title: A new uncemented hydroxyapatite-coated femoral component for the treatment of femoral neck fractures: two-year radiostereometric and bone densitometric evaluation in 50 hips.
abstract: Our aim in this pilot study was to evaluate the fixation of, the bone remodelling around, and the clinical outcome after surgery of a new, uncemented, fully hydroxyapatite-coated, collared and tapered femoral component, designed specifically for elderly patients with a fracture of the femoral neck. We enrolled 50 patients, of at least 70 years of age, with an acute displaced fracture of the femoral neck in this prospective single-series study. They received a total hip replacement using the new component and were followed up regularly for two years. Fixation was evaluated by radiostereometric analysis and bone remodelling by dual-energy x-ray absorptiometry. Hip function and the health-related quality of life were assessed using the Harris hip score and the EuroQol-5D. Up to six weeks post-operatively there was a mean subsidence of 0.2 mm (-2.1 to +0.5) and a retroversion of a mean of 1.2° (-8.2° to +1.5°). No component migrated after three months. The patients had a continuous loss of peri-prosthetic bone which amounted to a mean of 16% (-49% to +10%) at two years. The mean Harris hip score was 82 (51 to 100) after two years. The two-year results from this pilot study indicate that this new, uncemented femoral component can be used for elderly patients with osteoporotic fractures of the femoral neck.
authors.affiliation: Department of Clinical Sciences, Division of Orthopaedics, Karolinska Institute at Danderyd Hospital, S-18288 Stockholm, Sweden. olof.skoldenberg@ds.se
authors.forename: O G
authors.initials: OG
authors.lastname: Sköldenberg
authors.forename: M O
authors.initials: MO
authors.lastname: Salemyr
authors.forename: H S
authors.initials: HS
authors.lastname: Bodén
authors.forename: A
authors.initials: A
authors.lastname: Lundberg
authors.forename: T E
authors.initials: TE
authors.lastname: Ahl
authors.forename: P Y
authors.initials: PY
authors.lastname: Adolphson
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods; D015519:Bone Density; D016723:Bone Remodeling; D002484:Cementation; D020099:Coated Materials, Biocompatible; D017886:Durapatite; D004812:Epidemiologic Methods; D005260:Female; D005265:Femoral Neck Fractures / Q000503:physiopathology / Q000601:surgery*; D005269:Femur / Q000503:physiopathology; D006622:Hip Prosthesis; D006801:Humans; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000503:physiopathology / Q000601:surgery*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000601:surgery; D012086:Reoperation; D016896:Treatment Outcome
chemical_list: D020099:Coated Materials, Biocompatible; D017886:Durapatite