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Journal of Long-Term Effects of Medical Implants
SJR: 0.332 SNIP: 0.491 CiteScore™: 0.89

ISSN Print: 1050-6934
ISSN Online: 1940-4379

Journal of Long-Term Effects of Medical Implants

DOI: 10.1615/JLongTermEffMedImplants.v21.i4.40
pages 291-297

Decreased Tibial Bone Strength in Postmenopausal Women with Aseptic Loosening of Cemented Femoral Implants Measured by Peripheral Quantitative Computed Tomography (pQCT)

Andreas Morakis
'KAT' General Hospital, Nikis 2 Str., Kifisia, PC: 14561, Athens, Greece
S. Tournis
Laboratory for Research of the Musculoskeletal System "Th. Garofalidis," University of Athens, 'KAT' Hospital 10 Athinas Str., Kifisia, PC: 14561, Athens, Greece
E. Papakitsou
Orthopaedic Surgeon, Athens, Athens
I. Donta
Laboratory for Research of the Musculoskeletal System "Th. Garofalidis," University of Athens, 'KAT' Hospital 10 Athinas Str., Kifisia, PC: 14561, Athens, Greece
G. P. Lyritis
University of Athens

ABSTRACT

Aseptic loosening after total hip arthroplasty is related to bone loss of the operated leg. The aim of the present study was to investigate the effect of aseptic loosening on volumetric bone mineral density (vBMD) and bone geometry in the operated leg, in postmenopausal women with a loosened cemented femoral implant using peripheral quantitative computed tomography (pQCT). We matched 12 postmenopausal women with aseptic loosening of cemented femoral implant, with 12 women without aseptic loosening (control group) according to age, BMI, and years from operation. All patients underwent pQCT of both tibias, DXA of the lumbar spine, and determination of biochemical markers of bone turnover. pQCT values in the control group as well as the nonoperated legs between groups had no significant difference. In the aseptic loosening group, there was significant reduction of cortical vBMD (cort vBMD) at 14% and 38% sites (cortical site), cortical thickness at 38% site, and of polar stress strength index (SSIp) at 14% site (transition zone) in the operated compared with the nonoperated leg. Similarly, there was significant reduction of cort vBMD at 14% and 38% sites and total vBMD and trabecular vBMD (trab vBMD) at the 14% site in the operated legs between the two groups. The aseptic loosening group had increased osteocalcin and serum collagen cross-linked N- and C-telopeptides (sNTX and sCTX) levels compared with controls. Aseptic loosening is associated with significant decrease of cortical and trabecular vBMD, and impairment of bone geometry and strength only in the operated leg. Increased bone turnover probably represents a local phenomenon, and is not associated with systemic skeletal disease.