Please use this identifier to cite or link to this item: http://hdl.handle.net/1946/17352
Total hip replacement is one of the most successful practiced orthopaedic treatments, restoring hip function and relieving patients of pain. During the surgery the femoral head and the bearing surface of the acetabulum are removed and replaced with a prosthetic stem and a socket respectively. There are two types of total hip replacement; one uses bone cement to fix the components (cemented) and one uses a press-fitting technique without cement (cementless).
Cementless stems are preferred for two reasons. First, they induce bone growth and make permanent bond with bone. Second, when the stems ultimately fail, the cementless stems are far easier to remove and the success of revisions is better. However, not everyone can handle the cementless procedure. Amongst the important criteria to choose the implant type are age and gender. Today there are no quantitative pre-operative procedures to choose the correct implants for patients.
Thirty-nine total hip replacement patients were enrolled in this study which introduces a novel procedure relying on computer tomography image aquisition to measure bone mineral density of patients and create finite element models used to calculate a fracture risk index. The goal is to answer the question whether the femur can handle the press-fitting surgery.
The results indicate that although the bone mineral density tends to decrease with age, there are some patients that deviate from this trend; they have to be identified and the correct implant selected for them. The fracture risk index results indicate that fracture risk is not dependent on bone mineral density, age or type of implant. However, bone mineral density measurements are able to indicate bone quality of patients.
Although the fracture risk index does not reflect real risk of failure, the results indicate that all patients are different. The bone mineral density measurements demonstrate bone quality beyond age and gender.
|Bone Mineral Density and Fracture Risk Assessment for Patients Undergoing Total Hip Replacement - lokaútgáfa.pdf||2.41 MB||Open||Complete Text||View/Open|