Long-term results of a hydroxyapatite-coated femoral component in total hip replacement

Rajaratnam, S; Jack, C.; Tavakkolizadeh, Adel; George, Marc J.; Fletcher, Richard; Hankins, Matthew; Shepperd, J. A. N.

doi:10.1302/0301-620x.90b1.19731

Cited by 90 publications

(61 citation statements)

References 13 publications

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“…No other THA concept has this kind of result on THA stability, not even large head diameter metal-on-metal or ceramic-onceramic THA series. (Tables 1 and 2) If we compare our series to other cementless THA series [8][9][10][11][12][13][14][15][16][17], or cemented THA series [19][20][21][22], our series survival rate was similar. Mean global cementless THA survival rate was less than 80% at 15 years (from 76 to 88%).…”

Section: Dislocation Ratementioning

confidence: 81%

Primary total hip arthroplasty with dual mobility socket to prevent dislocation: a 22-year follow-up of 240 hips

Boyer

Philippot²,

Géringer

et al. 2011

International Orthopaedics (SICOT)

195

134

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Purpose The longest follow-up dual mobility series from inventor Gilles Bousquet focussing on implant survival and the incidence of dislocation. Methods This was a retrospective study from 1985 to 1990, on 240 hips using a PF® modular femoral stem and a dual mobility Novae® tripodal socket (SERF). Results The 22-year follow-up global survival rate was 74%. No dislocation occurred, 41 hips were revised, including ten retentive failures (RF), 12 hips were lost to follow-up, 87 patients (99 hips) died without revision, and 90 hips were still in situ. Conclusion The dual mobility socket global survival rate is comparable to similar series. The 0% dislocation rate demonstrates the success of dual mobility with regard to implant stability. The main issues were cup fixation, which might be improved by the use of macrostructures and HA coating, and osteolytic lesions, caused by polyethylene wear. Traditionally suitable for patients older than 60 years, dual mobility might be extended for use in patients over 50.

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Section: Dislocation Ratementioning

confidence: 81%

Primary total hip arthroplasty with dual mobility socket to prevent dislocation: a 22-year follow-up of 240 hips

Boyer

Philippot²,

Géringer

et al. 2011

International Orthopaedics (SICOT)

195

134

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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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“…Over the past 25 years, this has proved to be an effective technique in hip reconstructive surgery. 2 However, it has proved less successful in preventing revision surgery than PMMA in elderly patients undergoing total hip replacement or in ensuring reliable long-term survival of joint replacements in other anatomical locations such as the knee or ankle. 3,4 One method to potentially improve implant fixation and reduce the rate of revision surgery is through the development of a new generation of coatings with the ability to deliver osteostimulative agents to the bone-implant interface.…”

Section: Introductionmentioning

confidence: 99%

Enhanced Osseous Implant Fixation with Strontium-Substituted Bioactive Glass Coating

Newman

Lotfibakhshaiesh

O’Donnell

et al. 2014

Tissue Engineering Part A

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The use of endosseous implants is firmly established in skeletal reconstructive surgery, with rapid and permanent fixation of prostheses being a highly desirable feature. Implant coatings composed of hydroxyapatite (HA) have become the standard and have been used with some success in prolonging the time to revision surgery, but aseptic loosening remains a significant issue. The development of a new generation of more biologically active coatings is a promising approach for tackling this problem. Bioactive glasses are an ideal candidate material due to the osteostimulative properties of their dissolution products. However, to date, they have not been formulated with stability to devitrification or thermal expansion coefficients (TECs) that are suitable for stable coating onto metal implants while still retaining their bioactive properties. Here, we present a strontium-substituted bioactive glass (SrBG) implant coating which has been designed to encourage peri-implant bone formation and with a TEC similar to that of HA. The coating can be successfully applied to roughened Ti6Al4V and after implantation into the distal femur and proximal tibia of twenty-seven New Zealand White rabbits for 6, 12, or 24 weeks, it produced no adverse tissue reaction. The glass dissolved over a 6 week period, stimulating enhanced peri-implant bone formation compared with matched HA coated implants in the contralateral limb. Furthermore, superior mechanical fixation was evident in the SrBG group after 24 weeks of implantation. We propose that this coating has the potential to enhance implant fixation in a variety of orthopedic reconstructive surgery applications.

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Long-term results of a hydroxyapatite-coated femoral component in total hip replacement

Cited by 90 publications

References 13 publications

Primary total hip arthroplasty with dual mobility socket to prevent dislocation: a 22-year follow-up of 240 hips

Primary total hip arthroplasty with dual mobility socket to prevent dislocation: a 22-year follow-up of 240 hips

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

Enhanced Osseous Implant Fixation with Strontium-Substituted Bioactive Glass Coating

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