Clinical and Radiologic Outcomes of a Fully Hydroxyapatite-Coated Femoral Revision Stem: Excessive Stress Shielding Incidence and its Consequences

Cemented versus uncemented total hip arthroplasty for failed proximal femoral nail anti-rotation fixation in patients with intertrochanteric femur fractures: 5-year results of a retrospective observational study

“…Our findings are comparable to those of prior reports with at least a 2-year follow-up [7,26]. Nevertheless, the quantitative comparison is problematic for interpretation since a majority of prior reports included a mixed population of proximal femoral fractures and multi-ethnic, younger patients, and stress shielding of the proximal femur is especially age-dependent [3]. Previous literature has demonstrated that UTHA has a higher rate of orthopaedic complications than CTHA [21,28].…”

“…Therapeutic advances in proximal femoral nail anti-rotation (PFNA) have substantially improved the outcomes for an increasing number of patients with a clinical diagnosis of intertrochanteric femur fractures (IFFs), a subtype of proximal femoral fractures, which was previously associated with poor prognoses [1][2][3]. The number of IFFs treated with PFNA during the past decade has increased dramatically and will substantially increase, not only as a consequence of an ageing population but also owing to its increasing use in young patients [4,5].…”

Biomedical materials and techniques to improve the tribological, mechanical and biomedical properties of orthopedic implants – A review article

“…The need for implants increased dramatically in the past 5 years (the number of revision hip surgery increased by 26% and is predicted to reach 137% in 2030) [1]. This increasing need lead to more focus on developing more durable implants.…”

“…Coating techniques have become promising due to the combination of the superior properties of both metals and bioactive materials. The bioactive coating enhances the implant fixation and results in reduced mechanical failure (for fully HA coated implants the mechanical failure ranges from 1% to 6.9% which is much lower than cement type fixation) [1], prevent further ion-release form the metallic substrate, and prevent formation of fibrous tissue which may result from micro-movements of uncoated implant. Wide range of coating techniques introduced, but till now an optimal technique has not been developed yet [84].…”

“…Formation of new bone layer on HA surface[56];(1,2) Solubility of HA in physiological fluid,(3) equilibrium betweeen the HA phase and physiological fluid, (4) adsorbtion of proteins and other bio-organic compounds,(5,6) Cell adhesion and growth,(7,8) formation of new bone SEM image of cell growth after 11 days of cell-culture on (a) pure Ti, (b) Tri-calcium phosphates[66] …”