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Comparison of early femoral bone remodeling and functional outcome after total hip arthroplasty using the SL-PLUS MIA stem with and without hydroxyapatite coating.

Authors
  • Tanaka, A1
  • Kaku, N2
  • Tabata, T1
  • Tagomori, H1
  • Tsumura, H1
  • 1 Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, 1-1 Idaigaoka Hazamacho, Yufu, Oita, Japan. , (Japan)
  • 2 Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, 1-1 Idaigaoka Hazamacho, Yufu, Oita, Japan. [email protected] , (Japan)
Type
Published Article
Journal
Musculoskeletal surgery
Publication Date
Dec 01, 2020
Volume
104
Issue
3
Pages
313–320
Identifiers
DOI: 10.1007/s12306-019-00622-1
PMID: 31549343
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Few reports have evaluated the use of hydroxyapatite (HA) coating in SL-MIA-type stems in total hip arthroplasty (THA). Here, we compared early femoral bone remodeling after total hip arthroplasty using the SL-PLUS MIA stem with and without hydroxyapatite coating. From February 2012 to March 2017, 132 patients (150 hips) (HA group: 48 patients [52 hips], non-HA group: 84 patients [98 hips]) underwent THA with an SL-PLUS MIA stem. The mean follow-up duration was 3.7 years (standard deviation 1.2, range: 1.0-6.1). The Harris Hip Score (HHS), postoperative bleeding volume measurements and plain radiographs were used for clinical and radiological follow-up evaluations. Peri-prosthetic bone mineral density changes were measured by dual-energy X-ray absorptiometry. At 1 year, the HHS improved from 44.4 points preoperatively to 89.2 points postoperatively and from 44.5 points to 89.7 points in the HA and non-HA groups, respectively. At 1 year postoperatively, subsidence (≧ 3 mm) occurred in 0% and 8.2% of the HA and non-HA groups, respectively. Stress shielding (≧ Grade 3) occurred in 0% and 6% of the HA and non-HA groups, respectively. The radiolucent line was significantly smaller in the HA than in the non-HA group. There was no significant difference in the bone mineral density distribution in the two groups. Addition of HA to the SL-MIA stem can help enhance the initial fixation and early osseointegration. Further studies are required on the long-term effects of adding HA to reduce stress shielding of the proximal area of the stem.

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