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Adaptive Bone Remodeling of the Femoral Bone After Tumor Resection Arthroplasty With an Uncemented Proximally Hydroxyapatite-Coated Stem

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@article{da14ce8a6c8345678ffbb341585941a4,
title = "Adaptive Bone Remodeling of the Femoral Bone After Tumor Resection Arthroplasty With an Uncemented Proximally Hydroxyapatite-Coated Stem",
abstract = "Loss of bone stock and stress shielding is a significant challenge in limb salvage surgery. This study investigates the adaptive bone remodeling of the femoral bone after implantation of a tumor prosthesis with an uncemented press fit stem. We performed a prospective 1 yr follow-up of 6 patients (mean age: 55 (26-78) yr, female/male=3/3) who underwent bone tumor resection surgery of the proximal femur (n=3) or distal femur (n=3). Reconstruction was done using a Global Modular Replacement System (Stryker{\circledR} Orthopaedics, Mahwah, NJ) tumor prosthesis, and all patients received a straight-fluted 125-mm uncemented press-fit titanium alloy stem with hydroxyapatite coating of the proximal part of the stem. Measurements of bone mineral density (BMD; g/cm2) were done postoperatively and after 3, 6, and 12 mo in the part of the femur bone containing the Global Modular Replacement System stem using dual-energy X-ray absorptiometry. BMD was measured in 3 regions of interest (ROIs) in the femur bone. Nonparametric analysis of variance (Friedman test) for evaluation of changes in BMD over time. BMD decreased in all 3 ROIs with time. In ROI 1 (p=0.01), BMD decreased by 10{\%} after 3 mo and ended with a total decrease of 14{\%} after 1 yr. In ROI 2 (p=0.006), BMD was decreased by 6{\%} after 3 and 6 mo; after 1 yr of follow-up, BMD was 9{\%} below the postoperative value. In ROI 3 (p=0.009), BMD decreased by 6{\%} after 3 and 6 mo; after 1 yr of follow-up, BMD was 8{\%} below the postoperative value. A bone loss of 8{\%}-9{\%} during the first postoperative year was seen along the femoral stem, but in the bone containing the hydroxyapatite-coated part of the stem, the decrease in BMD was 14{\%}, thus indicating that stress shielding of this part of the bone may play a role for the adaptive bone remodeling.",
keywords = "Absorptiometry, Photon, Adult, Aged, Arthroplasty, Replacement, Hip, Biocompatible Materials, Bone Density, Bone Neoplasms, Bone Remodeling, Denmark, Durapatite, Female, Femur, Follow-Up Studies, Hip Prosthesis, Humans, Male, Middle Aged, Osteoporosis, Postoperative Complications, Prosthesis Design, Sarcoma, Ewing, Journal Article",
author = "Andersen, {Mikkel R} and Petersen, {Michael M}",
note = "Copyright {\circledC} 2016 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.",
year = "2015",
month = "4",
day = "7",
doi = "10.1016/j.jocd.2015.02.009",
language = "English",
volume = "19",
pages = "202--7",
journal = "Journal of Clinical Densitometry",
issn = "1094-6950",
publisher = "Elsevier BV",
number = "2",

}

RIS

TY - JOUR

T1 - Adaptive Bone Remodeling of the Femoral Bone After Tumor Resection Arthroplasty With an Uncemented Proximally Hydroxyapatite-Coated Stem

