title: Proximal bone remodelling differed between two types of titanium long femoral components after cementless revision arthroplasty.
abstract: In revision surgery with proximal femoral bone loss, progressive bone atrophy due to stress shielding remains a concern. We compared 2-year radiological results between two types of cementless long titanium stems with different configurations and surface coatings. Of 17 hips implanted with a wholly hydroxyapatite-coated stem, 12 (71%) exhibited stress shielding of the second degree or higher according to Engh's criteria, and the mean relative bone mass index decreased from 22.1% pre-operatively to 14.6% at 2 years post-operatively. In 23 hips implanted with a sand-blasted, conically shaped stem, no hip showed stress shielding of the second degree or higher. The mean relative bone mass index increased from 21.6% to 31.4%. These results indicate that the configuration and surface coating of the stem have a significant influence on proximal bone remodelling after revision surgery.
authors.affiliation: Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Kyowakai Hospital, Osaka, Japan. iwana-d@umin.ac.jp
authors.forename: Daiki
authors.initials: D
authors.lastname: Iwana
authors.forename: Takashi
authors.initials: T
authors.lastname: Nishii
authors.forename: Hidenobu
authors.initials: H
authors.lastname: Miki
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Sugano
authors.forename: Takashi
authors.initials: T
authors.lastname: Sakai
authors.forename: Kenji
authors.initials: K
authors.lastname: Ohzono
authors.forename: Hideki
authors.initials: H
authors.lastname: Yoshikawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D016723:Bone Remodeling; D020099:Coated Materials, Biocompatible; D017886:Durapatite; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D013499:Surface Properties; D014025:Titanium; D016896:Treatment Outcome
chemical_list: D020099:Coated Materials, Biocompatible; D017886:Durapatite; D014025:Titanium