Hydroxyapatite-Coated Femoral Stems in Primary Total Hip Arthroplasty: An Updated Meta-Analysis

Kim, William T.; Woodruff, Robert; Kalore, Niraj V.; Vallem, Madan M.; Cyrus, John W.; Krumme, John W.; Patel, Nirav K.; Golladay, Gregory J.

doi:10.1016/j.arth.2023.08.071

Cited by 2 publications

(1 citation statement)

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“…This has been attributed to enhanced osseointegration and stable fixation facilitated by HA coating, emphasizing the importance of the preservation of bone around the stem. [28][29][30] The periprosthetic BMD with the N-HA stem was significantly lower than with the T-HA stem, which has shown excellent long-term clinical outcomes. 8 However, the BMD with the N-HA stem was not as markedly reduced as it is with other designs.…”

Section: Discussionmentioning

confidence: 99%

Contact states with femoral cortical bone and periprosthetic bone mineral density changes differ between traditional and newly introduced fully hydroxyapatite-coated stems

Ohyama,

Minoda,

Masuda

et al. 2024

Bone Joint J

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AimsThe aim of this study was to compare the pattern of initial fixation and changes in periprosthetic bone mineral density (BMD) between patients who underwent total hip arthroplasty (THA) using a traditional fully hydroxyapatite (HA)-coated stem (T-HA group) and those with a newly introduced fully HA-coated stem (N-HA group).MethodsThe study included 36 patients with T-HA stems and 30 with N-HA stems. Dual-energy X-ray absorptiometry was used to measure the change in periprosthetic BMD, one and two years postoperatively. The 3D contact between the stem and femoral cortical bone was evaluated using a density-mapping system, and clinical assessment, including patient-reported outcome measurements, was recorded.ResultsThere were significantly larger contact areas in Gruen zones 3, 5, and 6 in the N-HA group than in the T-HA group. At two years postoperatively, there was a significant decrease in BMD around the proximal-medial femur (zone 6) in the N-HA group and a significant increase in the T-HA group. BMD changes in both groups correlated with BMI or preoperative lumbar BMD rather than with the extent of contact with the femoral cortical bone.ConclusionThe N-HA-coated stem showed a significantly larger contact area, indicating a distal fixation pattern, compared with the traditional fully HA-coated stem. The T-HA-coated stem showed better preservation of periprosthetic BMD, two years postoperatively. Surgeons should consider these patterns of fixation and differences in BMD when selecting fully HA-coated stems for THA, to improve the long-term outcomes.Cite this article: Bone Joint J 2024;106-B(6):548–554.

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Section: Discussionmentioning

confidence: 99%