Bone remodeling in proximal HA-coated versus uncoated cementless SL-Plus((R)) femoral components: a 5-year follow-up study.
OBJECTIVE
Bone resorption at the femoral stem due to stress shielding has been particularly observed secondary to cementless hip replacement. This prospective study of 126 total-hip replacements was performed to examine clinical outcomes and changes in peri-prosthetic bone density after implantation of a double-tapered cementless femoral component manufactured with versus without hydroxyapatite (HA) coating.


METHODS
Sixty-seven femoral components with and 59 femoral components without proximal HA coating were implanted and examined after a mean follow-up of 5.8 (SD 1.1, 2.8-7.8) years. The Harris hip score (HHS) and plain radiographs were used for clinical and radiological follow-up evaluations. Possible changes in peri-prosthetic bone mineral density (BMD) were measured by dual-energy X-ray absorptiometry (DEXA).


RESULTS
Clinical outcome, measured by HHS, was similar in both groups. On plain radiographs, significantly less radiolucent lines were observed for the coated implants. DEXA revealed a significant increase in BMD at the proximal zones, along the medial side, and at the stem tips in the coated compared with the non-coated implants.


CONCLUSIONS
Hydroxyapatite-coated implants yield favorable radiographic characteristics, but no greater clinical benefit after 5 years' implantation.
Steens
W
W
Paracelsus Klinik, Marl, Germany. wsteens@gmx.de
Schneeberger
A G
AG
Skripitz
R
R
Fennema
P
P
Goetze
C
C
D015502:Absorptiometry, Photon; D016723:Bone Remodeling; D020099:Coated Materials, Biocompatible; D017886:Durapatite; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011474:Prosthesis Design; D013997:Time Factors
D020099:Coated Materials, Biocompatible; D017886:Durapatite