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Peri-acetabular bone mineral density in total hip replacement

OBJECTIVES: To quantify and compare peri-acetabular bone mineral density (BMD) between a monoblock acetabular component using a metal-on-metal (MoM) bearing and a modular titanium shell with a polyethylene (PE) insert. The secondary outcome was to measure patient-reported clinical function. METHODS:...

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Autores principales: Gauthier, L., Dinh, L., Beaulé, P. E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: British Editorial Society of Bone and Joint Surgery 2013
Materias:
Hip
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3743302/
https://www.ncbi.nlm.nih.gov/pubmed/23913361
http://dx.doi.org/10.1302/2046-3758.28.2000173
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author Gauthier, L.
Dinh, L.
Beaulé, P. E.
author_facet Gauthier, L.
Dinh, L.
Beaulé, P. E.
author_sort Gauthier, L.
collection PubMed
description OBJECTIVES: To quantify and compare peri-acetabular bone mineral density (BMD) between a monoblock acetabular component using a metal-on-metal (MoM) bearing and a modular titanium shell with a polyethylene (PE) insert. The secondary outcome was to measure patient-reported clinical function. METHODS: A total of 50 patients (25 per group) were randomised to MoM or metal-on-polyethlene (MoP). There were 27 women (11 MoM) and 23 men (14 MoM) with a mean age of 61.6 years (47.7 to 73.2). Measurements of peri-prosthetic acetabular and contralateral hip (covariate) BMD were performed at baseline and at one and two years’ follow-up. The Western Ontario and McMaster Universities osteoarthritis index (WOMAC), University of California, Los Angeles (UCLA) activity score, Harris hip score, and RAND-36 were also completed at these intervals. RESULTS: At two years, only zone 1 showed a loss in BMD (-2.5%) in MoM group compared with a gain in the MoP group (+2.2%). Zone 2 showed loss in both groups (-2.2% for MoM; -3.9% for MoP) and zones 3 and 4 a gain in both groups (+0.1% for MoM; +3.3% for MoP). No other between-group differences were detected. When adjusting for BMD of the contralateral hip, no differences in BMD were observed. The only significant differences in functional scores at two years were higher UCLA activity (7.3 (sd 1.2) vs 6.1 (sd 1.5); p = 0.01) and RAND-36 physical function (82.1 (sd 13.0) vs 64.5 (sd 26.4); p = 0.02) for MoM bearings versus MoP. One revision was performed in the MoM group, for aseptic acetabular loosening at 11 months. CONCLUSIONS: When controlling for systemic BMD, there were no significant differences between MoM and MoP groups in peri-acetabular BMD. However, increasing reports of adverse tissue reactions with large head MoM THR have restricted the use of the monoblock acetabular component to resurfacing only.
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spelling pubmed-37433022013-08-21 Peri-acetabular bone mineral density in total hip replacement Gauthier, L. Dinh, L. Beaulé, P. E. Bone Joint Res Hip OBJECTIVES: To quantify and compare peri-acetabular bone mineral density (BMD) between a monoblock acetabular component using a metal-on-metal (MoM) bearing and a modular titanium shell with a polyethylene (PE) insert. The secondary outcome was to measure patient-reported clinical function. METHODS: A total of 50 patients (25 per group) were randomised to MoM or metal-on-polyethlene (MoP). There were 27 women (11 MoM) and 23 men (14 MoM) with a mean age of 61.6 years (47.7 to 73.2). Measurements of peri-prosthetic acetabular and contralateral hip (covariate) BMD were performed at baseline and at one and two years’ follow-up. The Western Ontario and McMaster Universities osteoarthritis index (WOMAC), University of California, Los Angeles (UCLA) activity score, Harris hip score, and RAND-36 were also completed at these intervals. RESULTS: At two years, only zone 1 showed a loss in BMD (-2.5%) in MoM group compared with a gain in the MoP group (+2.2%). Zone 2 showed loss in both groups (-2.2% for MoM; -3.9% for MoP) and zones 3 and 4 a gain in both groups (+0.1% for MoM; +3.3% for MoP). No other between-group differences were detected. When adjusting for BMD of the contralateral hip, no differences in BMD were observed. The only significant differences in functional scores at two years were higher UCLA activity (7.3 (sd 1.2) vs 6.1 (sd 1.5); p = 0.01) and RAND-36 physical function (82.1 (sd 13.0) vs 64.5 (sd 26.4); p = 0.02) for MoM bearings versus MoP. One revision was performed in the MoM group, for aseptic acetabular loosening at 11 months. CONCLUSIONS: When controlling for systemic BMD, there were no significant differences between MoM and MoP groups in peri-acetabular BMD. However, increasing reports of adverse tissue reactions with large head MoM THR have restricted the use of the monoblock acetabular component to resurfacing only. British Editorial Society of Bone and Joint Surgery 2013-08-01 /pmc/articles/PMC3743302/ /pubmed/23913361 http://dx.doi.org/10.1302/2046-3758.28.2000173 Text en ©2013 The British Editorial Society of Bone & Joint Surgery ©2013 The British Editorial Society of Bone & Joint Surgery. This is an open-access article distributed under the terms of the Creative Commons Attributions licence, which permits unrestricted use, distribution, and reproduction in any medium, but not for commercial gain, provided the original author and source are credited.
spellingShingle Hip
Gauthier, L.
Dinh, L.
Beaulé, P. E.
Peri-acetabular bone mineral density in total hip replacement
title Peri-acetabular bone mineral density in total hip replacement
title_full Peri-acetabular bone mineral density in total hip replacement
title_fullStr Peri-acetabular bone mineral density in total hip replacement
title_full_unstemmed Peri-acetabular bone mineral density in total hip replacement
title_short Peri-acetabular bone mineral density in total hip replacement
title_sort peri-acetabular bone mineral density in total hip replacement
topic Hip
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3743302/
https://www.ncbi.nlm.nih.gov/pubmed/23913361
http://dx.doi.org/10.1302/2046-3758.28.2000173
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