Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Arthroplasty - Hip
Abstract number: 24208
PREOPERATIVE BONE QUALITY AS A RISK FACTOR OF UNCEMETED
ENDOPROSTHETIC COMPONENTS FAILURE.
Istvan GERGELY, Sorin POP TUDOR, Octav RUSSU, Sandor ZUH, Ors NAGY
Universitary Clinic of Orthopaedics and Traumatology, Tg. Mures (ROMANIA)
Introduction: The outcome of uncemented total hip arthroplasty can be influenced by
many factors. Aim: Our aim was to determine if there was a difference in the quality
of the bone in patients with and without loosening of a hip replacement and to
establish if there were any simple methods for predicting those hips which were likely
to develop loosening. Methods: We matched 32 patients with a loose uncemented
total hip replacement by age, gender, race, prosthesis and time from surgery with 44
patients with a wellfixed stable uncemented hip replacement, to determine if poor
bone quality predisposes to loosening. Clinical, radiological, biomechanical and bone
mineral density indicators of bone quality were assessed. Results: Of 70 patients
with preoperative radiographs available 32% had atrophic, 62%, normotrophic and
6% hypertrophic OA. Patients with loose endoprosthetic components had more pain,
were more likely to have presented with atrophic arthritis. The cortex ratio was
significantly less in those with loosening compared with those with a stable THR. The
mean peri-prosthetic BMD was significantly lower in patients with signs of loosening;
they also tended to be smokers. Vitamin-D deficiency was common, but not
significantly different between the two groups. Conclusions: In conclusion patients
with risk factors for loosening should be warned about the increased risk of loosening
and encouraged to attend for radiological surveillance. To ensure longer durability of
THAs, these factors should be assessed further and efforts, especially biological
initiatives, should be made to resolve them.
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