ArticleArchives of orthopaedic and trauma surgery2024
Areal bone mineral density is not associated with femoral stem subsidence in patients younger than 70 years undergoing total hip arthroplasty.
Article in Archives of orthopaedic and trauma surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 2 citations in OpenAlex.
- [Femoral Stem Subsidence in Total Hip Arthroplasty: Comparison between Fixation Principles].Revista brasileira de ortopedia · 2026Article
- Femoral Stem Subsidence in Total Hip Arthroplasty: Comparison between Fixation Principles.Revista brasileira de ortopedia · 2026Article
- Factors Affecting Early Implant Subsidence after Arthroplasty Using a Cementless Femoral Stem for Displaced Femoral Neck Fracture.Hip & pelvis · 2025Article
- Femoral stem subsidence after uncemented total or hemiarthroplasty for femoral neck fractures does not correlate with local femoral bone quality evaluated by Dorr and cortical thickness index.Archives of orthopaedic and trauma surgery · 2025Article
- [Risk factors and prevention strategies for periprosthetic femoral fractures in hip arthroplasty].Orthopadie (Heidelberg, Germany) · 2024Review
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionFemoral stem subsidence is a known complication after uncemented total hip arthroplasty (THA). The purpose of this study was to determine the frequency of osteoporosis and to investigate the relationship between areal bone mineral density (aBMD) and subsidence in a cohort of patients younger than 70 years.
methodsOne hundred consecutive patients (age 60 ± 6 years; 52 female, 48 male) undergoing uncemented THA using a collarless press fit femoral stem were retrospectively reviewed. Dual-energy X-ray absorptiometry (DXA) was performed preoperatively at the proximal femur and lumbar spine, and if not feasible at these sites, at the distal radius. DXA results were compared to a cohort of 100 patients ≥ 70 years scheduled for cemented THA. Age, sex, and body mass index (BMI), canal flare index (CFI), and canal fill ratio (CFR) were assessed. Analysis of stem subsidence and migration was performed on standardized, calibrated radiographs obtained postoperatively and at follow-up.
resultsThe frequency of osteoporosis was considerably lower in the study cohort compared to patients ≥ 70 years (7% vs. 19%, p = 0.02). Illustrated by the high CFR (mean 96 ± 4%) in the mid-stem region, a sufficient press fit was achieved. After a mean follow-up of 7.4 months, the mean stem subsidence was 0.9 ± 0.9 mm. Only two patients had subsidence greater than 3 mm, one of whom was morbidly obese and the other diagnosed with severe osteoporosis. There were no correlations between any of the parameters (CFI, CFR, age, sex, BMI) and femoral stem subsidence. In addition, aBMD T-scores showed no correlations with subsidence.
conclusionaBMD by DXA does not appear to be associated with stem subsidence in patients younger than 70 years and with adequate press fit.
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