Bone remodelling around the Metha short stem in total hip arthroplasty

A prospective dual-energy X-ray absorptiometry study

authored by: Matthias Lerch, Annelene Von Der Haar-Tran, Henning Windhagen, Bernd A. Behrens, Patrick Wefstaedt, Christina M. Stukenborg-Colsman
Abstract: Purpose: On the basis of positive clinical results with mid- and long-term follow-up using the Mayo short stem, the Metha neck-preserving stem (BBraun, Aesculap, Tuttlingen, Germany) was introduced. The purpose of this study was to validate the implant design by direct acquisition of bone remodelling data from total hip arthroplasty (THA) recipients using dual-energy X-ray absorptiometry (DEXA). Methods: After power analysis, 25 patients were included in this prospective study. Patients were examined clinically and underwent DEXA examinations preoperatively and postoperatively at one week, six months and one and two years after THA. Gruen zones were adapted to the short stem design (R1-R7). Results: The Harris Hip Score (HHS) increased significantly by 31 points. No stem had to be revised. Bone mineral density (BMD) in the greater trochanter decreased significantly from 0.78 g/cm ² postoperatively to 0.72 g/cm ² two years after surgery. Marginal changes were seen in the lateral distal regions (R4-R5). In the minor trochanter region, BMD increased significantly after two years by 12.9%. In the calcar region, BMD exceeded the baseline value by 6.1% two years after implantation. Conclusions: Stress shielding seems to occur at the greater trochanter due to the vast cross-section of the implant. However, the aim of proximal load transfer of the Metha stem seems to be partially achieved. DEXA analysis revealed a concentrated load distribution on the medial portion of the femur, which is an important region to guarantee long-term implant survival.
Organisation(s): Institute of Metal Forming and Metal Forming Machines
External Organisation(s): Hannover Medical School (MHH)
University of Veterinary Medicine of Hannover, Foundation
Type: Article
Journal: International orthopaedics
Volume: 36
Pages: 533-538
No. of pages: 6
ISSN: 0341-2695
Publication date: 03.2012
Publication status: Published
Peer reviewed: Yes
ASJC Scopus subject areas: Surgery, Orthopedics and Sports Medicine
Electronic version(s): https://doi.org/10.1007/s00264-011-1361-0 (Access: Unknown)
: Details in the research portal "Research@Leibniz University"

BibTeX

@article{62e0653ca42842dca51047a25f459a09,
title = "Bone remodelling around the Metha short stem in total hip arthroplasty: A prospective dual-energy X-ray absorptiometry study",
abstract = "Purpose: On the basis of positive clinical results with mid- and long-term follow-up using the Mayo short stem, the Metha neck-preserving stem (BBraun, Aesculap, Tuttlingen, Germany) was introduced. The purpose of this study was to validate the implant design by direct acquisition of bone remodelling data from total hip arthroplasty (THA) recipients using dual-energy X-ray absorptiometry (DEXA). Methods: After power analysis, 25 patients were included in this prospective study. Patients were examined clinically and underwent DEXA examinations preoperatively and postoperatively at one week, six months and one and two years after THA. Gruen zones were adapted to the short stem design (R1-R7). Results: The Harris Hip Score (HHS) increased significantly by 31 points. No stem had to be revised. Bone mineral density (BMD) in the greater trochanter decreased significantly from 0.78 g/cm 2 postoperatively to 0.72 g/cm 2 two years after surgery. Marginal changes were seen in the lateral distal regions (R4-R5). In the minor trochanter region, BMD increased significantly after two years by 12.9%. In the calcar region, BMD exceeded the baseline value by 6.1% two years after implantation. Conclusions: Stress shielding seems to occur at the greater trochanter due to the vast cross-section of the implant. However, the aim of proximal load transfer of the Metha stem seems to be partially achieved. DEXA analysis revealed a concentrated load distribution on the medial portion of the femur, which is an important region to guarantee long-term implant survival.",
author = "Matthias Lerch and {Von Der Haar-Tran}, Annelene and Henning Windhagen and Behrens, {Bernd A.} and Patrick Wefstaedt and Stukenborg-Colsman, {Christina M.}",
note = "Funding information: The study was performed in subproject D6 of the collaborative research center 599 “Sustainable degradable and permanent implants out of metallic and ceramic materials”. The authors thank the German Research foundation (DFG) for financial support.",
year = "2012",
month = mar,
doi = "10.1007/s00264-011-1361-0",
language = "English",
volume = "36",
pages = "533--538",
journal = "International orthopaedics",
issn = "0341-2695",
publisher = "Springer Verlag",
number = "3",
}