Periacetabular bone density after total hip arthroplasty a postmortem analysis.
To clinically verify the bony response to a press-fit acetabular component, this study assessed 5 postmortem-retrieved pelves with unilateral total hip arthroplasties. Changes in periacetabular bone density between implanted and contralateral bone were assessed with dual energy x-ray absorptiometry and computed tomography. At a mean of 9.1 years postarthroplasty, bone density decreased an average of 1.5% to 7.1% proximal and 12.8% medial to the cup. This supports shorter-term in vivo investigations demonstrating periacetabular stress shielding proximal to press-fit cups as well as computer models predicting bone loss medially, but in much greater magnitudes. Unlike femoral remodeling, the average magnitudes of pelvic bone loss are not extensive; therefore, we question whether periacetabular remodeling should be a primary concern for orthopedic surgeons.
Anderson Orthopaedic Research Institute, Alexandria, Virginia 22307, USA.
Adam S
AS
Stepniewski
Hiroshi
H
Egawa
Christi
C
Sychterz-Terefenko
Serena
S
Leung
Charles A
CA
Engh
D015502:Absorptiometry, Photon; D000077:Acetabulum / Q000473:pathology*; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee; D015519:Bone Density / Q000502:physiology*; D003198:Computer Simulation; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D016348:Osseointegration / Q000502:physiology; D011183:Postoperative Complications / Q000473:pathology*; D011474:Prosthesis Design; D036542:Tomography, Spiral Computed