The Effect of Hydroxyapatite Coating on Long-term Results of Total Hip Arthroplasty with Hydroxyapatite-coated Anatomic Femoral Stem
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Purpose: To evaluate the clinical and radiological results, as well as the survival rate, associated with total hiparthroplasty using a hydroxyapatite (HA)-coated anatomical femoral stem at a follow-up of ≥12 years. Materials and Methods: From April 1992 to May 1997, 86 patients (102 hips) underwent total hip arthroplastywith a HA-coated ABG I (Anatomical Benoist Giraud; Howmedica) hip prosthesis. The average age at the timeof surgery was 53.4 years and the mean duration of follow-up was 17.1 years (range, 12.1-21.0 years). TheHarris hip score (HHS) and radiographic assessments of thigh pain were used to evaluate the clinical results. Weobserved osteointegration, cortical hypertrophy, reactive line, calcar resorption and osteolysis around the femoralstems. The survival rate of the femoral stems was evaluated by using the span of time to a revision operation forany reasons was defined as the end point. Results: The mean HHS was 50.5 preoperatively and 84.2 at the time of last follow-up. Osteolysis only aroundthe HA-coated proximal portion of the femoral stem was observed in 72 hips, cortical hypertrophy all around thedistal portion of the femoral stem was observed in 38 hips, and calcar resorption was observed in 44 hips. Areactive line was observed in 13 hips, but was unrelated to component loosening. Stem revision operations wereperformed in 24 (23%) hips due to osteolysis (14 hips), fracture (5 hips) and infection (5 hips). The femoral stemsurvival rate was 75% over the mean duration of follow-up. Conclusion: Total hip arthroplasty using a HA-coated anatomical femoral stem showed necessitated a high rateof revision operations due to osteolysis around the femoral stem in this long term follow-up study.
Abstract
Purpose: To evaluate the clinical and radiological results, as well as the survival rate, associated with total hiparthroplasty using a hydroxyapatite (HA)-coated anatomical femoral stem at a follow-up of ≥12 years. Materials and Methods: From April 1992 to May 1997, 86 patients (102 hips) underwent total hip arthroplastywith a HA-coated ABG I (Anatomical Benoist Giraud; Howmedica) hip prosthesis. The average age at the timeof surgery was 53.4 years and the mean duration of follow-up was 17.1 years (range, 12.1-21.0 years). TheHarris hip score (HHS) and radiographic assessments of thigh pain were used to evaluate the clinical results. Weobserved osteointegration, cortical hypertrophy, reactive line, calcar resorption and osteolysis around the femoralstems. The survival rate of the femoral stems was evaluated by using the span of time to a revision operation forany reasons was defined as the end point. Results: The mean HHS was 50.5 preoperatively and 84.2 at the time of last follow-up. Osteolysis only aroundthe HA-coated proximal portion of the femoral stem was observed in 72 hips, cortical hypertrophy all around thedistal portion of the femoral stem was observed in 38 hips, and calcar resorption was observed in 44 hips. Areactive line was observed in 13 hips, but was unrelated to component loosening. Stem revision operations wereperformed in 24 (23%) hips due to osteolysis (14 hips), fracture (5 hips) and infection (5 hips). The femoral stemsurvival rate was 75% over the mean duration of follow-up. Conclusion: Total hip arthroplasty using a HA-coated anatomical femoral stem showed necessitated a high rateof revision operations due to osteolysis around the femoral stem in this long term follow-up study.
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