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Hydroxyapatite-coated hip stem offers good long-term reliability

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NICE — Study results presented here suggest that using an anatomic cementless stem with a hydroxyapatite coating for total hip arthroplasty provides good long-term reliability and longevity.

“Cementless hydroxyapatite (HA)-coated prostheses have proven their reliability, but we wanted to see how they rated in terms of their outcomes over the long term,” said Romain Bidar, MD, of Nîmes, France, who presented the study at the 9th European Federation of National Associations of Orthopaedics and Traumatology Congress, here.

One senior orthopedic surgeon performed 111 total hip arthroplasties (THAs) using the ABG 1 HA-coated hip prosthesis (Stryker) in 101 patients. The surgeon used the posterolateral approach to perform the procedures. The average patient age at surgery was 61.3 years.

The researchers reviewed 75 THAs; 21 patients were dead and 15 were lost to follow-up. The average follow-up was 13 years.

“The outcomes overall were very good, and we saw excellent osteointegration (98%),” Bidar said.

The average preoperative Harris Hip and Postel Merle d’Aubigné scores were 56.7 and 11.8, respectively, which rose to 87.3 and 16.3 at the longest follow-up.

Most patients were satisfied with the outcome, and they reported no thigh pain, he said.

There were 16 revisions, including one bipolar revision for loosening of both components, 14 cup revisions for osteolysis (11) and loosening (3), and one stem revision for periprosthetic fracture.

“The radiographic changes were also consistent with bone remodeling,” he noted.

The global survivorship of ABG 1 THA at 13 years was 78.7% and the acetabular cup survivorship was 80%. Likewise, “The stem survivorship was 97.3%, and the failure rate of the femoral stem due to aseptic loosening was only 1.3%,” said Bidar, who attributed the stem results to “good osteointegration, the anatomic design of the stem and the hydroxyapatite coating.”

For more information:

• Bidar R, Asencio G. The ABG hydroxyapatite-coated hip stem results at a mean follow-up of 13 years. Paper F223. Presented at the 9th European Federation of National Associations of Orthopaedics and Traumatology Congress. May 29-June 1, 2008. Nice.