Difference in periprosthetic acetabular bone mineral density: Prior total hip arthroplasty: Osteonecrosis of the femoral head versus primary osteoarthritis

作者：Craiovan B; Woerner M; Maderbacher G; Grifka J; Renkawitz T; Keshmiri A^*

来源：Orthopaedics & Traumatology-Surgery & Research, 2015, 101(7): 797-801.

DOI：10.1016/j.otsr.2015.08.006

• Total hip arthroplasty
• Bone mineral density
• Osteonecrosis of the femoral head
• Dual energy X-ray absorptiometry
• Acetabular cup
• Loosening

Background: Total hip arthroplasty (THA) could be associated with a higher failure rate in patients after osteonecrosis of the femoral head (ONFH) compared to a patient population with primary osteoarthritis prior THA, especially regarding the acetabular component. One major reason could be the compromised acetabular bone quality. Therefore, we performed a retrospective case matched study to assess: 1) Is there a difference in periprosthetic bone mineral density between patients with an ONFH prior THA and controls? 2) Do patients with an ONFH prior THA have a lower bone mineral density compared to controls? 3) Which region in the periprosthetic bone stock is more likely to present differences in periprosthetic bone mineral density between both groups?
Hypothesis: We hypothesized that there is a poorer bone mineral density (BMD) in the periacetabular bone stock in patients with an ONFH prior THA compared to controls receiving a THA due to primary osteoarthritis.
Patients and methods: We compared the BMD of 50 patients with ONFH to 50 controls with primary osteoarthritis prior THA using the same implant in mean 5 years after surgery by means of dual energy Xray absorptiometry (DXA). We analysed 3 acetabular ROIs according to DeLee and Charnley in a modified measurement technique.
Results: In ROI 3, representing acetabulum's upper aspect, statistically significant lower BMD values for the ONFH group could be found (P<0.05). No difference was found for the modified ROIs 1 and 2 (respectively medial and lower acetabulum).
Discussion: The results indicate a poorer periacetabular BMD in patients with ONFH prior THA, which might be responsible for premature loosening of the acetabular cup in THA. Due to a lack of literature, further clinical investigations are required to confirm our results.

• 出版日期2015-11