Increase in Physical Activity after Resurfacing Hip Arthroplasty is Associated with Calcar and Acetabular Bone Mineral Density Changes

Purpose Bone preservation is an important advantage of the resurfacing hip arthroplasty (RHA) concept. We hypothesised that patients’ increase in physical activity level after RHA would positively relate with periprosthetic bone mineral density (BMD) changes and thus facilitate bone preservation. Me...

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Veröffentlicht in:Hip international 2017-03, Vol.27 (2), p.140-146
Hauptverfasser: Gerhardt, Davey M.J.M., Hannink, Gerjon, Rijnders, Ton, Van Susante, Job L.C.
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container_end_page 146
container_issue 2
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container_title Hip international
container_volume 27
creator Gerhardt, Davey M.J.M.
Hannink, Gerjon
Rijnders, Ton
Van Susante, Job L.C.
description Purpose Bone preservation is an important advantage of the resurfacing hip arthroplasty (RHA) concept. We hypothesised that patients’ increase in physical activity level after RHA would positively relate with periprosthetic bone mineral density (BMD) changes and thus facilitate bone preservation. Methods BMD-changes were prospectively recorded in 38 patients after RHA. Dual-energy absorptiometry was used to quantify BMD-changes in 6 periprosthetic regions of interest preoperatively, at 6 months, 1, 2 and 3 years postoperative. The effect estimates of patients’ physical activity, according to their Harris Hip Score (HHS) and University of California at Los Angeles (UCLA) Activity Score, on these BMD changes were assessed in linear mixed models. Results The UCLA (coefficient = 0.02 (95% CI, 0.010-0.034); p
doi_str_mv 10.5301/hipint.5000433
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We hypothesised that patients’ increase in physical activity level after RHA would positively relate with periprosthetic bone mineral density (BMD) changes and thus facilitate bone preservation. Methods BMD-changes were prospectively recorded in 38 patients after RHA. Dual-energy absorptiometry was used to quantify BMD-changes in 6 periprosthetic regions of interest preoperatively, at 6 months, 1, 2 and 3 years postoperative. The effect estimates of patients’ physical activity, according to their Harris Hip Score (HHS) and University of California at Los Angeles (UCLA) Activity Score, on these BMD changes were assessed in linear mixed models. Results The UCLA (coefficient = 0.02 (95% CI, 0.010-0.034); p&lt;0.001) and HHS (coefficient = 0.002 (95% CI, 0.001-0.003); p&lt;0.001) were associated with the BMD in the calcar region. As for BMD changes in the femoral neck only the HHS was associated (coefficient = 0.0006 (95% CI, &lt;0.0001-0.001); p = 0.04). Both the UCLA and the HHS were inversely associated with BMD in the medial acetabular region (UCLA: coefficient = -0.02 (95% CI, -0.038 to -0.007); p = 0.005, HHS: coefficient = -0.002 (95% CI, -0.003 to -0.001), the same accounted for the HHS to BMD-change cranial to the acetabulum (-0.001 [95% CI, -0.0018 to -0.0001]; p = 0.03). For the caudal acetabular and femoral subtrochanteric region no relation with BMD-changes was found. Conclusions The increase in activity scores after RHA was indeed associated with an increase in BMD in the calcar region, however unexpectedly also with a BMD decrease on the acetabular side. Stress shielding from the implant is the most likely causative factor.</description><identifier>ISSN: 1120-7000</identifier><identifier>EISSN: 1724-6067</identifier><identifier>DOI: 10.5301/hipint.5000433</identifier><identifier>PMID: 28218380</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><ispartof>Hip international, 2017-03, Vol.27 (2), p.140-146</ispartof><rights>2017 SAGE Publications</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c331t-b37a19216bb718bf64d7bb586dc076eeddb85fdd22cfe77548e9d4c5a45fbe8d3</citedby><cites>FETCH-LOGICAL-c331t-b37a19216bb718bf64d7bb586dc076eeddb85fdd22cfe77548e9d4c5a45fbe8d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.5301/hipint.5000433$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.5301/hipint.5000433$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>315,781,785,21824,27929,27930,43626,43627</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28218380$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gerhardt, Davey M.J.M.