Abstract
BackgroundTotal hip arthroplasty is the most common orthopaedic procedure for the end-stage hip diseases. Periprosthetic bone loss is closely related to the increased risk of implant loosening and periprosthetic fractures, but the predictive value of periprosthetic bone mineral density (BMD) measured immediately after surgery has not yet been investigated.MethodsFrom April 2015 to October 2017, 64 patients with femoral neck fracture, hip osteoarthritis, femoral head necrosis, or developmental dysplasia of the hip underwent unilateral total hip arthroplasty. Demographic data, bone mineral density of the hip and spine, periprosthetic BMD of 7 Gruen zones, and radiographic parameters measured preoperatively, 1 week, 3 months, and 12 months after surgery were collected. A p value < 0.05 was considered to be statistically significant.ResultsSignificant decreases of the periprosthetic BMD were found in Gruen zone 1 (− 8.0%; p < 0.05), Gruen zone 2 (− 6.3%; p < 0.05), Gruen zone 7 (− 8.6%; p < 0.05), and total Gruen zone (− 4.7%; p < 0.05) in the first postoperative year, compared with the values measured 1 week after surgery. The relationship between the preoperative BMD of the hip/spine and the BMD of Gruen zone 1 and Gruen zone 7 measured 1 week after surgery did not reach statistical significance. The multiple linear regression analysis illustrated that the bone loss in Gruen zone 7 at the end of the follow-up period was negatively affected (β = − 0.703) by the BMD of Gruen zone 7 measured 1 week after surgery, with a R2 of 0.486 (p < 0.05). Similar results were also found in Gruen zone 1 (β = − 0.448, R2 = 0.186; p < 0.05).ConclusionThere were marked decreases in periprosthetic BMD of the proximal femur in the first postoperative year. The predictive values of preoperative BMD of hip and spine on periprosthetic bone loss after THA were limited. Higher periprosthetic BMD measured in immediate postoperative period may not guarantee less periprosthetic bone loss in the proximal femur after cementless THA.
Highlights
Total hip arthroplasty (THA) is the most common orthopaedic procedure for the end-stage hip diseases
In the first postoperative week, we found the periprosthetic bone mineral density (BMD) data were increased in Gruen zone 1 (+ 27.3%; p = 0.000; Fig. 2a), Gruen zone 2 (+ 5.5%; p = 0.034; Fig. 2b), and total Gruen zone (+ 3.5%; p = 0.021; Fig. 2h) compared with the preoperative data
In the first postoperative year, we found the periprosthetic BMD data in total Gruen zone and all the 7 Gruen zones were decreased compared with the data measured 1 week after surgery
Summary
Total hip arthroplasty (THA) is the most common orthopaedic procedure for the end-stage hip diseases. It could effectively restore hip function and improve patients’ quality of life [1]. As one of the major concerns after THA, periprosthetic bone loss is closely related to the increased risk of implant loosening and periprosthetic fractures, as well as being the major risk factor of implant failure and total hip revision [3]. Early identification of such high-risk patients is crucial to decrease periprosthetic bone loss and the related complications. Periprosthetic bone loss is closely related to the increased risk of implant loosening and periprosthetic fractures, but the predictive value of periprosthetic bone mineral density (BMD) measured immediately after surgery has not yet been investigated
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
