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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 4, 455-459.
doi: 10.1302/0301-620X.88B4.16786  
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
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Bone remodelling around a cemented polyethylene cup

A LONGITUDINAL DENSITOMETRY STUDY

N. R. Shetty, MRCS, Orthopaedic Senior House Officer1; A. J. Hamer, MD, FRCS(Orth), Consultant Orthopaedic Surgeon1; R. M. Kerry, FRCS(Orth), Consultant Orthopaedic Surgeon1; I. Stockley, MD, FRCS, Consultant Orthopaedic Surgeon1; R. Eastell, MD, FRCP, Professor of Bone Metabolism2; and J. M. Wilkinson, PhD, FRCS(Orth), Orthopaedic Registrar2

1 Department of Orthopaedics
2 Academic Department of Bone Metabolism, Division of Clinical Sciences (North), University of Sheffield, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK.

Correspondence should be sent to Mr J. M. Wilkinson; e-mail: wilkomark{at}aol.com

The aims of this study were to examine the repeatability of measurements of bone mineral density (BMD) around a cemented polyethylene Charnley acetabular component using dual-energy x-ray absorptiometry and to determine the longitudinal pattern of change in BMD during the first 24 months after surgery.

The precision of measurements of BMD in 19 subjects ranged from 7.7% to 10.8% between regions, using a four-region-of-interest model. A longitudinal study of 27 patients demonstrated a transient decrease in net pelvic BMD during the first 12 months, which recovered to baseline at 24 months. The BMD in the region medial to the dome of the component reduced by between 7% and 10% during the first three months, but recovered to approximately baseline values by two years.

Changes in BMD in the pelvis around cemented acetabular components may be measured using dual-energy x-ray absorptiometry. Bone loss after insertion of a cemented Charnley acetabular component is small, transient and occurs mainly at the medial wall of the acetabulum. After two years, bone mass returns to baseline values, with a pattern suggesting a uniform transmission of load to the acetabulum.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General