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HYDROXYAPATITE-COATED TOTAL HIP ARTHROPLASTY IN OSTEOPOROTIC PATIENTS



Abstract

Aim: To evaluate the clinical and radiological results of hydroxyapatite stem in primary total hip replacement.

Method: A prospective review was performed on 22 osteoporotic patients (Singh index 1–3) with hydroxyapatite-coated total hip replacements. These results were compared with a control group (Singh index 4–6) of 45 patients (48 hips) with respect to clinical and radiographic data. Surgery was performed over a six year period (1991–1996) and the time to follow-up evaluation averaged 5 years (range 2–7 years). Clinical evaluation was based on the Harris Hip score and radiographic evaluations using Engh’s criteria.

Results: There was no significant difference between the final average Harris hip score in the osteoporotic bone group which was 87 points and that for the control group which was 91 points (p> 0.05). Radiographic evaluation demonstrated confirmed bone ingrowths in all patients except for one patient in each group, each with suspected bone ingrowth. There were no stems revised for aseptic loosening and no endosteal lysis was found. Progressive bone formation was seen around the femoral stem proximally. The acetabular components demonstrated no sign of mechanical loosening or osteolysis. Bone formation was found in most patients in zone I, and less in zone III.

Conclusion: The basis of the results of this study, it is believed that osteoporotic bone as a factor by itself should not compromise the early results of hydroxyapatite total hip arthroplasty and hopefully give as good results n the long term.

The abstracts were prepared by Orah Naor. Correspondence should be addressed to him at the Israel Orthopaedic Association, PO Box 7845, Haifa 31074, Israel.