The Journal of Arthroplasty
Volume 23, Issue 4 , Pages 593-599, June 2008

Periacetabular Bone Density After Total Hip Arthroplasty:

A Postmortem Analysis

  • Adam S. Stepniewski, MD

      Affiliations

    • Anderson Orthopaedic Research Institute, Alexandria, Virginia
    • Klinik fuer Orthopaedie, Universitaetsklinikum Goettingen, Germany
  • ,
  • Hiroshi Egawa, MD

      Affiliations

    • Anderson Orthopaedic Research Institute, Alexandria, Virginia
  • ,
  • Christi Sychterz-Terefenko, MS

      Affiliations

    • Independent Orthopaedic Consultant, Wyomissing, Pennsylvania
  • ,
  • Serena Leung, MS

      Affiliations

    • Anderson Orthopaedic Research Institute, Alexandria, Virginia
    • Corresponding Author InformationReprint requests: Serena Leung, MS, Anderson Orthopaedic Research Institute, P.O. Box 7088, Alexandria, VA 22307.
  • ,
  • Charles A. Engh Sr, MD

      Affiliations

    • Anderson Orthopaedic Research Institute, Alexandria, Virginia

Received 12 September 2006; accepted 8 May 2007.

Abstract 

To clinically verify the bony response to a press-fit acetabular component, this study assessed 5 postmortem-retrieved pelves with unilateral total hip arthroplasties. Changes in periacetabular bone density between implanted and contralateral bone were assessed with dual energy x-ray absorptiometry and computed tomography. At a mean of 9.1 years postarthroplasty, bone density decreased an average of 1.5% to 7.1% proximal and 12.8% medial to the cup. This supports shorter-term in vivo investigations demonstrating periacetabular stress shielding proximal to press-fit cups as well as computer models predicting bone loss medially, but in much greater magnitudes. Unlike femoral remodeling, the average magnitudes of pelvic bone loss are not extensive; therefore, we question whether periacetabular remodeling should be a primary concern for orthopedic surgeons.

Key words: acetabular remodeling, hip arthroplasty, press-fit cup, bone loss

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 Benefits or funds were received in partial or total support of the research material described in this article. These benefits or support were received from Innova Health Care Services, Fairfax, VA.

 Investigation was performed at Anderson Orthopaedic Research Institute, Alexandria, VA.

 Level of evidence: prognostic study, level II-1 (retrospective study).

PII: S0883-5403(07)00291-4

doi:10.1016/j.arth.2007.05.030

The Journal of Arthroplasty
Volume 23, Issue 4 , Pages 593-599, June 2008