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Clinical outcome and periprosthetic bone remodelling of an uncemented femoral component with taper design
Authors:Rainer Schmidt  Lutz Mueller  Tobias E Nowak  Rocco P Pitto
Institution:Department of Orthopaedic Surgery, University of Erlangen, Nuremberg, Germany.
Abstract:We followed 48 consecutive patients (50 hips) with osteoarthritis who received a primary total hip replacement using a tapered stem with hydroxylapatite coating (Cerafit Multicone H-A.C.) and a press-fit cup. Mean follow-up was 3 years, mean patient age was 54.7 years, and mean preoperative Harris hip score was 57. Quantitative evaluation of periprosthetic bone remodelling was assessed 1 year after the index operation using computed tomography (CT). Clinical and radiological follow-up was obtained in all hips. The mean Harris hip score at follow-up was 96. Forty-nine hips were clinically rated good or excellent. No thigh pain was reported. Radiographs showed stable fixation by bone ingrowth in all hips. Fifteen hips were eligible for CT. Three years after operation, mean decrease of overall bone mineral density (BMD) was 14.2% and mean decrease of cortical BMD 15.5% in the metaphyseal portion. In the diaphyseal portion, mean decrease of overall BMD was 10.0% and mean decrease of cortical BMD 7.7%. Minimal changes were observed at the level of the tip of the stem. Clinical and radiological outcome using a tapered femoral stem with hydroxylapatite coating compares favourably with other reports. Osteodensitometry shows limited proximal femoral bone resorption.
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