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Is bone remodelling around fully hydroxyapatite-coated and tapered-wedge stems related to the stem fixation pattern?

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to compare bone mineral density (BMD) changes around the femoral component after total hip arthroplasty (THA) in a fully hydroxyapatite-coated stem (CORAIL) and in a tapered-wedge stem (Taperloc complete) and identify predictors of BMD changes.

Methods

This retrospective study compared 43 hips in the CORAIL group and 40 hips in the Taperloc group. The relative changes in BMD at 2 years after THA measured using dual-energy X-ray absorptiometry and the three-dimensional quantified contact states of the stem with the femoral cortical bone were assessed. Predictors of the relative change in the BMD around the proximal part of the stem were examined using multiple regression analysis.

Results

The decrease in BMD in Gruen zone 7 was significantly less in the CORAIL group than in the Taperloc group (P = 0.02). In the CORAIL group, the contact area in any zone was not a significant predictor of the relative changes in BMD. The contact area between the Taperloc stem and the femoral cortical bone in zones 2 and 6 was a positive predictor of the relative changes in BMD in zones 1 (P = 0.02 and P = 0.04, respectively) and 2 (P = 0.008 and P = 0.004, respectively).

Conclusion

The CORAIL stem suppressed the postoperative BMD loss around the stem, irrespective of the contact state. The Taperloc complete stem required contact with the proximal femoral metaphysis to suppress the postoperative BMD loss around the stem.

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Acknowledgements

We thank Hiroyoshi Iwaki and Shigekazu Mizokawa for their assistance in the data collection of this study and the orthopaedic surgery.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahi-Machi Abeno-Ku Osaka-City, Osaka, 545-8585, Japan

    Yohei Ohyama, Yukihide Minoda, Sho Masuda, Ryo Sugama, Yoichi Ohta & Hiroaki Nakamura

Authors
  1. Yohei Ohyama
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  2. Yukihide Minoda
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  3. Sho Masuda
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  4. Ryo Sugama
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  5. Yoichi Ohta
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  6. Hiroaki Nakamura
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by YO and YM. The first draft of the manuscript was written by YO, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yukihide Minoda.

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Conflict of interests

Each author certifies that he or she has no commercial associations (e.g. consultancies, stock ownership, equity interest, or patent/licensing arrangements) that might pose a conflict of interest in connection with the submitted article.

Consent to participate

All patients provided written informed consent prior to their participation.

Ethical approval.

This study was conducted in accordance with ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards, and the study protocol was approved by the institutional review board.

Device status/drug statement

The FDA or corresponding national agency approved the device(s)/drug(s) for this indication.

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Ohyama, Y., Minoda, Y., Masuda, S. et al. Is bone remodelling around fully hydroxyapatite-coated and tapered-wedge stems related to the stem fixation pattern?. Eur J Orthop Surg Traumatol 34, 2041–2047 (2024). https://doi.org/10.1007/s00590-024-03891-0

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