Comparaison de la densité minérale osseuse acétabulaire au cours des arthroplasties de première intention entre ostéonécrose de la tête fémorale et coxarthrose - 20/11/15
Difference in periprosthetic acetabular bone mineral density: Prior total hip arthroplasty osteonecrosis of the femoral head versus primary osteoarthritis
Abstract |
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 X-ray absorptiometry (DXA). We analyzed 3 acetabular regions of interest (ROIs) according to De Lee 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.
Level of evidence |
Level III: retrospective case control study.
Le texte complet de cet article est disponible en PDF.Keywords : Total hip arthroplasty, Bone mineral density, Osteonecrosis of the femoral head, Dual energy X-ray absorptiometry, Acetabular cup, Loosening
| ☆ | Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (www.sciencedirect.com/) en utilisant le DOI ci-dessus. |
Vol 101 - N° 7
P. 528 - novembre 2015 Retour au numéro
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