Dual X-ray absorptiometry for the evaluation of bone density from the proximal femur after total hip arthroplasty: Analysis protocols and reproducibility

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Abstract
Summary Dual X-ray absorptiometry (DXA) instruments are now able to evaluate bone mineral density (BMD) of bone surrounding metal implants. The assessment of BMD around prosthetic components could provide additional information for the follow-up of total hip arthroplasty (THA). In this study, we evaluated the potential application of DXA in the field of THA. BMD was measured in the proximal femur of both THA and THA-free sides in 14 postmenopausal women 6–18 months after THA. The explored segment was divided into seven zones as proposed by Gruen et al. [18]. The precision error of BMD measurements ranged from 1.8 to 6.8% on the THA side and from 1.1 to 2% to the THA-free side. The reduction of BMD of the THA versus the THA-free side was significant in all seven zones (P < 0.01, t-test for paired data). These results showed significant differences in BMD around femoral components of THA with respect to contralateral healthy side, and demonstrate the sensitivity of DXA for detecting these changes.