Changes in tibial bone mass after primary cementless and revision cementless total hip arthroplasty in canine models

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Abstract
The purpose of this study was to examine right—left differences in tibial bone mass after unilateral (left) cementless total hip arthroplasty (THA). Of 39 dogs with THAs, 9 had primary cementless porous‐coated femoral stems for 6 months and 15 had similar stems for 2 years. Five dogs had aseptically failed cemented hips, and 10 had aseptically failed cemented hips that were revised with cementless porous‐coated femoral stems (5 without bone graft and 5 with autogenous bone graft). These animals were sacrificed 6 months after the revision surgery. The primary cementless dogs showed no right‐left difference in tibial bone mineral content (BMC) or cortical bone cross‐sectional geometry after 6 months, but after 2 years there was a distal right‐left difference in BMC of 6% caused by expansion of the medullary canal in the tibia of the operated limb. Tibial BMC was more than 20% lower in the operated limb of the failed cemented dogs, approximately 15% lower in the nongrafted group, and 7% lower in the grafted group. The right‐left tibial difference in BMC in the 2‐year primary cementless group is most probably because of subclinical disuse of the operated limb. Among the dogs with failed cemented stems, the lower right‐left difference in the two revised groups compared with the nonrevised group suggests that improved limb function after cementless revision THA may cause gain of previously lost bone.

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