Larger femoral periprosthetic bone mineral density decrease following total hip arthroplasty for femoral neck fracture than for osteoarthritis: a prospective, observational cohort study.

Abstract

Studies on patients with degenerative joint disease of the hip show that femoral periprosthetic bone mineral decreases following total hip arthroplasty. Scarcely any osteodensitometric data exist on femoral neck fracture (FNF) patients and periprosthetic bone remodelling. In two parallel cohorts we enrolled 87 patients (mean age, 72 ± 12 years; male:female ratio, 30:57) undergoing total hip arthroplasty for either primary osteoarthritis (OA) of the hip (n = 37) or for an acute FNF (n = 50) and followed them for a mean of 5.4 years. Outcomes were bone mineral density (BMD) changes in the periprosthetic Gruen zones 1-7, the incidence of periprosthetic fractures and clinical outcome. The bone mineral loss in the fracture group was more than twice that of the osteoarthritis group, -16.9% versus -6.8% (p = 0.004). The incidence of periprosthetic fractures was 12% (6/50) in the fracture cohort compared with none (0%) in the OA cohort (p = 0.03). Periprosthetic bone mineral loss following total hip arthroplasty is significantly greater in patients who are treated for acute FNF than in OA patients. This decrease of BMD follows a different pattern with the FNF patients losing larger proportions of bone in Gruen zones 1, 2, 6, and 7 while the OA patients tend to have larger losses only in zones 1 and 7.

• Authors: Tobias Mann, Thomas Eisler, Henrik Bodén, Olle Muren, André Stark, Mats Salemyr, Olof Sköldenberg
• Journal: Journal of orthopaedic research : official publication of the Orthopaedic Research Society (J Orthop Res) Vol. 33 Issue 4 Pg. 504-12 (Apr 2015) ISSN: 1554-527X [Electronic] United States
• PMID: 25663278 (Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)
• Copyright: © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Topics

• Aged
• Arthroplasty, Replacement, Hip (adverse effects, statistics & numerical data)
• Bone Density
• Bone Resorption (epidemiology, etiology)
• Cohort Studies
• Comorbidity
• Female
• Femoral Neck Fractures (therapy)
• Follow-Up Studies
• Humans
• Incidence
• Male
• Osteoarthritis, Hip (epidemiology, therapy)
• Periprosthetic Fractures (epidemiology, prevention & control)
• Prospective Studies
• Quality of Life
• Reoperation