of Orthopaedics, Eberhard-Karls-University Tuebingen, Germany.
U G
UG
Leichtle
C I
CI
Leichtle
B
B
Schmidt
F
F
Martini
D015502:Absorptiometry, Photon / Q000379:methods; D000328:Adult; D015519:Bone Density / Q000502:physiology*; D016723:Bone Remodeling; D005260:Female; D005269:Femur / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D006621:Hip Joint / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016348:Osseointegration / Q000502:physiology; D011184:Postoperative Period; D011474:Prosthesis Design