Omnifit-HA Stem in Total Hip Arthroplasty

Dd, D'Lima; Rh, Walker; Cw, Colwell

doi:10.1097/00003086-199906000-00021

Cited by 18 publications

(17 citation statements)

References 18 publications

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“…Since the introduction of ceramics for the replacement of bone, 21 26 Many authors have reported that metal implants coated with HA achieve rapid surface bone apposition with good stability [16][17][18] and HA has been packed into massive bone defects in revised total hip arthroplasties by Oonishi et al 27 There have been few reports in the English literature on the clinical application of HA in surgery for bone tumours. In our series, HA was well incorporated into the surrounding host bone in all cases within a mean period of 4.2 months.…”

Section: Discussionmentioning

confidence: 99%

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Use of hydroxyapatite to fill cavities after excision of benign bone tumours

Yamamoto

Onga

Marui

et al. 2000

The Journal of Bone and Joint Surgery. British volume

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Much of the basic research on calcium hydroxyapatite (HA) has concerned its clinical use as a bone-graft substitute. Biological, 1,2 histological 3-12 and biomechanical surveys of its implantation into bone [13][14][15] reveal that the material is safe and has excellent osteoconductive properties. It is often used as a coating for prostheses as well as to fill bone defects. [16][17][18] There have, however, been few reports on the outcome of its clinical use in surgery for bone tumours. 19,20 Since 1988, we have implanted HA for bone defects after resection of benign bone tumours. Patients and MethodsWe analysed the outcome in 75 patients with benign bone tumours. There were 28 women and 47 men, with a mean age of 27.7 years (3 to 80). All the lesions were imaged by plain radiography, CT and MRI. All patients had curettage of the tumour and filling of the resulting bone defect with HA, without autologous bone. Cortical fenestration was carried out using an osteotome and the intraosseous tumours were removed by a curette. When sclerotic margins were present they were drilled to establish a connection to healthy bone marrow. After filling the bone defect with HA, the cortical window was replaced. No other adjuvant treatment such as phenol or cryotherapy was used after curettage. Internal fixation was not employed. External stabilisation with splints or slings was utilised postoperatively for patients judged to be at risk of pathological fracture. The tumours were located in the femur (26 patients), phalanx or metacarpal (18), tibia (11), humerus (9), calcaneus (4), pelvis (3), radius or ulna (3) and fibula (1). Histological examination revealed that 21 were enchondromas, 18 fibrous dysplasias, 12 non-ossifying fibromas, eight solitary bone cysts, six Langerhans-cell histiocytomas, three chondroblastomas, two giant-cell tumours of bone, one aneurysmal bone cyst, one intraosseous haemangioma, one osteofibrous dysplasia, one osteoid osteoma and one enostosis (bone island).We used an HA compound ([Ca 10 (PO 4 ) 6 (OH) 2 ]) with tricalcium phosphate (TCP) in a ratio of 70% HA to 30% TCP (Chugai Inc, Tokyo, Japan). The porosity was 3% to 55% and the pore size 1 to 15 m. The sintering temperature ranged from 900° to 1300°C, and the bending strength from 50 to 800 kg/cm 2 . Variously shaped pieces of HA were used in the operations, depending on the location and size of the tumour. The mass of implanted HA ranged from 3 to 55 g. After surgery radiographs were assessed according to the criteria of Uchida et al 19 to determine changes in the radiolucent zone around the HA and the amount of incorporation and displacement of HA. Postoperative CT was carried out on some patients. The mean follow-up was 41 months (5 to 140). Of the 30 patients with lesions of the upper limb, 24 were immobilised in a sling or a splint. All 18 patients with lesions in the phalanges and metacarpals had splints. The mean period of immobilisation was 3.5 weeks. Of the 42 patients with lesions in the lower limb, six were immobilised in splints. The me...

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Section: Discussionmentioning

confidence: 99%

“…It is often used as a coating for prostheses as well as to fill bone defects. [16][17][18] There have, however, been few reports on the outcome of its clinical use in surgery for bone tumours. 19,20 Since 1988, we have implanted HA for bone defects after resection of benign bone tumours.…”

mentioning

confidence: 99%

Use of hydroxyapatite to fill cavities after excision of benign bone tumours

Yamamoto

Onga

Marui

et al. 2000

The Journal of Bone and Joint Surgery. British volume

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“…Both of these studies were on the "porous pressfit" cup design and with mean annual wear rates of 0.19 and 0.15 mm, respectively, i.e., of about the same size as in our study on a non-porous pressfit, but HA-coated design. In the study by DʼLima et al (1999) the time of observation was only 3 years, but in the study by Hsieh et al (2002) the observation period was 10 years. In the latter report, 7 of 173 acetabular components were revised.…”

Section: Wear Ratesmentioning

confidence: 95%

“…Only two studies on the wear rate have been presented for the Omnifit prosthesis (DʼLima et al 1999, Hsieh et al 2002. Both of these studies were on the "porous pressfit" cup design and with mean annual wear rates of 0.19 and 0.15 mm, respectively, i.e., of about the same size as in our study on a non-porous pressfit, but HA-coated design.…”

Section: Wear Ratesmentioning

confidence: 99%

Catastrophic failure of an uncemented acetabular component due to high wear and osteolysisAn analysis of 154 Omnifit prostheses with mean 6-year follow-up

Schewelov

Sanzén

Önsten

et al. 2004

Acta Orthopaedica Scandinavica

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“…Hydroxyapatite (HA) coating is commonly used for fixation of uncemented femoral components, and several studies have shown satisfactory results [5,7,9,12,17,21,22]. However, it has been suggested that HA particles detached from the stem surface may enhance osteolysis either by stimulating bone loss or by migration to the joint space producing third-body wear [2,4].…”

Section: Introductionmentioning

confidence: 99%

Comparison of wear and osteolysis in hip replacement using two different coatings of the femoral stem

Sánchez-Sotelo

Lewallen

Harmsen

et al. 2004

International Orthopaedics (SICOT)

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We compared the clinical and radiographic results of two matched series of total hip arthroplasties, one with hydroxyapatite-coated femoral stems, the other with a similar but porous-coated femoral stem. The prevalence of radiographic osteolysis was 16% in hips with hydroxyapatite-coated stems and 43% in hips with porous-coated femoral stems. In hips with hydroxyapatitecoated stems, osteolysis was always limited to Gruen zones 1 and 7. In contrast, distal osteolysis was present around 26% of the porous-coated stems. At 7 years, the survival-free rate of distal osteolysis was 100% in hips with hydroxyapatite-coated stems but 90% in hips with porous-coated stems (p=0.04). Circumferential hydroxyapatite coating of the femoral component reduced the occurrence of osteolysis and eliminated distal osteolysis at 5-10 years of follow-up. In addition, hydroxyapatite coating did not alter the wear rate.

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Omnifit-HA Stem in Total Hip Arthroplasty

Cited by 18 publications

References 18 publications

Use of hydroxyapatite to fill cavities after excision of benign bone tumours

Use of hydroxyapatite to fill cavities after excision of benign bone tumours

Catastrophic failure of an uncemented acetabular component due to high wear and osteolysisAn analysis of 154 Omnifit prostheses with mean 6-year follow-up

Comparison of wear and osteolysis in hip replacement using two different coatings of the femoral stem

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