uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Effects of different weight bearing regimes on stability of press fit cups: A randomized study with 5 years of follow-up using radiostereometry
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
Show others and affiliations
(English)Article in journal (Refereed) Submitted
Abstract [en]

There is little evidence supporting immediate weight bearing after uncemented THA. Thirty-seven patients with unilateral osteoarthritis of the hip received a press fit cup. They were randomized to immediate full weight bearing or partial weight bearing for 3 months. At 5 years we found no difference in micromotion as assessed with radiostereometry. Numerically there was more proximal translation and increased inclination with immediate weight bearing, but these values barely exceeded the precision limit for the method. Pooled data for the two groups revealed translations of 0.1-0.3 mm and rotations of 0.2-0.3° over the 5 year follow-up period. To conclude, we found no adverse effects of immediate weight bearing after THA on stability of these press fit cups. Early mobilization might have other advantages.

National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-131035OAI: oai:DiVA.org:uu-131035DiVA: diva2:352483
Available from: 2010-09-21 Created: 2010-09-21 Last updated: 2013-08-16Bibliographically approved
In thesis
1. Osteoarthritis of the Hip and Uncemented Total Hip Arthroplasty: Effects of Immediate Weight Bearing on Implant Stability, Bone Mineral Density, and Body Composition
Open this publication in new window or tab >>Osteoarthritis of the Hip and Uncemented Total Hip Arthroplasty: Effects of Immediate Weight Bearing on Implant Stability, Bone Mineral Density, and Body Composition
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The initial recommendation for the postoperative regime after uncemented total hip arthroplasty (THA) was 6-12 weeks of partial weight bearing (PWB) to obtain a stable implant position during bone ingrowth. In recent years patients with uncemented THA have increasingly practiced full weight bearing (FWB) after surgery, which has largely been based on clinical experience rather than on scientific evidence. The aim of this thesis was to investigate the effects of FWB versus PWB for 3 months on the stability of the implants and on bone mineral density (BMD), as well as body composition (BC) of the lower extremities.

We used radiostereometric analysis (RSA) to measure implant micromotion and dual X-ray absorptiometry (DXA) to measure BMD and BC. Forty-six patients with strictly unilateral osteoarthritis of the hip (OAH) received uncemented THA. These patients were then randomized to the FWB or PWB groups and followed for 5 years.

In a preoperative cross-sectional study the BMD of the hip and heel were compared between the OAH-affected side and the healthy side. The study showed an increase of BMD at the femoral neck and a decrease at the total hip and trochanter. The results of a RSA study of cup stability showed that there might be minimal movement in medial and proximal directions during the first postoperative week. These results indicate that the RSA baseline investigation of uncemented cups should be performed as early as possible after the first postoperative day. FWB had no adverse effects on the stability of the uncemented press-fit cups or the uncemented cementless Spotorno (CLS) femoral stems after a 5-year follow-up. There was no difference in periprosthetic BMD around the CLS stem regardless of the postoperative weight bearing regime. All zones around the femoral stem indicated a recovery in BMD toward baselines, except the calcar region, which showed progressive loss in BMD to -22% at 5 years post-surgery. FWB had no effect on the changes in BC after surgery.

In conclusion, FWB is safe in uncemented THA in terms of stability, BMD and BC. Furthermore, THA apparently counteracts age-related changes in BC but not in BMD.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2010. 72 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 600
Osteoarthritis of the hip, uncemented, total hip arthroplasty, stability, RSA, BMD, DXA, body composition, weight bearing
National Category
Research subject
urn:nbn:se:uu:diva-131092 (URN)978-91-554-7899-5 (ISBN)
Public defence
2010-11-05, Grönwallsalen, Akademiska sjukhuset, ingång 70, Uppsala, 09:15 (Swedish)
Available from: 2010-10-15 Created: 2010-09-22 Last updated: 2013-08-16Bibliographically approved

Open Access in DiVA

No full text

By organisation
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Total: 173 hits
ReferencesLink to record
Permanent link

Direct link