Hydroxyapatite-Coated Femoral Stem Survivorship at 10 Years

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Abstract

Ninety-six patients were implanted with the Omnifit-HA femoral stem and the Omnifit-PSL porous-coated dual-radius acetabular shell (Stryker, Mahwah, NJ) and liners that were sterilized by γ-radiation in air. The mean age at the time of surgery was 52 years (range, 27-78 years), and male/female ratio was 54:42. The mean follow-up was 10.3 years (range, 7-12 years). The survivorship of the stem and cup was 100% and 90%, respectively. Four cups were revised for aseptic loosening, and 6 liners were exchanged. The mean polyethylene wear rate was 0.24 mm/y. Lysis was noted in 23% of the cups. No patient developed femoral lysis distally. This hydroxyapatite-coated stem continues to perform well and appears to protect against the migration of wear debris along the femoral stem.

Section snippets

Materials and Methods

The first 103 hip arthroplasties implanted with the Omnifit-HA stem (Fig. 1) and Omnifit-PSL cup (Stryker, Mahwah, NJ) by one surgeon (CWC) in 96 patients between July 1991 and December 1993, were followed up. The criteria for selecting patients were advanced hip disease, physiological age less than 65 years, and anthropometric compatibility between the proximal femur and the stem. During the same period, patients with advanced hip disease and physiological age of more than 65 years underwent

Results

Ninety-six patients (103 hips) were selected for the study. Complete clinical follow-up was obtained for 81 patients including 46 patients (47 hips) older than 50 years at the time of surgery and 35 patients (38 hips) 50 years or younger. Three patients (3 hips) died, 4 patients (5 hips) were lost to follow-up, and 10 hips were revised during the course of the study. Of the 10 hips, 8 were revised at less than 10 years. The mean follow-up was 10.3 years (range, 7-12 years). Clinical outcomes

Discussion

Short-term follow-up of this hydroxyapatite-coated stem design has shown excellent clinical outcomes 5, 7, 13, 14. The longer-term follow-up of hydroxyapatite-coated stems has shown similar clinical and radiological results 6, 15, 16, 17, supporting the findings of early studies that hydroxyapatite is effective in rapid osseointegration and prevention of distal osteolysis by sealing the proximal femur against polyethylene debris distal migration. D'Antonio et al [6] reported excellent clinical

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