Host-bone response to porous-coated cobalt-chrome and hydroxyapatite-coated titanium femoral components in hip arthroplasty. Dual-energy x-ray absorptiometry analysis of paired bilateral cases at 5 to 7 years

• Published in: The Journal of arthroplasty Vol. 11; no. 4; pp. 429 - 437
• Main Authors: Scott, D F, Jaffe, W L
• Format: Journal Article
• Language: English
• Published: United States 01-06-1996
• Subjects: Absorptiometry, Photon; Adult; Biocompatible Materials; Bone Density; Bone Remodeling - physiology; Chromium Alloys; Durapatite; Female; Femur - diagnostic imaging; Hip Prosthesis; Humans; Male; Osseointegration; Porosity; Prosthesis Design; Retrospective Studies; Titanium
• ISSN: 0883-5403
• DOI: 10.1016/S0883-5403(96)80033-7

Uncemented porous-coated cobalt-chrome femoral stems have produced satisfactory short-term clinical results, although slightly inferior to the results of cemented total hip arthroplasty. Proximal femoral bone resorption, osteolysis and fibrous ingrowth have been reported with porous-coated stems. Hydroxyapatite-coated stems and titanium stems have been introduced to avoid these findings through improved fixation. Dual-energy x-ray absorptiometry allows quantitative examination of bone density changes after uncemented total hip arthroplasty. This study examines the host-bone response to hydroxyapatite-coated titanium and porous-coated cobalt-chrome stems of identical geometry in three paired bilateral cases at 5 to 7 years. Distinctly different patterns of femoral bone mineral density changes were observed with the two stem designs. The authors conclude that dual-energy x-ray absorptiometry is a promising technique allowing noninvasive analysis of uncemented stem fixation, and that the data from this study suggest improved fixation and stress transfer with hydroxyapatite-coated titanium stems.