TY - JOUR
T1 - Short-term success of proximal bone stock preservation in short hip stems
T2 - a systematic review of the literature
AU - de Waard, Sheryl
AU - van der Vis, Jacqueline
AU - Venema, Pascale A. H. T.
AU - Sierevelt, Inger N.
AU - Kerkhoffs, Gino M. M. J.
AU - Haverkamp, Daniël
N1 - Funding Information: No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. Publisher Copyright: © 2021 The author(s). All Rights Reserved.
PY - 2021/11/1
Y1 - 2021/11/1
N2 - Total hip arthroplasty is performed more frequently in younger patients nowadays, making long-term bone stock preservation an important topic. A mechanism for late implant failure is periprosthetic bone loss, caused by stress shielding around the hip stem due to different load distribution. Short stems are designed to keep the physical loading in the proximal part of the femur to reduce stress shielding. The aim of this review is to give more insight into how short and anatomic stems behave and whether they succeed in preservation of proximal bone stock. A systematic literature search was performed to find all published studies on bone mineral density in short and anatomic hip stems. Results on periprosthetic femoral bone mineral density, measured with dual-energy X-ray absorptiometry (DEXA), were compiled and analysed per Gruen zone in percentual change. A total of 29 studies were included. In short stems, Gruen 1 showed bone loss of 5% after one year (n = 855) and 5% after two years (n = 266). Gruen 7 showed bone loss of 10% after one year and -11% after two years. In anatomic stems, Gruen 1 showed bone loss of 8% after one year (n = 731) and 11% after two years (n = 227). Gruen 7 showed bone loss of 14% after one year and 15% after two years. Short stems are capable of preserving proximal bone stock and have slightly less proximal bone loss in the first years, compared to anatomic stems.
AB - Total hip arthroplasty is performed more frequently in younger patients nowadays, making long-term bone stock preservation an important topic. A mechanism for late implant failure is periprosthetic bone loss, caused by stress shielding around the hip stem due to different load distribution. Short stems are designed to keep the physical loading in the proximal part of the femur to reduce stress shielding. The aim of this review is to give more insight into how short and anatomic stems behave and whether they succeed in preservation of proximal bone stock. A systematic literature search was performed to find all published studies on bone mineral density in short and anatomic hip stems. Results on periprosthetic femoral bone mineral density, measured with dual-energy X-ray absorptiometry (DEXA), were compiled and analysed per Gruen zone in percentual change. A total of 29 studies were included. In short stems, Gruen 1 showed bone loss of 5% after one year (n = 855) and 5% after two years (n = 266). Gruen 7 showed bone loss of 10% after one year and -11% after two years. In anatomic stems, Gruen 1 showed bone loss of 8% after one year (n = 731) and 11% after two years (n = 227). Gruen 7 showed bone loss of 14% after one year and 15% after two years. Short stems are capable of preserving proximal bone stock and have slightly less proximal bone loss in the first years, compared to anatomic stems.
KW - DEXA
KW - anatomic stem
KW - bone mineral density
KW - bone stock loss
KW - periprosthetic bone loss
KW - short stem
KW - total hip arthroplasty
UR - http://www.scopus.com/inward/record.url?scp=85121226202&partnerID=8YFLogxK
U2 - https://doi.org/10.1302/2058-5241.6.210030
DO - https://doi.org/10.1302/2058-5241.6.210030
M3 - Article
C2 - 34909223
SN - 2396-7544
VL - 6
SP - 1040
EP - 1051
JO - EFORT Open Reviews
JF - EFORT Open Reviews
IS - 11
ER -