Femoral cortical remodeling after uncemented total hip arthroplasty. A prospective radiologic study of 26 hips followed for 2 to 4 years.

Abstract

Twenty-six consecutive, hydroxyapatite-coated Bi-Metric femoral stem prostheses (Biomet, Warsaw, IN) were studied in 20 patients. The follow-up period averaged 37 months (range, 24-48 months). Clinical rating (Harris score) was determined and radiography were taken at regular intervals. Digital imaging and computer-assisted videodensitometry were used to quantify the cortical remodeling. The anteroposterior radiographs of the femur were scanned and digitized, and the pictures were analyzed by a digital image processing software program. The periosteal diameter, the cortices of the femur, and the total endosteal diameter in five regions were determined. The mean preoperative Harris score was 50 and improved to 97 at the latest follow-up evaluation. After surgery, there was hypertrophy of the periprosthetic cortical bone and an increase in the periosteal diameter. The medullary canal of the operated femur did not change.