Clinical and radiological outcome of hydroxyapatite-coated femoral stem in revision hip arthroplasty.
We used a proximally hydroxyapatite-coated femoral stem in revision arthroplasty of 48 cases with aseptic loosening and Paprosky defect class 1 or 2. We reviewed the outcome after 6.1 (4--9.3) years. The clinical outcome was good, with a mean postoperative HHS of 90 (51--100) points. There were five reoperations all on the acetabular side and none for the femoral stem. At follow-up, we observed cancellous sclerosis radiographically in 19 cases-especially in non-tightly fitted stems and mainly in Gruen zones 2 and 6. In 13 cases, cortical thickening was seen, mainly in Gruen zones 3 and 5 and especially in tightly fitted stems. These bony changes were significant and not related to any clinical parameter. They started to appear from 6 months onward, with increasing frequency with longer follow-up. We find that the standard Mallory-Head hydroxyapatite-coated femoral stem is suitable for revision in cases with lower-class femoral defects.
Gosens
T
T
St. Elisabeth Hospital, Hilvarenbeekseweg 60, 5022 GC Tilburg, The Netherlands. t.gosens@elisabeth.nl
van Langelaan
E J
EJ
D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation*; D020099:Coated Materials, Biocompatible / Q000627:therapeutic use*; D017886:Durapatite / Q000627:therapeutic use*; D006621:Hip Joint; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007592:Joint Diseases / Q000601:surgery; D008875:Middle Aged; D011446:Prospective Studies; D011475:Prosthesis Failure; D012086:Reoperation; D016896:Treatment Outcome
D020099:Coated Materials, Biocompatible; D017886:Durapatite