Host-bone response to porous-coated cobalt-chrome and hydroxyapatite-coated titanium femoral components in hip arthroplasty. Dual-energy x-ray absorptiometry analysis of paired bilateral cases at 5 to 7 years.
Uncemented porous-coated cobalt-chrome femoral stems have produced satisfactory short-term clinical results, although slightly inferior to the results of cemented total hip arthroplasty. Proximal femoral bone resorption, osteolysis and fibrous ingrowth have been reported with porous-coated stems. Hydroxyapatite-coated stems and titanium stems have been introduced to avoid these findings through improved fixation. Dual-energy x-ray absorptiometry allows quantitative examination of bone density changes after uncemented total hip arthroplasty. This study examines the host-bone response to hydroxyapatite-coated titanium and porous-coated cobalt-chrome stems of identical geometry in three paired bilateral cases at 5 to 7 years. Distinctly different patterns of femoral bone mineral density changes were observed with the two stem designs. The authors conclude that dual-energy x-ray absorptiometry is a promising technique allowing noninvasive analysis of uncemented stem fixation, and that the data from this study suggest improved fixation and stress transfer with hydroxyapatite-coated titanium stems.
Scott
D F
DF
Department of Orthopaedics, Hospital For Joint Diseases Orthopaedic Institute, New York, NY 10003, USA.
Jaffe
W L
WL
D015502:Absorptiometry, Photon; D000328:Adult; D001672:Biocompatible Materials; D015519:Bone Density; D016723:Bone Remodeling / Q000502:physiology; D002858:Chromium Alloys; D017886:Durapatite; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D016348:Osseointegration; D016062:Porosity; D011474:Prosthesis Design; D012189:Retrospective Studies; D014025:Titanium
D001672:Biocompatible Materials; D002858:Chromium Alloys; D017886:Durapatite; D014025:Titanium