5-15 Year Follow-up of Hydroxyapatite-Coated Total Hip Replacements | Revista Española de Cirugía Ortopédica y Traumatología (English Edition)

Article information

Purpose

This retrospective study was carried out to assess the survival of hydroxyapatite-coated total hip replacements (THR) implanted in our department.

Materials and methods

Of a total 136 patients we reviewed 154 THRs with 154 hydroxyapatite-coated stems and 144 hydroxyapatite coated cups with an evolution of 5-15 years. Each case was assessed clinically and radiologically using the information from the last control and the patients’ clinical record. In the 24 cases that required replacement the causes of failure and reasons for review were assessed.

Results

The mean age of the patients at the time of surgery was 61 years. Intraoperative complications were seen in 10 cases and postoperative complications in 18. Replacements were performed of 7 isolated polyethylene components, 17 cups and 2 stems. The reasons for replacement were: polyethylene wear: 7 cases; cup loosening: 9 cases; cup loosening and polyethylene wear: 4 cases; dislocation: 3 cases; and infection: 1 case.

Conclusions

Hydroxyapatite-coated THRs, especially stems, deliver a long time survival that is at least comparable to that of other non-cemented implants. Compared to other types of fixation, hydroxyapatite offers long-term stable fixation and facilitates replacement in cases of failure.

Key words:

total hip replacement

hydroxyapatite

survival

Objetivo

Hemos realizado un estudio retrospectivo para valorar la supervivencia de las prótesis totales de cadera recubiertas de hidroxiapatita implantadas en nuestro Servicio.

Material y método

En 136 pacientes se han revisado 154 prótesis totales de cadera con 154 vástagos recubiertos de hidroxiapatita y 144 cótilos recubiertos también de hidroxiapatita, con una evolución entre 5 y 15 años. Cada caso fue valorado clínica y radiológicamente con la información de la historia clínica y del último control. En los 24 casos que precisaron algún tipo de recambio se valoraron las causas del fracaso y el motivo de la reintervención.

Resultados

La edad media de los pacientes en el momento de la intervención fue de 61 años. Se presentaron complicaciones intraoperatorias en 10 casos y 18 en el posoperatorio. Se recambiaron 7 polietilenos aislados, 17 cótilos y 2 vástagos. Las causas de recambio fueron desgaste del polietileno (7 casos), aflojamiento del cótilo (9 casos), aflojamiento del cótilo asociado a desgaste del polietileno (4 casos), luxación (3 casos) e infección (1 caso).

Conclusiones

Las prótesis totales de cadera recubiertas de hidroxiapatita, y en especial los vástagos, ofrecen una supervivencia a largo plazo como mínimo comparable a la de otros implantes no cementados. Frente a otros tipos de anclaje, la hidroxiapatita ofrece una fijación estable a largo plazo y facilita el recambio en caso de fracaso.

Palabras clave:

prótesis total de cadera

hidroxiapatita

supervivencia

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