Effect of femoral stem surface coating on clinical and radiographic outcomes of cementless primary total hip arthroplasty: a patient-matched retrospective study.
Cementless stem
Clinical outcomes
Radiographic outcomes
Surface coating
Total hip arthroplasty
Total hip replacement
Journal
International orthopaedics
ISSN: 1432-5195
Titre abrégé: Int Orthop
Pays: Germany
ID NLM: 7705431
Informations de publication
Date de publication:
01 2023
01 2023
Historique:
received:
20
10
2022
accepted:
27
10
2022
pubmed:
18
11
2022
medline:
6
1
2023
entrez:
17
11
2022
Statut:
ppublish
Résumé
This study aims to determine whether changing the stem coating grants superior outcomes at a minimum follow-up of five years. Retrospective review of a consecutive series of primary total hip arthroplasties (THAs) operated by direct anterior approach between 01/01/2013 and 31/12/2014. Two stems were compared, which were identical except for their surface coating; "the Original stem" was fully coated with hydroxyapatite (HA), while "the ProxCoat stem" was proximally coated with plasma-sprayed titanium and HA. Matching was performed. Clinical assessment included modified Harris hip score (mHHS), Oxford hip score (OHS), and forgotten joint score (FJS). Radiographic assessment evaluated alignment, subsidence, pedestal formation, heterotopic ossification, radiolucent lines ≥ 2 mm, spot welds, cortical hypertrophy, and osteolysis. 232 hips received the Original stem and 167 the ProxCoat stem, from which respectively five hips (2.2%) and no hips (0%) underwent revision. Matching identified two groups of 91 patients, with comparable patient demographics. At > five years follow-up, there were no differences in OHS (16 ± 6 vs 15 ± 5; p = 0.075) nor FJS (81 ± 26 vs 84 ± 22; p = 0.521), but there were differences in mHHS (89 ± 15 vs 92 ± 12; p = 0.042). There were no differences in alignment, subsidence, pedestal formation, heterotopic ossification, cortical hypertrophy, and osteolysis. There were differences in prevalence of proximal radiolucent lines (12% vs 0%; p < 0.001) and distal spot welds (24% vs 54%; p < 0.001). At a minimum follow-up of five years, this study on matched patients undergoing primary THA found that ProxCoat stems results in significantly fewer radiolucent lines, more spot welds, and less revisions than Original stems, thus suggesting better bone ingrowth.
Identifiants
pubmed: 36385185
doi: 10.1007/s00264-022-05629-1
pii: 10.1007/s00264-022-05629-1
pmc: PMC9668389
doi:
Substances chimiques
Durapatite
91D9GV0Z28
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
165-174Informations de copyright
© 2022. The Author(s) under exclusive licence to SICOT aisbl.
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