Comparison of porous-coated titanium femoral stems with and without hydroxyapatite coating.
BACKGROUND
The purpose of this prospective, randomized study was to evaluate the clinical and radiographic results associated with proximally porous-coated titanium stems that were identical in geometry but differed with regard to proximal surface treatment (with or without hydroxyapatite coating).


METHODS
A prospective, randomized study was performed to evaluate fifty patients (100 hips) who had undergone sequential bilateral primary total hip replacement. A proximally porous-coated titanium stem with hydroxyapatite coating was implanted on one side and a proximally porous-coated titanium stem without hydroxyapatite coating was implanted on the other side during the same operative setting in all fifty patients. A cementless acetabular component made of titanium was used in all hips. There were thirty-six men and fourteen women; the mean age at the time of the operation was 45.3 years. The mean duration of follow-up was 6.6 years. Clinical and radiographic evaluations were performed preoperatively; at six weeks; at three, six, and twelve months; and yearly thereafter.


RESULTS
The Harris hip scores in the hydroxyapatite-coated group (mean, 94 points) and non-hydroxyapatite-coated group (mean, 92 points) were similar at the final follow-up examination. The prevalence of transient pain in the thigh was 4% in each group. No acetabular or femoral component demonstrated aseptic loosening. Bone-remodeling patterns, including calcar atrophy, were similar in the two groups. No acetabular or femoral osteolysis was seen.


CONCLUSIONS
At a mean of 6.6 years postoperatively, the clinical and radiographic results associated with proximally porous-coated femoral prostheses with identical geometries that differed only with regard to the presence or absence of hydroxyapatite coating were similar.
Kim
Young-Hoo
YH
The Joint Replacement Centre of Korea, Seoul, Korea. younghookim@netsgo.com
Kim
Jun-Shik
JS
Oh
Seung-Hwan
SH
Kim
Ju-Moon
JM
D000328:Adult; D000704:Analysis of Variance; D019644:Arthroplasty, Replacement, Hip; D020099:Coated Materials, Biocompatible / Q000737:chemistry; D017886:Durapatite / Q000737:chemistry; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D011475:Prosthesis Failure; D011859:Radiography; D013499:Surface Properties; D014025:Titanium / Q000737:chemistry; D016896:Treatment Outcome
D020099:Coated Materials, Biocompatible; D017886:Durapatite; D014025:Titanium