title: Complications with hydroxyapatite particulate separation in total hip arthroplasty.
abstract: This study reports on the results of the implant and tissue analysis of clinically retrieved hydroxyapatite (HA)-coated implants. Five of the patients with fixed HA-coated stems had been clinically diagnosed with osteolysis. The semiquantitative histologic grading in these patients showed HA, polyethylene, and metal particles were all present (Grade 3+) in the osteolytic regions of the periprosthetic tissue. Additionally, inflammatory cells (Grade 3+) were present in these regions. Back-scattered electron (BSE) and correlated elemental analysis showed HA particulate was present in the polyethylene inserts. The HA could be distinguished from bone chips in the polyethylene based on morphology and anatomic number gray level differences. This study was limited in that no clinical results of particular HA-coated implant series were reported. Careful follow-up care in patients with coated devices is recommended.
authors.affiliation: Bone and Joint Research Laboratory, Department of Veterans Affairs Medical Center, Salt Lake City, UT 84148.
authors.forename: R D
authors.initials: RD
authors.lastname: Bloebaum
authors.forename: D
authors.initials: D
authors.lastname: Beeks
authors.forename: L D
authors.initials: LD
authors.lastname: Dorr
authors.forename: C G
authors.initials: CG
authors.lastname: Savory
authors.forename: J A
authors.initials: JA
authors.lastname: DuPont
authors.forename: A A
authors.initials: AA
authors.lastname: Hofmann
mesh_terms: D000328:Adult; D000368:Aged; D002452:Cell Count; D003343:Corrosion; D005260:Female; D006622:Hip Prosthesis; D006644:Histiocytes; D006801:Humans; D006882:Hydroxyapatites / Q000032:analysis*; D008297:Male; D008670:Metals / Q000032:analysis; D008875:Middle Aged; D009504:Neutrophils; D010014:Osteolysis / Q000378:metabolism*; D011095:Polyethylenes / Q000032:analysis; D011183:Postoperative Complications; D012086:Reoperation
chemical_list: D006882:Hydroxyapatites; D008670:Metals; D011095:Polyethylenes