title: Total Hip Arthroplasty around the Inception of the Interface Bioactive Bone Cement Technique.
abstract: BACKGROUND
  To augment cement-bone fixation, Dr. Hironobu Oonishi attempted additional physicochemical bonding through interposition of osteoconductive crystal hydroxyapatite (HA) granules at the cement-bone interface in 1982. He first used the interface bioactive bone cement (IBBC) technique in 12 selected patients (12 hips) in 1982 (first stage) and followed them for 2 years. In 1985, the technique was applied in 25 total hip arthroplasty (THA) patients (second stage) and the effects were investigated by comparing the side with the IBBC technique and the other side without the IBBC technique. He has employed this technique in all THA patients since 1987 (third stage).
  
  
  METHODS
  In the IBBC technique, HA granules (2 to 3 g) were smeared on the bone surface just before the acetabular and femoral components were cemented. In the first stage, 12 hips were operated using the IBBC technique in 1982. In the second stage, THA was performed without the IBBC technique on one side and with the IBBC technique on the other side within 1 year in 25 patients. In the third stage, THA was performed with the IBBC technique in 285 hips in 1987.
  
  
  RESULTS
  In the first stage patients, implant loosening was not detected at 30 years after operation. In the second stage patients, revision was required in 7 hips without the IBBC technique due to cup loosening (5 hips) and stem loosening (2 hips), whereas no hip was revised after THA with the IBBC technique at 26 years after operation. In the third stage patients, the incidence of radiolucent lines and osteolysis was very few at 25 years after operation.
  
  
  CONCLUSIONS
  The long-term follow-up of THA performed around the inception of the IBBC technique has revealed low incidences of radiolucent lines, osteolysis, and revision surgery.
authors: Department of Orthopaedic Surgery, Tominaga Hospital, H. Oonishi Memorial Joint Replacement Institute, Osaka, Japan.
authors: Hiroyuki
authors: H
authors: Oonishi
authors: Department of Orthopaedic Surgery, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan.
authors: Hirotsugu
authors: H
authors: Ohashi
authors: Department of Orthopaedic Surgery, Tominaga Hospital, H. Oonishi Memorial Joint Replacement Institute, Osaka, Japan.
authors: Ikuo
authors: I
authors: Kawahara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D001843:Bone Cements / Q000009:adverse effects / Q000627:therapeutic use; D000069343:Bone-Implant Interface / Q000502:physiology; D005500:Follow-Up Studies; D006615:Hip / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D006882:Hydroxyapatites / Q000627:therapeutic use; D008875:Middle Aged; D055815:Young Adult
chemical_list: D001843:Bone Cements; D006882:Hydroxyapatites
keywords: Bioactive bone cement; Bone-cement interface; Hydroxyapatites; Total hip arthroplasty