TY - JOUR
T1 - Femoral remodeling around charnley total hip arthroplasty is unpredictable
AU - Teusink, Matthew J.
AU - Callaghan, Katharine A.
AU - Klocke, Noelle F.
AU - Goetz, Devon D.
AU - Callaghan, John J.
N1 - Funding Information:
The institution of one or more of the authors (JJC) received funding from The Bierbaum Research Fund (Iowa City, IA, USA) to help defray the cost of this study. One of the authors (JJC) has or may receive payments or benefits, during the study period, an amount of more than USD 1,000,001 from DePuy (Warsaw, IN, USA) for consulting and royalties for intellectual property transfer. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request. Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained. This work was performed at the University of Iowa Health Care, Iowa City, IA, USA, and Des Moines Orthopaedic Surgeons, Des Moines, IA, USA.
PY - 2013/12
Y1 - 2013/12
N2 - Background: There are two unusual remodeling patterns of the proximal femur around well-fixed Charnley total hip arthroplasties: cortical thinning leading to endosteal widening around the femoral component and hypertrophy of the distal femoral cortex. Previous studies have shown remodeling patterns are affected by stem design and occur early postoperatively. It is unclear if these changes are related to patient demographics or if they progress throughout the lifetime of the implant. Questions/purposes: We determined if patient demographic variables influence remodeling patterns after cemented Charnley total hip arthroplasty and if the observed remodeling changes persist long-term. Methods: We retrospectively reviewed the radiographs of 106 well-fixed Charnley femoral components. Using a novel digital edge detection program, we determined the femoral remodeling pattern and time-related changes in femoral dimensions. The minimum followup was 20 years (mean, 25.3 years; range, 19.5-37 years). Results: We found no association between remodeling type and age at surgery, sex, preoperative diagnosis, body mass index, or postoperative activity level. There was also no association between initial implant alignment and remodeling type. Cortical thickening in the distal hypertrophy group was an early phenomenon occurring primarily within the first 2 years, whereas cortical thinning begins later and is a more progressive process. Conclusions: These data show remodeling after cemented Charnley total hip arthroplasty is not related to patient demographic variables; however, distal cortical hypertrophy can be predicted in the early postoperative period. Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
AB - Background: There are two unusual remodeling patterns of the proximal femur around well-fixed Charnley total hip arthroplasties: cortical thinning leading to endosteal widening around the femoral component and hypertrophy of the distal femoral cortex. Previous studies have shown remodeling patterns are affected by stem design and occur early postoperatively. It is unclear if these changes are related to patient demographics or if they progress throughout the lifetime of the implant. Questions/purposes: We determined if patient demographic variables influence remodeling patterns after cemented Charnley total hip arthroplasty and if the observed remodeling changes persist long-term. Methods: We retrospectively reviewed the radiographs of 106 well-fixed Charnley femoral components. Using a novel digital edge detection program, we determined the femoral remodeling pattern and time-related changes in femoral dimensions. The minimum followup was 20 years (mean, 25.3 years; range, 19.5-37 years). Results: We found no association between remodeling type and age at surgery, sex, preoperative diagnosis, body mass index, or postoperative activity level. There was also no association between initial implant alignment and remodeling type. Cortical thickening in the distal hypertrophy group was an early phenomenon occurring primarily within the first 2 years, whereas cortical thinning begins later and is a more progressive process. Conclusions: These data show remodeling after cemented Charnley total hip arthroplasty is not related to patient demographic variables; however, distal cortical hypertrophy can be predicted in the early postoperative period. Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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U2 - 10.1007/s11999-013-2873-2
DO - 10.1007/s11999-013-2873-2
M3 - Article
C2 - 23440619
AN - SCOPUS:84890437165
SN - 0009-921X
VL - 471
SP - 3838
EP - 3846
JO - Clinical Orthopaedics and Related Research
JF - Clinical Orthopaedics and Related Research
IS - 12
ER -