</creatorcontrib><creatorcontrib>Hannink, Gerjon</creatorcontrib><creatorcontrib>Rijnders, Ton</creatorcontrib><creatorcontrib>Van Susante, Job L.C.</creatorcontrib><title>Increase in Physical Activity after Resurfacing Hip Arthroplasty is Associated with Calcar and Acetabular Bone Mineral Density Changes</title><title>Hip international</title><addtitle>Hip Int</addtitle><description>Purpose Bone preservation is an important advantage of the resurfacing hip arthroplasty (RHA) concept. We hypothesised that patients’ increase in physical activity level after RHA would positively relate with periprosthetic bone mineral density (BMD) changes and thus facilitate bone preservation. Methods BMD-changes were prospectively recorded in 38 patients after RHA. Dual-energy absorptiometry was used to quantify BMD-changes in 6 periprosthetic regions of interest preoperatively, at 6 months, 1, 2 and 3 years postoperative. The effect estimates of patients’ physical activity, according to their Harris Hip Score (HHS) and University of California at Los Angeles (UCLA) Activity Score, on these BMD changes were assessed in linear mixed models. Results The UCLA (coefficient = 0.02 (95% CI, 0.010-0.034); p&lt;0.001) and HHS (coefficient = 0.002 (95% CI, 0.001-0.003); p&lt;0.001) were associated with the BMD in the calcar region. As for BMD changes in the femoral neck only the HHS was associated (coefficient = 0.0006 (95% CI, &lt;0.0001-0.001); p = 0.04). Both the UCLA and the HHS were inversely associated with BMD in the medial acetabular region (UCLA: coefficient = -0.02 (95% CI, -0.038 to -0.007); p = 0.005, HHS: coefficient = -0.002 (95% CI, -0.003 to -0.001), the same accounted for the HHS to BMD-change cranial to the acetabulum (-0.001 [95% CI, -0.0018 to -0.0001]; p = 0.03). For the caudal acetabular and femoral subtrochanteric region no relation with BMD-changes was found. Conclusions The increase in activity scores after RHA was indeed associated with an increase in BMD in the calcar region, however unexpectedly also with a BMD decrease on the acetabular side. 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We hypothesised that patients’ increase in physical activity level after RHA would positively relate with periprosthetic bone mineral density (BMD) changes and thus facilitate bone preservation. Methods BMD-changes were prospectively recorded in 38 patients after RHA. Dual-energy absorptiometry was used to quantify BMD-changes in 6 periprosthetic regions of interest preoperatively, at 6 months, 1, 2 and 3 years postoperative. The effect estimates of patients’ physical activity, according to their Harris Hip Score (HHS) and University of California at Los Angeles (UCLA) Activity Score, on these BMD changes were assessed in linear mixed models. Results The UCLA (coefficient = 0.02 (95% CI, 0.010-0.034); p&lt;0.001) and HHS (coefficient = 0.002 (95% CI, 0.001-0.003); p&lt;0.001) were associated with the BMD in the calcar region. As for BMD changes in the femoral neck only the HHS was associated (coefficient = 0.0006 (95% CI, &lt;0.0001-0.001); p = 0.04). Both the UCLA and the HHS were inversely associated with BMD in the medial acetabular region (UCLA: coefficient = -0.02 (95% CI, -0.038 to -0.007); p = 0.005, HHS: coefficient = -0.002 (95% CI, -0.003 to -0.001), the same accounted for the HHS to BMD-change cranial to the acetabulum (-0.001 [95% CI, -0.0018 to -0.0001]; p = 0.03). For the caudal acetabular and femoral subtrochanteric region no relation with BMD-changes was found. Conclusions The increase in activity scores after RHA was indeed associated with an increase in BMD in the calcar region, however unexpectedly also with a BMD decrease on the acetabular side. Stress shielding from the implant is the most likely causative factor.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>28218380</pmid><doi>10.5301/hipint.5000433</doi><tpages>7</tpages></addata></record>
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title Increase in Physical Activity after Resurfacing Hip Arthroplasty is Associated with Calcar and Acetabular Bone Mineral Density Changes
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