A new cementless total hip arthroplasty with bioactive titanium porous-coating by alkaline and heat treatment: average 4.8-year results.
A method has been developed for creating a bioactive coating on titanium by alkaline and heat treatment, and shown that it forms a thin layer of hydroxyapatite (HA) on the surface of implants when soaked in simulated body fluid. A series of 70 cementless primary total hip arthroplasties using this coating technique on a porous titanium surface was performed, and followed up the patients for a mean period of 4.8 years. There were no instances of loosening or revision, or formation of a reactive line on the porous coating. Although radiography just after operation showed a gap between the host bone and the socket in over 70% of cases, all the gaps disappeared within a year, indicating the good osteoconduction provided by the coating. Alkaline-heat treatment of titanium to provide a thin HA coating has several advantages over plasma-spraying, including no degeneration or absorption of the HA coating, simplicity of the manufacturing process, and cost effectiveness. In addition, this method allows homogeneous deposition of bone-like apatite within a porous implant. Although this was a relatively short-term study, treatment that creates a bioactive surface on titanium and titanium alloy implants has considerable promise for clinical application.
Kawanabe
Keiichi
K
Department of Orthopaedic Surgery, Kyoto University, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan. kawanabe@kcgh.gr.jp
Ise
Kentaro
K
Goto
Koji
K
Akiyama
Haruhiko
H
Nakamura
Takashi
T
Kaneuji
Ayumi
A
Sugimori
Tanzo
T
Matsumoto
Tadami
T
D000328:Adult; D000368:Aged; D000468:Alkalies; D019644:Arthroplasty, Replacement, Hip; D001843:Bone Cements; D005260:Female; D006801:Humans; D008297:Male; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D014025:Titanium
D000468:Alkalies; D001843:Bone Cements; D014025:Titanium