Stepniewski Adam S, Egawa Hiroshi, Sychterz-Terefenko Christi, Leung Serena, Engh Charles A
Anderson Orthopaedic Research Institute, Alexandria, Virginia 22307, USA.
J Arthroplasty. 2008 Jun;23(4):593-9. doi: 10.1016/j.arth.2007.05.030.
To clinically verify the bony response to a press-fit acetabular component, this study assessed 5 postmortem-retrieved pelves with unilateral total hip arthroplasties. Changes in periacetabular bone density between implanted and contralateral bone were assessed with dual energy x-ray absorptiometry and computed tomography. At a mean of 9.1 years postarthroplasty, bone density decreased an average of 1.5% to 7.1% proximal and 12.8% medial to the cup. This supports shorter-term in vivo investigations demonstrating periacetabular stress shielding proximal to press-fit cups as well as computer models predicting bone loss medially, but in much greater magnitudes. Unlike femoral remodeling, the average magnitudes of pelvic bone loss are not extensive; therefore, we question whether periacetabular remodeling should be a primary concern for orthopedic surgeons.