Hydroxyapatite-coated Femoral Components

Capello, William N.; DʼAntonio, James A.; Jaffe, William L.; Geesink, R. G. T.; Manley, Michael; Feinberg, Judy R.

doi:10.1097/01.blo.0000246534.44629.b2

Cited by 86 publications

(42 citation statements)

References 32 publications

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“…Second, we lacked an age-matched control group who underwent THA with uncemented stems of conventional length. However, a number of historical reports indicate such stems can be successfully implanted in older patients [9,10,25,32]. Third, radiographic analysis is inferior to roentgen stereophotogrammetric and dual-energy xray analysis in determining bone mass, remodeling, and component migration [11,23].…”

Section: Discussionmentioning

confidence: 99%

“…Stems of various designs provide stable initial and longterm fixation in patients who undergo THA [3,4,7,9,20,32,33,38]. Metaphyseal-engaging short stems provide theoretical benefits compared to conventional uncemented stems, including avoiding proximal-distal mismatch, decreasing proximal stress shielding, and limiting perioperative periprosthetic fractures.…”

Section: Discussionmentioning

confidence: 99%

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Stable Fixation of Short-stem Femoral Implants in Patients 70 Years and Older

Patel

Smith

Woodward

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Limitations of conventional uncemented femoral stems persist, including proximal-distal mismatch, nonideal load transfer, loss of bone, and difficulties with minimally invasive surgery. Metaphyseal-engaging shortstem implants have been designed to address these issues in THA. While these devices have been studied in younger patients, it is unclear whether they offer advantages in older patients. Questions/purposes We asked whether the stability and bony ingrowth of an off-the-shelf short stem in patients 70 years and older were similar to those achieved in patients younger than 70 years at 2-year followup. Furthermore, we asked whether pain and function scores were affected by age, bone quality, or varus alignment. Patients and Methods We retrospectively reviewed 60 patients (65 hips) 70 years and older (mean, 75 years; range, 70-86 years) treated with an uncemented short stem (range, 90-105 mm). We compared radiographic alignment, stability, and bony ingrowth, as well as Harris hip scores and WOMAC pain scores, to a cohort of 89 patients (91 hips) younger than 70 years. Minimum followup was 24 months (mean, 35 months; range, 24-60 months). Results Radiographs showed proximal bony ingrowth and stable fixation of all implants. Average Harris hip score at last followup was 88 (range, 70-100) for the 70 years and older cohort and 93 (range, 70-100) for younger than 70 years cohort; no patients reported thigh pain. Postoperative WOMAC scores averaged 6 (range, 0-43) and 5 (range, 0-25), respectively.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Stable Fixation of Short-stem Femoral Implants in Patients 70 Years and Older

Patel

Smith

Woodward

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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“…Conventional cementless femoral stems are known to provide a high rate of satisfactory clinical and radiographic performance at long-term followups [1,7,12,14,15,18,33]. However, they may have potential clinical consequences related to stress shielding, thigh pain, periprosthetic fractures, proximodistal dimensional mismatch, and removal during revision [9, 11, 16, 17, 19, 21-23, 35, 38].…”

Section: Introductionmentioning

confidence: 99%

Ultrashort versus Conventional Anatomic Cementless Femoral Stems in the Same Patients Younger Than 55 Years

Kim

Park

Kim

2016

Clinical Orthopaedics &Amp; Related Research

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Background Because the clinical and radiographic performance of an ultrashort anatomic cementless stem has been investigated in only two randomized controlled studies, well-designed trials should aim for a thorough comparison of the outcomes of ultrashort anatomic cementless and conventional anatomic cementless stems. Questions/purposes The purposes of this study were to compare (1) the clinical results, including Harris hip score, thigh pain, and WOMAC index score, (2) radiographic results, (3) bone mineral density; and (4) proportions of patients undergoing revision of a THA using an ultrashort anatomic cementless stem versus a conventional anatomic cementless stem in the same patients who underwent bilateral sequential THAs under the same anesthetic. Methods Two hundred patients (mean age, 53 years; range, 26-54 years) who underwent bilateral sequential THAs received an ultrashort anatomic cementless stem in one hip and a conventional anatomic cementless stem in the contralateral hip. From January 2004 to December 2005, we performed 524 same-day bilateral short and conventional anatomic cementless THAs in 262 patients, of whom 212 (81%) participated in this study. Five patients were lost to followup before 2 years, five were lost between 2 to 10 years, and two were lost between 10 to 13 years, leaving 200 patients. Patients who had end-stage bilateral hip disease and were younger than 55 years were selected for inclusion. The predominant diagnoses were osteonecrosis (118 patients, 59%) and osteoarthritis (44 patients, 22%). One hundred thirty-eight were men and 62 were women. At the time of each followup, the patients were assessed clinically and radiographically. In addition, each patient completed the WOMAC and the University of California Los Angeles (UCLA) activity scores. The minimum followup was 10 years (mean, 11.8 years; range, 10-13 years). Followups were done in person, with all images and followup clinic notes. Based on the power analysis, we estimated a sample size of 178 hips was needed in each group to detect a 3-point difference in the Harris hip score with 80% power. Results At the latest followup, there were no differences between the two groups regarding the mean Harris hip scores (94 versus 94 points; p = 0.189), mean WOMAC scores (17 versus 16 points; p = 0.191), or mean UCLA activity scores (9 versus 9 points; p = 0.381). Two patients in the ultrashort stem group and one patient in the conventional stem group had severe (9 points) thigh pain, and

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“…4,6,20,21 However, the results of clinical studies are divided, and some have reported that HA-coated femoral components had equal or better clinical results than uncoated femoral components in mid-and long-term follow-up periods. [22][23][24] Conversely, Goosen et al, after reviewing eight randomized controlled studies, concluded that HA coating had no positive effect when clinically and radiologically compared with porous surfaces. 7 In a metaanalysis, Gandhi et al also show that there are no clinical benefits in the use of HA/porous coating over porous coating alone in primary hip arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

Effects of NSAIDs and hydroxyapatite coating on osseointegration

Salduz

Dikici

Kılıçoğlu

et al. 2017

J Orthop Surg (Hong Kong)

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Purpose: The aim of our study is to investigate the bone ongrowth of two different alternative surfaces and the effect of nonsteroidal anti-inflammatory drugs (NSAIDs) on osseointegration. Methods: Hips of 40 New Zealand white rabbits were operated bilaterally. Hydroxyapatite (HA)-coated titanium rods were implanted into the right femur, and gritblasted titanium rods were implanted into the left femur. They were divided into three groups. At the end of 8 weeks, both femora of the rabbits were removed and investigated biomechanically and histologically. Results: HA-coated implants had a significantly better failure load and ''percentage of bone-implant contact'' than grit-blasted implants. There was no significant difference between the medication groups as a result of the biomechanical and histologic investigations. Conclusions: Our results indicate that NSAIDs did not have any negative effect on the osseointegration. HA-coated implants may provide more tensile strength and greater bone-implant contact rate in comparison with gritblasted implants.

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Hydroxyapatite-coated Femoral Components

Cited by 86 publications

References 32 publications

Stable Fixation of Short-stem Femoral Implants in Patients 70 Years and Older

Stable Fixation of Short-stem Femoral Implants in Patients 70 Years and Older

Ultrashort versus Conventional Anatomic Cementless Femoral Stems in the Same Patients Younger Than 55 Years

Effects of NSAIDs and hydroxyapatite coating on osseointegration

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