Severe osteolysis after third-body wear due to hydroxyapatite particles from acetabular cup coating.
One concern about the fixation of HA-coated implants is the possible disintegration of the surface, with the migration of HA granules into the joint space, producing third-body wear. We report a study of six revisions of HA-coated polyethylene RM cups at 9 to 14 years after successful primary arthroplasty. In all six hips, we found HA granules embedded in the articulating surface of the polyethylene, with abrasive wear of the cup and the metal femoral head. The cup had loosened in four hips and three showed severe osteolysis of the proximal femur. Third-body wear due to HA particles from implant coating may produce severe clinical problems with few early warning signs. Further clinical, radiological and histological observations are needed to determine the possible incidence of this late complication in the various types of coating of a variety of substrates.
Morscher
E W
EW
Orthopaedic Department, University of Basel, Switzerland.
Hefti
A
A
Aebi
U
U
D000077:Acetabulum / Q000000981:diagnostic imaging / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D001672:Biocompatible Materials / Q000009:adverse effects* / Q000032:analysis / Q000737:chemistry; D002118:Calcium / Q000032:analysis; D002244:Carbon / Q000032:analysis; D002858:Chromium Alloys / Q000032:analysis / Q000737:chemistry; D017886:Durapatite / Q000009:adverse effects* / Q000032:analysis / Q000737:chemistry; D004577:Electron Probe Microanalysis; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000473:pathology*; D005270:Femur Head / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000150:complications / Q000473:pathology; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008297:Male; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D010014:Osteolysis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D010100:Oxygen / Q000032:analysis; D010758:Phosphorus / Q000032:analysis; D011095:Polyethylenes / Q000737:chemistry; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation; D013499:Surface Properties
D001672:Biocompatible Materials; D002858:Chromium Alloys; D011095:Polyethylenes; D010758:Phosphorus; D002244:Carbon; D017886:Durapatite; D010100:Oxygen; D002118:Calcium