Complications With Hydroxyapatite Participate Separation in Total Hip Arthroplasty

Bloebaum, Roy D.; BEEKS, DAVID; Dorr, Lawrence D.; SAVORY, CARLTON G.; DUPONT, JOSEPH A.; Hofmann, Aaron A.

doi:10.1097/00003086-199401000-00005

Cited by 233 publications

(193 citation statements)

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“…The higher variation of femoral head penetration in the HA group as opposed to the Ti group (SD 0.26 mm/year and 0.14 mm/year, respectively) supports the concerns expressed in other studies with individual cases of high PE wear with HA-coated cups leading to implant failure [7,8,11,21,29,42]. The cases of high PE wear in our study could be related to HA particles separating from the coating leading to increased backside wear and articulate wear on the PE, a mechanism described by Bauer, Morscher et al, and Rokkum et al [4,33,43].…”

Section: Discussionsupporting

confidence: 77%

“…However, theories of coating degradation resulting in particulate HA-induced third-body wear [5,8,33] have long been discussed. This study was initiated to evaluate the potential disadvantages of HA-coated implants for THA including (1) survival, (2) increased wear, and (3) increased osteolysis.…”

Section: Discussionmentioning

confidence: 99%

“…The cases of high PE wear in our study could be related to HA particles separating from the coating leading to increased backside wear and articulate wear on the PE, a mechanism described by Bauer, Morscher et al, and Rokkum et al [4,33,43]. Disintegration of the HA coating is influenced by numerous factors, including the purity of HA, manufacturing, crystallinity, porosity, method of coating, the thickness of the HA coating, the surface on which HA is deposited (smooth or rough), the adhesive strength of HA to the substrate [33], and the speed of resorption [8,35,45]. Calcium phosphate coatings have been applied plasma-sprayed with different quality and coating thicknesses ranging from 300 lm [33,43], over 150 lm [42], to 40 lm [41].…”

Section: Discussionmentioning

confidence: 99%

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Inferior Survival of Hydroxyapatite versus Titanium-coated Cups at 15 Years

Stilling

Rahbek²,

Søballe³

2009

Clinical Orthopaedics &Amp; Related Research

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Hydroxyapatite (HA) particles have long been suspected to disintegrate from implant surfaces, become entrapped in joint spaces of orthopaedic bearing couples, and start a cascade leading to progressive polyethylene (PE) wear, increased osteolysis, and aseptic loosening. We compared cup revision at 15 years' followup in a randomized group of patients with 26 cementless THA components with titanium (Ti) versus first-generation HA coating. We also assessed radiographic PE wear and osteolysis to the 12-year followup or end point revision at a minimum of 5 years (mean, 10.9 years; range, 5-12.6 years). Two Ti-coated cups (17%) and eight HA-coated cups (57%) were revised at 15 years' followup. Femoral head penetration rate was 0.46 mm/year (standard deviation, 0.26) with the HAcoated cups (n = 12) and 0.38 mm/year (standard deviation, 0.14) with the Ti-coated cups (n = 10); we observed a wide variance of linear wear with the HA-coated cups. We also observed a positive association between high wear rate and revision, and between a high volume of osteolysis and revision. Our findings suggest inferior survival of mediumthickness spray-dried HA-coated cups with individual cases of excessive PE wear and premature cup failure. These findings apply to first-generation modular cups and may not apply to other cup designs and new HA-coating technologies.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Inferior Survival of Hydroxyapatite versus Titanium-coated Cups at 15 Years

Stilling

Rahbek²,

Søballe³

2009

Clinical Orthopaedics &Amp; Related Research

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“…However, unsatisfactory bonding strength of the HA layer with respect to Ti substrate, particularly in the case of plasma-sprayed thick coatings, has led to biological concerns, such as HA particulate debris and inflammation reaction [5,6].…”

Section: Introductionmentioning

confidence: 99%

Initial responses of human osteoblasts to sol–gel modified titanium with hydroxyapatite and titania composition

et al. 2006

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“…However, recently, some concerns have been raised about the safety and clinical prognosis of plasma-spray Ca-P coated oral implants (Wheeler 1996). Failures have been reported, which mainly have to do with the deg radation and fatigue behavior of these coatings (Frayssinet et al 1995;Bloebaum & Dupont 1993;Bloebaum et al 1994). This can hamper the further use of Ca-P implants.…”

mentioning

confidence: 99%

Initial interfacial healing events around calcium phosphate (Ca‐P) coated oral implants

Hulshoff

Jansen

1997

Clinical Oral Implants Res

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The bone response to different calcium phosphate (Ca‐P) coated and non‐coated titanium implants was evaluated in a goat animal model. Two types of Ca‐P coatings have been investigated: an experimental plasma‐spray bi‐layered Ca‐P coating (FA‐HA) and an amorphous RF magnetron sputter coating (Ca‐P‐a). Fifty‐four conical screw shaped implants were inserted in the lateral and medial femoral condyles of 18 Saanen goats. After implantation periods of 3, 12 and 24 days, the bone‐implant interface was evaluated histologically and histomorphometrically. Light microscopical evaluation revealed that bone formation on the Ca‐P coated implants proceeded faster. At 24 days higher percentages of bone contact were measured for both Ca‐P coated implants than for non‐coated implants. However, this difference was only significant for the FA‐HA coated implants. On basis of these findings. we concluded that Ca‐P coatings show improved bone response due to an initial difference in bone cell response.

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Complications With Hydroxyapatite Participate Separation in Total Hip Arthroplasty

Cited by 233 publications

References 0 publications

Inferior Survival of Hydroxyapatite versus Titanium-coated Cups at 15 Years

Inferior Survival of Hydroxyapatite versus Titanium-coated Cups at 15 Years

Initial responses of human osteoblasts to sol–gel modified titanium with hydroxyapatite and titania composition

Initial interfacial healing events around calcium phosphate (Ca‐P) coated oral implants

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