Periprosthetic bone remodeling around short stem.

Periprosthetic Bone Remodeling Around Short Stem MAREK SYNDER, MD, PHD; KAROL KRAJEWSKI, MD; MARCIN SIBINSKI, MD, PHD; MAREK DROBNIEWSKI, MD Total hip arthroplasty (THA) has become standard treatment for advanced degenerative changes of the hip. A few studies have reported promising clinical outcomes with the Metha stem fi xated by metaphyseal anchoring. This study evaluated early bone remodeling around the Metha stem during 12 months of follow-up. The study population included 36 patients (18 women and 18 men) with a mean age of 50.4 years who underwent THA between 2009 and 2011 for advanced degenerative changes of the hip with the Metha stem. Patients were evaluated on the day of surgery, 10 days postoperatively, and then at 3, 6, and 12 months postoperatively. Evaluation included Harris Hip Score and dual-energy x-ray absorptiometry (DEXA) scanning in 7 Gruen zones. At 12 months postoperatively, Harris Hip Score increased signifi cantly by 38 points. A signifi cant change in bone mineral density (BMD) was found immediately after surgery; this change was most pronounced in Gruen zone 3 (+36%), followed by Gruen zones 2 and 5. The smallest postoperative BMD increase was observed in Gruen zone 7 (+3.66%). In contrast, at 3 months postoperatively, a trend toward decreased BMD was observed in all Gruen zones. At 6 months postoperatively, mean BMD decreased in all Gruen zones except for Gruen zone 6. At 12 months postoperatively, mean BMD increased in Gruen zones 2 through 6, with the highest value (30%) observed in Gruen zone 3; in Gruen zones 1 and 2, mean BMD decreased. Short-term assessment of periprosthetic bone remodeling after uncemented Metha stem implantation revealed different host-bone responses. Apparently, the Metha stem can reduce BMD loss in the proximal femur. DEXA is a precise method for assessing BMD changes around implanted Metha stem. The authors are from the Department of Orthopaedics and Paediatric Orthopaedics, Medical University of Lodz, Lodz, Poland. The authors have no relevant fi nancial relationships to disclose. Correspondence should be addressed to: Marek Synder, MD, PhD, Medical University of Lodz, Pomorska Str. 251, 92-213 Lodz, Poland (msynder@pro.onet.pl). doi: 10.3928/01477447-20150215-55