• Shinya Hayashi, Yuichi Kuroda, Naoki Nakano, Tomoyuki Matsumoto, Tomoyuki Kamenaga, Masanori Tsubosaka, Shotaro Tachibana, and Ryosuke Kuroda.
• Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan. shayashi@med.kobe-u.ac.jp.
• Arch Orthop Trauma Surg. 2024 Jun 1; 144 (6): 288128872881-2887.

IntroductionBone maintenance after total hip arthroplasty (THA) is important for implant success. This study aimed to investigate the relationship between patient characteristics and periprosthetic bone maintenance after THA for better implant selection.Materials And MethodsThis retrospective cohort study enrolled 112 consecutive patients who underwent THA using full hydroxyapatite (HA) compaction with short (n = 55) or short-tapered wedge (n = 61) stems. Periprosthetic bone mineral density (BMD) was compared between the two groups after propensity score matching, and the relationship between periprosthetic BMD changes and patient background was analyzed.ResultsBoth groups showed similar periprosthetic BMD changes after adjusting for patient background using propensity score matching. Canal flare index > 3.7 in patients that underwent THA using tapered-wedge stem (odds ratio (OR), 3.2; 95% confidence interval (CI), 1.3-7.9, p = 0.013) and baseline zone 1 BMD > 0.65 in patients that received with short HA compaction stems (OR, 430.0; 95% CI 1.3-1420, p = 0.040) were associated with proximal periprosthetic bone maintenance after THA.ConclusionConsidering their predictive value, canal flare index and zone 1 BMD assessment might be useful strategies for implant selection during THA.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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