Periprosthetic bone density changes after MiniHipTM cementless femoral short stem: one-year results of dual-energy X-ray absorptiometry study

INTRODUCTION The purpose of the current study was to investigate the reaction of the femur to the implantation of the MiniHipTM in terms of: (1) bone density change during one year; (2) correlations between stem length, CCD (caput-collum-diaphyseal), femoral offset, T-value, and bone density; (3) other co-variables that influence the change of bone density. PATIENTS AND METHODS MiniHipTM implant was performed for 62 patients. The age range of the patients who underwent treatment was 25-78 years. Periprothestic bone density was determined within two weeks postoperatively, after three, six, and twelve months utilizing the DEXA scan. RESULTS The highest change was observed in the first three months post-implantation, while significant decrease in density was recorded at proximal Gruen zones 1, 2, and 7, and at distal Gruen zone 4. The decrease in density reached a plateau between the third and sixth months after operation. Afterwards, bone density recovered up to the 12th postoperative month. The correlation analysis showed significant difference between Gruen zone 1 and stem size and CCD. The same significant trend was not reached for Gruen zone 7. Femoral offset showed no correlation. Covariance analysis was unable to establish connection of the results with diagnosis, pairings, or gender. DISCUSSION MiniHipTM densitometric results are promising and comparable to good results of the other representatives of the femoral neck partially-sustaining short stem prostheses with a lower proximal bone density reduction. Periprosthetic bone resorption is a multifactorial process where stem size, CCD angle, and patient-specific variables such as T-value have an impact on the periprosthetic bone remodeling. In particular, this applies to Gruen zone 1.