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Hydroxyapatite coatings in femoral stem hip revision arthroplasty

I. Escriba, R. Sancho, X. Crusi, M. Valera

Category: Furlong Clinical Results

Orthopaedic and Traumatology Service, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

Aims: The bone – conductive properties of hydroxyapatite (HA) coatings are attractive in revision surgery with bone loss. The purpose of this study is to analyse the clinical and radiological results of 55 cases of revision hip arthroplasty using hydroxyapatite femoral stems.

Methods: Between May 1995 and October 2000 we performed 55 patients total hip replacements in 50 patients (5 bilateral) using hydroxyapatite (HA) – coated femoral stem. The average age of the patients at the time of the index revision was 67 years (range 44-84). Clinical evaluation was by a Merle d’Aubigné Score (preoperative 6.54 points). Radiological evaluation used the AAOS system for preoperative films and scaring system after Engh for the postoperative films. Bone grafts was required in 35 cases.

Results: Postoperative Merle d’Aubigné score was 17.25 points. Complications: 3 dislocations, one transitory nerve palsy and 14 associated intraoperative fractures. All grafts consolidated. None of the femoral stem components required revision because of aseptic loosening. No radiologically progressive lucency or signs indicating a loose implant were visible in any cases. There were no cases of femoral stem migration.

Conclusions: We conclude that the hydroxyapatite femoral stem is suitable for implantation at revision hip arthroplasty and can give good results in the short to medium term, because the clinical and radiological results are excellent, with a early consolidate fractures.

Paper presented at EFORT 2003, Helsinki, Finland, June 4 – 10 2003.