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.
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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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DOI: https://doi.org/10.1007/s00402-009-1040-4