AU - Andersen, Mikkel R

AU - Petersen, Michael M

N1 - Copyright © 2016 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

PY - 2015/4/7

Y1 - 2015/4/7

N2 - Loss of bone stock and stress shielding is a significant challenge in limb salvage surgery. This study investigates the adaptive bone remodeling of the femoral bone after implantation of a tumor prosthesis with an uncemented press fit stem. We performed a prospective 1 yr follow-up of 6 patients (mean age: 55 (26-78) yr, female/male=3/3) who underwent bone tumor resection surgery of the proximal femur (n=3) or distal femur (n=3). Reconstruction was done using a Global Modular Replacement System (Stryker® Orthopaedics, Mahwah, NJ) tumor prosthesis, and all patients received a straight-fluted 125-mm uncemented press-fit titanium alloy stem with hydroxyapatite coating of the proximal part of the stem. Measurements of bone mineral density (BMD; g/cm2) were done postoperatively and after 3, 6, and 12 mo in the part of the femur bone containing the Global Modular Replacement System stem using dual-energy X-ray absorptiometry. BMD was measured in 3 regions of interest (ROIs) in the femur bone. Nonparametric analysis of variance (Friedman test) for evaluation of changes in BMD over time. BMD decreased in all 3 ROIs with time. In ROI 1 (p=0.01), BMD decreased by 10% after 3 mo and ended with a total decrease of 14% after 1 yr. In ROI 2 (p=0.006), BMD was decreased by 6% after 3 and 6 mo; after 1 yr of follow-up, BMD was 9% below the postoperative value. In ROI 3 (p=0.009), BMD decreased by 6% after 3 and 6 mo; after 1 yr of follow-up, BMD was 8% below the postoperative value. A bone loss of 8%-9% during the first postoperative year was seen along the femoral stem, but in the bone containing the hydroxyapatite-coated part of the stem, the decrease in BMD was 14%, thus indicating that stress shielding of this part of the bone may play a role for the adaptive bone remodeling.

AB - Loss of bone stock and stress shielding is a significant challenge in limb salvage surgery. This study investigates the adaptive bone remodeling of the femoral bone after implantation of a tumor prosthesis with an uncemented press fit stem. We performed a prospective 1 yr follow-up of 6 patients (mean age: 55 (26-78) yr, female/male=3/3) who underwent bone tumor resection surgery of the proximal femur (n=3) or distal femur (n=3). Reconstruction was done using a Global Modular Replacement System (Stryker® Orthopaedics, Mahwah, NJ) tumor prosthesis, and all patients received a straight-fluted 125-mm uncemented press-fit titanium alloy stem with hydroxyapatite coating of the proximal part of the stem. Measurements of bone mineral density (BMD; g/cm2) were done postoperatively and after 3, 6, and 12 mo in the part of the femur bone containing the Global Modular Replacement System stem using dual-energy X-ray absorptiometry. BMD was measured in 3 regions of interest (ROIs) in the femur bone. Nonparametric analysis of variance (Friedman test) for evaluation of changes in BMD over time. BMD decreased in all 3 ROIs with time. In ROI 1 (p=0.01), BMD decreased by 10% after 3 mo and ended with a total decrease of 14% after 1 yr. In ROI 2 (p=0.006), BMD was decreased by 6% after 3 and 6 mo; after 1 yr of follow-up, BMD was 9% below the postoperative value. In ROI 3 (p=0.009), BMD decreased by 6% after 3 and 6 mo; after 1 yr of follow-up, BMD was 8% below the postoperative value. A bone loss of 8%-9% during the first postoperative year was seen along the femoral stem, but in the bone containing the hydroxyapatite-coated part of the stem, the decrease in BMD was 14%, thus indicating that stress shielding of this part of the bone may play a role for the adaptive bone remodeling.

KW - Absorptiometry, Photon

KW - Adult

KW - Aged

KW - Arthroplasty, Replacement, Hip

KW - Biocompatible Materials

KW - Bone Density

KW - Bone Neoplasms

KW - Bone Remodeling

KW - Denmark

KW - Durapatite

KW - Female

KW - Femur

KW - Follow-Up Studies

KW - Hip Prosthesis

KW - Humans

KW - Male

KW - Middle Aged

KW - Osteoporosis

KW - Postoperative Complications

KW - Prosthesis Design

KW - Sarcoma, Ewing

KW - Journal Article

U2 - 10.1016/j.jocd.2015.02.009

DO - 10.1016/j.jocd.2015.02.009

M3 - Journal article

VL - 19

SP - 202

EP - 207

JO - Journal of Clinical Densitometry

JF - Journal of Clinical Densitometry

SN - 1094-6950

IS - 2

ER -

ID: 49802940