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Peri-prosthetic bone density after implantation of a custom-made femoral component

A FIVE-YEAR FOLLOW-UP

¹ Department of Orthopaedics, University Hospital Hopp-Seyler-Strasse 3, D-72076, Tuebingen, Germany.

Correspondence should be sent to Dr F. Martini; e-mail: fmartini{at}joho.de

Peri-prosthetic bone loss caused by stress shielding may be associated with aseptic loosening of femoral components. In order to increase primary stability and to reduce stress shielding, a three-dimensional, cementless individual femoral (Evolution K) component was manufactured using pre-operative CT scans. Using dual energy x-ray absorptiometry, peri-prosthetic bone density was measured in 43 patients, three months, six months, 3.6 and 4.6 years after surgery. At final follow-up there was a significant reduction in mean bone density in the proximal Gruen zones of –30.3% (zone 7) and –22.8% (zone 1). The density in the other zones declined by a mean of between –4% and –16%. We conclude that the manufacture of a three-dimensional, custom-made femoral component could not prevent a reduction in peri-prosthetic bone density.