A prospective cohort study on the short collum femoris-preserving (CFP) stem using RSA and DXA. Primary stability but no prevention of proximal bone loss in 27 patients followed for 2 years.

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  • Additional Information
    • Source:
      Publisher: Medical Journals Sweden AB Country of Publication: Sweden NLM ID: 101231512 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1745-3682 (Electronic) Linking ISSN: 17453674 NLM ISO Abbreviation: Acta Orthop Subsets: MEDLINE
    • Publication Information:
      Publication: 2022- : Uppsala, Sweden : Medical Journals Sweden AB
      Original Publication: Basingstoke, Hampshire, UK : Taylor & Francis, c2005-
    • Subject Terms:
      Absorptiometry, Photon* ; Hip Prosthesis* ; Radiostereometric Analysis*; Arthroplasty, Replacement, Hip/*instrumentation ; Femur Neck/*surgery; Adult ; Aged ; Arthroplasty, Replacement, Hip/methods ; Bone Density ; Female ; Femur Neck/anatomy & histology ; Femur Neck/physiology ; Humans ; Male ; Middle Aged ; Prospective Studies ; Prosthesis Failure ; Treatment Outcome
    • Abstract:
      Background and Purpose: Short femoral stems have been introduced in total hip arthroplasty in order to save proximal bone stock. We hypothesized that a short stem preserves periprosthetic bone mineral density (BMD) and provides good primary stability.
      Methods: We carried out a prospective cohort study of 30 patients receiving the collum femoris-preserving (CFP) stem. Preoperative total hip BMD and postoperative periprosthetic BMD in Gruen zones 1-7 were investigated by dual-energy x-ray absorptiometry (DXA), stem migration was analyzed by radiostereometric analysis (RSA), and the Harris hip score (HHS) was determined.
      Results: 2 patients were excluded intraoperatively and 1 patient was revised due to a deep infection, leaving 27 patients for analysis. The mean HHS increased from 49 (24-79) preoperatively to 99 (92-100) after 2 years. DXA after 1 year showed substantial loss of BMD in Gruen zone 7 (-31%), zone 6 (-19%), and zone 2 (-13%, p < 0.001) compared to baseline BMD determined immediately postoperatively. The bone loss in these regions did not recover after 2 years, whereas the more moderate bone loss in Gruen zones 1, 3, and 5 partially recovered. There was a correlation between low preoperative total hip BMD and a higher amount of bone loss in Gruen zones 2, 6 and 7. RSA showed minor micromotion of the stem: mean subsidence was 0.13 (95% CI: -0.28 to 0.01) mm and mean rotation around the longitudinal axis was 0.01ยบ (95% CI: -0.1 to 0.39) after 2 years.
      Interpretation: We conclude that substantial loss in proximal periprosthetic BMD cannot be prevented by the use of a novel type of short, curved stem, and forces appear to be transmitted distally. However, the stems showed very small migration-a characteristic of stable uncemented implants.
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    • Publication Date:
      Date Created: 20130125 Date Completed: 20130405 Latest Revision: 20220316
    • Publication Date:
      20221213
    • Accession Number:
      PMC3584599
    • Accession Number:
      10.3109/17453674.2013.765623
    • Accession Number:
      23343375