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No long-term survival advantage found for HA-coated vs porous femoral sleeves
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Use of a hydroxyapatite coating on the metaphyseal sleeve of a modular titanium alloy stem had no long-term survival advantage when compared with a porous femoral sleeve, according to study results.
Between June 1997 and August 2004, researchers compared 117 porous sleeved total hip arthroplasties (THAs) performed in 106 patients with 102 hydroxyapatite (HA)-coated sleeved THAs performed in 95 patients. Clinical and radiographic assessments were done in patients preoperatively and postoperatively at 6 weeks, 1 year, 3 years and 5 years, and then subsequently every 2 years to 3 years.
At the latest follow-up, results showed the porous group had a mean Harris Hip score (HHS) of 94.7 and the HA group had an HHS of 94.5. With aseptic loosening as an endpoint, survival of the stem was 98.6% at a mean follow-up of 12.5 years in the porous group and was 98.4% at 13.7 years in the HA group.
Researchers found osteolysis around the stem in six hips in the porous group and in five hips in the HA group; cortical hypertrophy around the stem in three hips in both groups; and endosteal spot welds in 16 porous hips and 15 HA hips. According to study results, one stem in the porous group required revision 9 years following primary surgery for loosening in the absence of infection, and one hip underwent acetabular revision and bone grafting for polyethylene wear and gross osteolysis. Researchers found the HA group had one stem revised for early loosening and one for infection during a two-stage procedure, and two hips underwent revision procedures of the acetabulum alone. – by Casey Tingle
Disclosures: The researchers report no relevant financial disclosures.
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