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Bone remodeling in proximal HA-coated versus uncoated cementless SL-Plus® femoral components: a 5-year follow-up study

  • Orthopaedic Outcome Assessment
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background and purpose

Bone resorption at the femoral stem due to stress shielding has been particularly observed secondary to cementless hip replacement. This prospective study of 126 total-hip replacements was performed to examine clinical outcomes and changes in peri-prosthetic bone density after implantation of a double-tapered cementless femoral component manufactured with versus without hydroxyapatite (HA) coating.

Methods

Sixty-seven femoral components with and 59 femoral components without proximal HA coating were implanted and examined after a mean follow-up of 5.8 (SD 1.1, 2.8–7.8) years. The Harris hip score (HHS) and plain radiographs were used for clinical and radiological follow-up evaluations. Possible changes in peri-prosthetic bone mineral density (BMD) were measured by dual-energy X-ray absorptiometry (DEXA).

Results

Clinical outcome, measured by HHS, was similar in both groups. On plain radiographs, significantly less radiolucent lines were observed for the coated implants. DEXA revealed a significant increase in BMD at the proximal zones, along the medial side, and at the stem tips in the coated compared with the non-coated implants.

Interpretation

Hydroxyapatite-coated implants yield favorable radiographic characteristics, but no greater clinical benefit after 5 years’ implantation.

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Acknowledgments

This study was supported by Smith & Nephew Orthopaedics AG.

Conflict of interest statement

We guarantee that there was no financial or other conflict of interest that might have biased our work.

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Authors and Affiliations

  1. Paracelsus Klinik, Lipper Weg 11, 45770, Marl, Germany

    W. Steens

  2. Shoulder and Elbow Surgery, Seefeldstr. 27, 8008, Zurich, Switzerland

    A. G. Schneeberger

  3. Department of Orthopaedics, University of Rostock, Rostock, Germany

    R. Skripitz

  4. Smith and Nephew Orthopaedics AG, 6343, Rotkreuz, Switzerland

    P. Fennema

  5. Auguste-Viktoria-Klinik, 32545, Bad Oeynhausen, Germany

    C. Goetze

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  1. W. Steens
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  2. A. G. Schneeberger
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  4. P. Fennema
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  5. C. Goetze
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Correspondence to W. Steens.

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Steens, W., Schneeberger, A.G., Skripitz, R. et al. Bone remodeling in proximal HA-coated versus uncoated cementless SL-Plus® femoral components: a 5-year follow-up study. Arch Orthop Trauma Surg 130, 921–926 (2010). https://doi.org/10.1007/s00402-009-1040-4

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