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Clinical and radiological outcome of hydroxyapatite-coated femoral stem in revision hip arthroplasty

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Abstract

We used a proximally hydroxyapatite-coated femoral stem in revision arthroplasty of 48 cases with aseptic loosening and Paprosky defect class 1 or 2. We reviewed the outcome after 6.1 (4–9.3) years. The clinical outcome was good, with a mean postoperative HHS of 90 (51–100) points. There were five reoperations all on the acetabular side and none for the femoral stem. At follow-up, we observed cancellous sclerosis radiographically in 19 cases—especially in non-tightly fitted stems and mainly in Gruen zones 2 and 6. In 13 cases, cortical thickening was seen, mainly in Gruen zones 3 and 5 and especially in tightly fitted stems. These bony changes were significant and not related to any clinical parameter. They started to appear from 6 months onward, with increasing frequency with longer follow-up. We find that the standard Mallory–Head hydroxyapatite-coated femoral stem is suitable for revision in cases with lower-class femoral defects.

Résumé

Nous avons utilisé une tige fémorale enduite d’hydroxyapatite proximale dans l’arthroplastie de révision de 48 cas avec descellement aseptique et défauts osseux de classe 1 ou 2 selon Paprosky. Nous avons examiné le résultat après 6,1 (4–9,3) années. Le résultat clinique était bon avec un score HHS postopératoire moyen de 90 (51–100) points. Il y avait cinq réopérations, toujours pour des problèmes acétabulaires et jamais pour des problèmes de tige fémorale. Àu dernier recul nous avons observé radiologiquement des densifications spongieuses dans 19 cas—surtout pour des tiges imparfaitement ajustées et principalement dans les zones 2 et 6 de Gruen. Dans 13 cas un épaississement cortical a été noté, principalement dans les zones 3 et 5 et surtout pour les prothèses bien ajustées. Ces différences osseuses étaient significatives, sans rapport avec aucun paramètre clinique. Elles ont commencé à paraître à 6 mois avec une fréquence croissante au cours du suivi. Nous trouvons que la tête-Mallory standard–tige fémorale enduite d’hydroxyapatite est convenable pour les révisions avec défauts osseux fémoraux de bas grade.

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Authors and Affiliations

  1. St. Elisabeth Hospital, Hilvarenbeekseweg 60, 5022, GC Tilburg, The Netherlands

    T. Gosens

  2. Rijnland Hospital, Simon Smitweg 1, 2353, GA Leiderdorp, The Netherlands

    E. J. van Langelaan

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  1. T. Gosens
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  2. E. J. van Langelaan
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Correspondence to T. Gosens.

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Gosens, T., van Langelaan, E.J. Clinical and radiological outcome of hydroxyapatite-coated femoral stem in revision hip arthroplasty. International Orthopaedics (SICOT) 29, 219–223 (2005). https://doi.org/10.1007/s00264-005-0659-1

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  • DOI: https://doi.org/10.1007/s00264-005-0659-1

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