ArticleArchives of orthopaedic and trauma surgery2023
Bone remodeling and cortical thinning distal to the femoral stem: a retrospective review.
Article in Archives of orthopaedic and trauma surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- Osteoporosis and osteoporosis therapies as determinants of implant fixation failure in arthroplasty and spinal fusion constructs: a position statement from the Fracture Working Group of the Council of Scientific Advisors of the International Osteoporosis Foundation.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- Revision surgery for aseptic prosthetic loosening in patients treated for knee tumors: Role of gait and imaging parameters.Journal of orthopaedics · 2025Article
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThere is a paucity of information on the bone remodeling that occurs distal to the femoral stem following total hip arthroplasty as most previous studies have focused on proximal changes. In this study, we report the cortical thinning that occur distal to the femoral stem after primary total hip arthroplasty.
methodsA retrospective review was performed at one institution over a 5-year period. 156 primary total hip arthroplasty procedures were included. The Cortical Thickness Index (CTI) was measured on both operative and non-operative hips at 1 cm, 3 cm and 5 cm below the prosthetic stem tip on anteroposterior radiographic images pre-operatively as well as at 6 months, 12 months and 24 months post-operatively. The difference in average CTI was measured using paired t-tests.
resultsThere were statistically significant decreases in CTI distal to the femoral stem at 12 months and 24 months (-1.3% and -2.8%, respectively). Greater losses were seen in female patients, patients older than 75, and patients with BMI less than 35 at 6 months postoperative. There were no differences in CTI at any time point on the non-operative side.
conclusionThe current study demonstrates that patients undergo bone loss as measured by CTI distal to the stem in the first 2 years following total hip arthroplasty. Comparison to the contralateral non-operative side confirms that this change is greater than expected for the natural aging process. A greater understanding of these changes will help optimize post-operative management and direct future innovations in implant design.
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