Effect of proximal femoral osteoporosis on cementless hip arthroplasty: a short-term clinical analysis.
OBJECTIVE
The aim of this retrospective investigation was to explore the influence of femoral osteoporosis on short-term curative effects of cementless hip arthroplasty and to evaluate the femoral metaphyseal bone mineral density (BMD) for femoral osteoporosis in order to guide prosthesis choice and rehabilitation.


METHODS
We performed 127 total arthroplasty operations between June 1999 to February 2003 and investigated 49 cementless hip replacements with the Metalcancellous cementless Lubeck II system being used in all hips. There were twenty men and twenty-nine women whose mean age at the time of the operation was 60 years (range, 52~81 years). The patients were divided into osteoporosis or normal groups according to the femoral metaphyseal BMD measured preoperatively. The average duration of follow-up was 30 months (range, 8~52 months). We evaluated all of the patients from a clinical standpoint with use of a standard-terminology questionnaire with respect to the short-term curative effects and patients' satisfaction. Hip pain status and functional ability were important indicators of treatment efficacy.


RESULTS
Harris hip score and patients' satisfaction in femoral osteoporosis patients who underwent noncemented hip arthroplasty were lower (P=0.004, P=0.03) while the incidence of thigh pain was higher (P=0.03) than the patients with non-osteoporosis.


CONCLUSIONS
The higher incidence of pain, as well as the decrease in function experienced by the patients in osteoporosis group, supports the case that cementless arthroplasty is not a better choice for those patients and that we had better select prosthesis based on the femoral metaphyseal BMD.
Lou
Xian-feng
XF
Department of Orthopedics, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.
Li
Yu-hong
YH
Lin
Xiang-jin
XJ
D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods; D001843:Bone Cements; D015519:Bone Density; D005260:Female; D005269:Femur / Q000378:metabolism / Q000601:surgery; D005271:Femur Head Necrosis / Q000378:metabolism / Q000601:surgery; D006620:Hip Fractures / Q000378:metabolism / Q000601:surgery; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000378:metabolism / Q000601:surgery; D010024:Osteoporosis / Q000378:metabolism / Q000601:surgery*; D010146:Pain / Q000209:etiology / Q000503:physiopathology; D012189:Retrospective Studies
D001843:Bone Cements