A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä

Bone Mineral Density and Cortical-Bone Thickness of the Distal Radius Predict Femoral Stem Subsidence in Postmenopausal Women




TekijätSanaz Nazari-Farsani, Mia E. Vuopio, Hannu T. Aro

KustantajaElsevier

Julkaisuvuosi2020

JournalJournal of Arthroplasty

Tietokannassa oleva lehden nimiThe Journal of arthroplasty

Lehden akronyymiJ Arthroplasty

Vuosikerta35

Numero7

Aloitussivu1877

Lopetussivu1884.e1

Sivujen määrä9

ISSN0883-5403

eISSN1532-8406

DOIhttps://doi.org/10.1016/j.arth.2020.02.062

Rinnakkaistallenteen osoitehttps://research.utu.fi/converis/portal/detail/Publication/46735675


Tiivistelmä
The distal radius is an optional site for evaluation of bone quality in postmenopausal women before cementless total hip arthroplasty. We hypothesized that dual-energy X-ray absorptiometry (DXA) and pulse-echo ultrasonometry of the distal radius may help discriminate subjects at high risk of femoral stem subsidence.A prospective cohort of postmenopausal women with primary hip osteoarthritis underwent total hip arthroplasty with implantation of a parallel-sided femoral stem. Postoperative stem migration was measured using radiostereometric analysis. Preoperatively, subjects had multisite DXA measurement of bone mineral density (BMD) and pulse-echo ultrasonometry of the cortical-bone thickness. The diagnostic abilities of these methods to discriminate <2 mm and ≥2 mm femoral stem subsidence were tested.The accuracy of the distal radius BMD and cortical-bone thickness of the distal radius were moderate (area under the curve, 0.737 and 0.726, respectively) in discriminating between <2 mm and ≥2 mm stem subsidence. Women with low cortical-bone thickness of the radius were more likely (odds ratio = 6.7; P = .002) to develop stem subsidence ≥2 mm. These subjects had lower total hip BMD (P = .007) and reduced thickness of the medial cortex of the proximal femur (P = .048) with lower middle (P < .001) and distal (P = .004) stem-to-canal fill ratios.Femoral stem stability and resistance to subsidence are sensitive to adequate bone stock and unaltered anatomy. DXA and pulse-echo ultrasonometry of the distal radius may help discriminate postmenopausal women at high risk of stem subsidence.

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