Abstract
Introduction
The following study start from an idea of the evaluation of the osteointegration in the bone cage of the Equinoxe Reverse shoulder prosthesis.
The aim of the study is to assess the values of Bone Mineral Density (BMD) in periprosthetic areas, in patients undergoing shoulder arthroplasty with implants of the Equinoxe system by Excatech, Inc.
To better understand the steps of osteointegration time of the bone cage with the glenoid
The objectives of the work are not only expanded to the value of osteointegration, but could also be useful for the evaluation of both mechanical and septic loosening of the stem of the glenoid.
Materials and Methods
In the period from November 2011 to May 2012, 15 patients were evaluated.
All patients were subjected to bone densitometry type of DXA within the first 15 days after surgery and at 3 months after surgery.
The patients are all part of a homogeneous group for anatomical glenoid
Were excluded from the study all patients who were no significant alterations of the head and the glenoid.
The acquisitions were performed with the patient in an oblique position, with limb in a neutral position, in order to obtain images in the coronal plane “true” of the joint.
Were subsequently calculated values of BMD is around the stem with the 7 areas used by Gruen for the hip prosthesis and peripherally to the central peg using 3 areas, superiorly, medially and inferiorly to the same.
Results
The values obtained showed a significant increase in the time of bone density peripherally to the central peg demonstrating a significant osteointegration.
Being a prospective study these values will be integrated with new acquisition DXA to 6, 9, 12 months, 2, 3 and 5 years.
Conclusions
Although preliminary, through our study it was possible to obtain the standard values of BMD in patients with prosthetic replacement has been successful.
These BMD values represent a standard of reference for the physiological osseointegration; in the future must be evaluated for their variation in patients with prosthetic loosening and / or with infectious processes, in order to allow an early diagnosis of these diseases by studying DXA.
Also in future studies BMD values obtained by us of the Equinoxe prosthesis can be compared with those obtained in other models of the shoulder prosthesis to detect any advantages or disadvantages in terms of osteointegration
