A prospective randomized radiographic and dual-energy X-ray absorptiometric study of migration and bone remodeling after implantation of two modern short-stemmed femoral prostheses

被引：44

作者：

Brinkmann V. ^{[1
]}

Radetzki F. ^{[1
]}

Delank K.S. ^{[1
]}

Wohlrab D. ^{[1
]}

Zeh A. ^{[1
]}

机构：

[1] Department of Orthopaedics and Traumatology, Martin-Luther-University of Halle-Wittenberg, Ernst-Grube-Strasse 40, Halle/Saale

来源：

Journal of Orthopaedics and Traumatology | 2015年 / 16卷 / 3期

关键词：

DEXA; Metha™; Nanos™; Short-stemmed prosthesis; Stress shielding;

D O I：

10.1007/s10195-015-0335-1

中图分类号：

学科分类号：

摘要：

Background: The aim of this prospective randomized study was to analyze migration and strain transmission of the Metha™ and Nanos™ femoral prostheses. Materials and methods: Between 1 January 2011 and 2 April 2013, 50 patients were randomized to receive short-stemmed femoral prostheses. Metha™ stems were implanted in 24 patients (12 female, 12 male; mean age 58.7 years; mean body mass index [BMI] 27.4) and Nanos™ stems in 26 patients (10 female, 16 male; mean age 59.7 years; mean BMI 27.1). Longitudinal stem migration, varus−valgus alignment, changes of center of rotation (COR), femoral offset and caput-collum-diaphyseal angle, leg length discrepancy, periprosthetic radiolucent lines incidence, and dual-energy X-ray absorptiometry (DEXA) scans were analysed after an average of 98 and 381 days. Results: There was no significant change of varus−valgus alignment or clinically relevant migration of the Metha™ or Nanos™ prostheses during postoperative follow-up. After 12.3 months, the DEXA scans showed small but significant differences of bone mineral density in Gruen zones 1 (minus ~8 %) and 6 (plus ~9 %) for the Metha™ and in Gruen zone 1 (minus ~14 %) for the Nanos™ (paired t test). Visual analog scale (VAS) and Harris Hip Score (HHS) improved significantly for both implants (Nanos™/Metha™ 12.3 months postoperatively HSS 96.5/96.2; VAS 0.7/0.8, respectively). COR or offset did not change significantly after surgery. Conclusions: Neither implant showed signs of impaired osseointegration. DEXA demonstrated proximally located load transfer with only moderate proximal stress shielding. Level of evidence: II. © 2015, The Author(s).

引用

页码：237 / 243

页数：6

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