Alterations in bone remodeling in the femur after medullary reaming and cemented hip arthroplasty in dogs

Abstract Objective To determine whether medullary reaming alone, or followed by cemented hemiarthroplasty, influenced porosity, vascularity, and new bone formation in the proximal portion of the femur in dogs. Animals 12 adult mixed-breed dogs. Procedure Unilateral femoral head and neck excisions were performed, followed by femoral medullary reaming in 6 dogs and femoral medullary reaming and cemented hemiarthroplasty in 6 dogs; the contralateral femur was used as a control. All dogs were euthanatized 28 days after surgery, and femurs were harvested. Vascularity, porosity, and new bone formation were quantified for all femurs of dogs from both groups at 3 proximal-to-distal levels, 3 regions (periosteal, midcortical, and endosteal), and 4 quadrants (cranial, caudal, medial, and lateral) of the femur. Results Medullary reamed and cemented hemiarthroplasty femurs had significant increases in vascularity and porosity at all levels and in new bone formation at levels 2 and 3. Porosity was increased significantly in the periosteal region of the cemented hemiarthroplasty (9.7 ± 0.7%), compared with control (2.3 ± 0.2%) and medullary reamed (8.4 ± 0.7%) femurs. Porosity was increased in the caudal and medial quadrants in the medullary reamed and cemented hemiarthroplasty femurs; vascularity results were similar. Conclusion Increased porosity, vascularity, and new bone formation in reamed and cemented hemiarthroplasty-treated femurs supports the theory that surgical trauma associated with medullary reaming is an important factor in early cortical bone loss after hip arthroplasty. Clinical Relevance Femoral remodeling associated with reaming and broaching is appreciable but may be only a temporary response, whereas other factors may be responsible for chronic cortical bone loss. (Am J Vet Res 1999;60:922–928)