5-15 Year Follow-up of Hydroxyapatite-Coated Total Hip Replacements

Faig-Martí, J.; Faig-Garrober, J.

doi:10.1016/S1988-8856(07)70022-6

Información del artículo

Resumen

Bibliografía

Descargar PDF

Estadísticas

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

El Texto completo está disponible en PDF

References

[1.]

L. Palm, S.A. Jacobsson, I. Ivarsson.

Hydroxyapatite coating improves 8- to 10-year performance of the Link RS cementless femoral stem.

J Arthroplasty, 17 (2002), pp. 172-175

Medline

[2.]

W.N. Capello, J.A. D’Antonio, M.T. Manley, J.R. Feinberg.

Hydroxyapatite in total hip arthroplasty.

Clin Orthop, 355 (1998), pp. 200-211

Medline

[3.]

B. Sandén, C. Olerud, C. Johansson, S. Larsson.

Improved extraction torque of hydroxyapatite-coated pedicle screws.

Eur Spine J, 9 (2000), pp. 534-537

Medline

[4.]

C.A. Engh, J.D. Bobyn, A.H. Glassman.

Porous-coated hip replacement. The factors governing bone ingrowth, stress shielding, and clinical results.

J Bone Joint Surg, 69B (1987), pp. 45-55

[5.]

J.P. Hodgkinson, P. Shelley, B.M. Wroblewski.

The correlation between the roentgenographic appearance and operative findings at the bone-cement junction of the socket in Charnley low friction arthroplasties.

Clin Orthop, 228 (1988), pp. 105-109

Medline

[6.]

J.M. Bland, D.G. Altman.

Statistics notes. Survival probabilities (the Kaplan-Meier method).

BMJ, 317 (1998), pp. 1572

Medline

[7.]

F. Dorey, S. Nasser, H. Amstutz.

Current concepts review. The need for confidence intervals in the presentation of orthopaedic data.

J Bone Joint Surg, 75-A (1993), pp. 1844-1852

[8.]

O. Reikeras, R.B. Gunderson.

Excellent results of HA coating on a grit-blasted stem. 245 patients followed for 8-12 years.

Acta Orthop Scand, 74 (2003), pp. 140-145

http://dx.doi.org/10.1080/00016470310013851 | Medline

[9.]

W.J. Geesink, B. Pekarsky, D.L. O’Connell.

Six-year results of hydroxyapatite-coated hip replacement.

J Bone Joint Surg, 77B (1995), pp. 534-547

[10.]

K. Soballe, S. Toksvig-Larsen, J. Gelineck, S. Fruensgaard, E.S. Hansen, L. Ryd, et al.

Migration of hydroxyapatite coated femoral prostheses. A Roentgen Stereophotogrammetric study.

J Bone Joint Surg B, 75 (1993), pp. 681-687

[11.]

R. Sancho-Navarro, J. Caso Rodríguez, M. Valera-Pertegás, X. Crusi-Seresols.

Revisión acetabular en los defectos óseos severos con cotilos esféricos atornillados recubiertos de hidroxiapatita y homoinjertos fragmentados impactados.

Rev Ortop Traumatol, 49 (2005), pp. 170-176

[12.]

E.W. Morscher, A. Hefti, U. Aebi.

Severe osteolysis after thirdbody wear due to hydroxyapatite particles from acetabular cup coating.

J Bone Joint Surg B, 80 (1998), pp. 267-272

[13.]

J.A. D’Antonio, W.N. Capello, M.T. Manley, R. Geesink.

Hydroxyapatite femoral stems for total hip arthroplasty. 10- to 13-year followup.

Clin Orthop, 393 (2001), pp. 101-111

Medline

[14.]

K. Soballe, H. Brockstedt-Rasmussen, E.S. Hansen, C. Bünger.

Hydroxyapatite coating modifies implant membrane formation. Controlled micromotion studied in dogs.

Acta Orthop Scand, 63 (1992), pp. 128-140

Medline

[15.]

K. Soballe, A.S. Hansen, H. Brockstedt-Rasmussen, C. Bünger.

Hydroxyapatite coating converts fibrous tissue to bone around loaded implants.

J Bone Joint Surg, 75B (1993), pp. 270-278

[16.]

