• Takuma Maeda, Yuichi Kuroda, Tomoyuki Kamenaga, Tomoyuki Matsumoto, Ryosuke Kuroda, and Shinya Hayashi.
• Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
• Arch Orthop Trauma Surg. 2024 Dec 21; 145 (1): 7474.

IntroductionThigh pain, aseptic loosening, and failure after total hip arthroplasty has been reported. Therefore, this study examines the impact of femoral stem alignment on periprosthetic bone mineral density (BMD) in THA using the Avenir Complete cementless stem, focusing on the role of precise stem alignment in maintaining proximal femoral BMD.Materials And MethodsConsecutive patients who received the Avenir Complete stem via mini anterolateral approach in the supine position between March 2019 and March 2022 were included. Dual-energy X-ray absorptiometry was used to assess BMD changes, and computed tomography scans were used to evaluate stem alignment.ResultsBMD was maintained in the distal femur, but showed a slight decrease in the proximal femur. A negative correlation was observed among varus malalignment, anteversion errors, and changes in BMD in the proximal femur.ConclusionsThe findings underscore the importance of accurate stem positioning in THA, particularly in avoiding varus malalignment and anteversion errors, as misalignment can adversely affect proximal femoral BMD and potentially lead to early stem loosening. This study enhances the understanding of the influence of the Avenir Complete stem on postoperative BMD, highlighting the need for precise alignment to optimize outcomes.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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