2004   Volume No 8 - pages 65-75

Title: Early periprosthetic femoral bone remodelling using different bearing material combinations in total hip arthroplasties: a prospective randomised study

Authors: M. Nygaard, B. Zerahn, C. Bruce, K. Søballe and A. Borgwardt

Address: Department of Orthopaedic Surgery, Frederiksberg University Hospital, Ndr. Fasanvej 57, DK-2000 Frederiksberg, Denmark.

E-mail: many@dadlnet.dk

Key Words: Bearing materials, alumina, CoCr, zirconia, ultra-high molecular weight polyethylene (UHMWPE), Dual-energy X-ray absorptiometry (DEXA), wear debris, hip arthroplasty, bone remodelling.

Publication date: December 31st 2004

Abstract: The present study was performed to test the hypothesis that different bearing materials have an impact on femoral bone remodelling within the first year after a total hip arthroplasty. A total of 225 patients with osteoarthrosis of the hip or avascular necrosis of the femoral head were included in this randomised prospective study. All patients had an identical hybrid total hip arthroplasty (cemented BiMetric stem and cementless RingLoc acetabular cup) except for the bearing materials: polyethylene-on-zirconia (n = 78), CoCr-on-CoCr (n = 71), or alumina-on-alumina (n = 76). Bone mineral density (BMD) was measured with Dual-energy X-ray absorptiometry (DEXA) in seven Gruen zones adjacent to the femoral implant. The DEXA scan was performed within one week after surgery and was repeated one year postoperatively. There was no significant difference in periprosthetic BMD change between the three groups. After twelve months the relative BMD decrease was highest in the proximal part of the femur, - 6.2% in the greater trochanter region and - 12.7% in the lesser trochanter region. In the distal zones the relative BMD decrease was -5.3, -4.2, -2.1, -2.3, and -5.6%, respectively. The use of different bearing materials had no significant impact on femoral bone remodelling adjacent to the cemented hip stem within one year after surgery.

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