L.I. Havelin, L.B. Engesaeter, B. Espehaug, O. Furnes, S.A. Lie, S.E. Vollset.

The Norwegian Arthroplasty Register: 11 years and 73,000 arthroplasties.

Acta Orthop Scand, 71 (2000), pp. 337-353

http://dx.doi.org/10.1080/000164700317393321 | Medline

[17.]

O. Rahbek, S. Overgaard, M. Lind, K. Bendix, C. Bünger, K. Soballe.

Sealing effect of hydroxyapatite coating on peri-implant migration of particles.

J Bone Joint Surg B, 83 (2001), pp. 441-447

[18.]

T.P. Schmalzried, M. Jasty, W.H. Harris.

Periprosthetic bone loss in total hip arthroplasty. Polyethylene wear debris and the concept of the effective joint space.

J Bone Joint Surg, 74A (1992), pp. 849-863

[19.]

J.D. Bobyn, J.J. Jacobs, M. Tanzer, R.M. Urban, R. Aribindi, D.R. Sumner, et al.

The susceptibility of smooth implant surfaces to periimplant fibrosis and migration of polyethylene wear debris.

Clin Orthop, 311 (1995), pp. 21-39

Medline

[20.]

R.H. Emerson Jr., S.B. Sanders, W.C. Head, L. Higgins.

Effect of circumferential plasma-spray porous coating on the rate of femoral osteolysis after total hip arthroplasty.

J Bone Joint Surg, 81A (1999), pp. 1291-1298

[21.]

N. Aebli, J. Krebs, D. Schwenke, H. Stich, P. Schawalder, J.C. Theis.

Degradation of hydroxyapatite coating on a well-functioning femoral component.

J Bone Joint Surg B, 85 (2003), pp. 499-503

[22.]

T.W. Bauer, R.C.T. Geesink, R. Zimmerman, J.T. McMahon.

Hydroxyapatite-coated femoral stems. Histological analysis of components retrieved at autopsy.

J Bone Joint Surg, 73A (1991), pp. 1439-1452

[23.]

M.J. Coathup, G.W. Blunn, N. Flynn, C. Williams, N.P. Thomas.

A comparison of bone remodelling around hydroxyapatitecoated, porous-coated and grit-blasted hip replacements retrieved at post-mortem.

J Bone Joint Surg, 83B (2001), pp. 118-123

[24.]

D.C.R. Hardy, P. Frayssinet, G. Bonel, T. Authom, S.A. Le Naelou, P.E. Delincé.

Two-year outcome of hydroxyapatite-coated prostheses. Two femoral prostheses retrieved at autopsy.

Acta Orthop Scand, 65 (1994), pp. 253-257

Medline

[25.]

Y.H. Kim, J.S. Kim, S.H. Oh, J.M. Kim.

Comparison of porouscoated titanium femoral stems with and without hydroxyapatite coating.

J Bone Joint Surg Am, 85A (2003), pp. 1682-1688

[26.]

A.J. Tonino, M. Therin, Ch. Doyle.

Hydroxyapatite-coated femoral stems. Histology and histomorphometry around five components retrieved at post mortem.

J Bone Joint Surg, 81B (1999), pp. 148-154

[27.]

K.A. Lai, W.J. Shen, Ch.H. Chen, Ch.Y. Yang, W.P. Hu, G.L. Chang.

Failure of hydroxyapatite-coated acetabular cups. Ten-year follow-up of 85 Landos Atoll arthroplasties.

J Bone Joint Surg, 84B (2002), pp. 641-646

[28.]

J. Dumbleton, M.T. Manley.

Current concepts review. Hydroxyapatite-coated prostheses in total hip and knee arthroplasty.

J Bone Joint Surg, 86A (2004), pp. 2526-2540

[29.]

M. Fernández-Fairén, F.J. Gil-Mur.

Nuevos materiales en artroplastia total de cadera.

Rev Ortop Traumatol, 47 (2003), pp. 434-442

[30.]

W.N. Capello, J.A. D’Antonio, J.R. Feinberg, M.T. Manley.

Ten-year results with hydroxyapatite-coated total hip femoral components in patients less than fifty years old. A concise follow-up of a previous report.

J Bone Joint Surg, 85A (2003), pp. 885-889

Indexada en:

Síguenos:

Indexada en:

Síguenos:

Suscríbase a la newsletter