Farzi, M., Morris, R.M., Penny, J. et al. (5 more authors) (2017) Quantitating the effect of prosthesis design on femoral remodeling using high-resolution region-free densitometric analysis (DXA-RFA). Journal of Orthopaedic Research, 35 (10). pp. 2203-2210. ISSN 0736-0266
Abstract
Dual energy X-ray absorptiometry (DXA) is the reference standard method used to study bone mineral density (BMD) after total hip arthroplasty (THA). However, the subtle, spatially-complex changes in bone mass due to strain-adaptive bone remodeling relevant to different prosthesis designs are not readily resolved using conventional DXA analysis. DXA region free analysis (DXA RFA) is a novel computational image analysis technique that provides a high-resolution quantitation of periprosthetic BMD. Here we applied the technique to quantitate the magnitude and areal size of periprosthetic BMD changes using scans acquired during two previous randomized clinical trials (2004 to 2009); one comparing three cemented prosthesis design geometries, and the other comparing a hip resurfacing versus a conventional cementless prosthesis. DXA RFA resolved subtle differences in magnitude and area of bone remodeling between prosthesis designs not previously identified in conventional DXA analyses. A mean bone loss of 10.3%, 12.1%, and 11.1% occurred for the three cemented prostheses within a bone area fraction of 14.8%, 14.4%, and 6.2%, mostly within the lesser trochanter (P < 0.001). For the cementless prosthesis, a diffuse pattern of bone loss (-14.3%) was observed at the shaft of femur in a small area fraction of 0.6% versus no significant bone loss for the hip resurfacing prosthesis (P < 0.001). BMD increases were observed consistently at the greater trochanter for all prostheses except the hip-resurfacing prosthesis, where BMD increase was widespread across the metaphysis (P < 0.001). DXA RFA provides high-resolution insights into the effect of prosthesis design on the local strain environment in bone. This article is protected by copyright. All rights reserved.
Metadata
Item Type: | Article |
---|---|
Authors/Creators: |
|
Copyright, Publisher and Additional Information: | © 2017 The Authors Journal of Orthopaedic Research published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society. This is an open access article under the terms of the Creative Commons Attribution License, (http://creativecommons.org/licenses/by/4.0/) which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
Keywords: | Bone mineral density; Dual energy X-ray absorptiometry (DXA); False discovery rate (FDR); Hip Arthroplasty; Strain-adaptive bone remodeling |
Dates: |
|
Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > The Medical School (Sheffield) > Division of Genomic Medicine (Sheffield) > Department of Oncology and Metabolism (Sheffield) The University of Sheffield > Sheffield Teaching Hospitals |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 15 Feb 2017 16:09 |
Last Modified: | 07 Jul 2023 16:17 |
Published Version: | https://doi.org/10.1002/jor.23536 |
Status: | Published |
Publisher: | Wiley |
Refereed: | Yes |
Identification Number: | 10.1002/jor.23536 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:112326 |