Randomised trial comparing bone remodelling around two uncemented stems using modified Gruen zones

Rene H. M. ten Broeke*, Roel P. M. Hendrickx, Pieter Leffers, Liesbeth M. C. Jutten, Rudolph G. T. Geesink

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


For assessment of bone remodelling around total hip arthroplasty using dual-emission X-ray absorptiometry (DEXA), a variety of different systems to identify regions of interest (ROI) have been used, making comparisons between stem designs difficult. The Gruen zones are now widely used for this purpose. We present the results of a randomised clinical trial comparing 2 uncemented stem designs with proximal coating, using a modification of the Gruen zones to allow improved representation of the effect of the implant on bone mineral density (BMD) over time. DEXA-data were used in a randomised trial with 2 years follow up, comparing the uncemented Symax (TM) (n=25) and Omnifit (R) (n=24) stems. The effect on BMD was determined using the 'standard' adapted Gruen zones, and a modification which studied an equal length and position for zones 1 and 7 around both stems, assuring that the same regions in terms of cancellous and cortical bone were compared. The 'modified' regions of interest give lower BMD values around the Omnifit (R) than using the 'standard' Gruen zones (3.6 % in zone 7, p
Original languageEnglish
Pages (from-to)41-49
JournalHip International
Issue number1
Publication statusPublished - 2012


  • Total hip arthroplasty
  • DEXA scan
  • Regions of interest

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