title: Clinical and Radiologic Outcomes of a Fully Hydroxyapatite-Coated Femoral Revision Stem: Excessive Stress Shielding Incidence and its Consequences.
abstract: Stress shielding remains a concern in total hip arthroplasty. The consequences of stress shielding in hydroxyapatite-coated femoral component revisions were evaluated in a prospective cohort study. A total of 106 patients operated on by revision total hip arthroplasty were identified. Sixty-three patients were eligible for clinical and radiologic assessment of osseointegration, bone remodeling, and stress shielding. Five patients showed evidence of excessive stress shielding. One patient experienced a periprosthetic fracture. No adverse events occurred in the remaining patients with a low rate of thigh pain and reliable osseointegration. This is the only available study concerning mid- to long-term consequences of excessive stress shielding in hydroxyapatite-coated revision stems. We advocate surgeons using these stems to remain vigilant and be aware of possible stress shielding side effects.
authors.affiliation: Department of Orthopaedic Surgery, Research School Caphri, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Ilknur
authors.initials: I
authors.lastname: Sanli
authors.affiliation: Department of Orthopaedic Surgery, Research School Caphri, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Jacobus Johannes Christiaan
authors.initials: JJ
authors.lastname: Arts
authors.affiliation: Department of Orthopaedic Surgery, Research School Caphri, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Jan
authors.initials: J
authors.lastname: Geurts
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000295:instrumentation*; D016723:Bone Remodeling; D017886:Durapatite / Q000737:chemistry*; D005260:Female; D005269:Femur / Q000033:anatomy & histology; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016348:Osseointegration; D010146:Pain / Q000209:etiology; D057068:Periprosthetic Fractures / Q000209:etiology; D011446:Prospective Studies; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation / Q000009:adverse effects; D013314:Stress, Mechanical
chemical_list: D017886:Durapatite
keywords: femoral; hydroxyapatite; revision; stem; stress-shielding