HYDROXY-APATITE TOTAL HIP REPLACEMENT: 4–5 YEAR REVIEW OF A PROSPECTIVE RANDOMISED TRIAL COMPARING PARTIAL AND FULLY COATED STEMS

R Hussein; A Smith; J Shepperd; H Apthorp; A Butler-Manuel

doi:10.1302/0301-620X.85BSUPP_I.0850062e

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HYDROXY-APATITE TOTAL HIP REPLACEMENT: 4–5 YEAR REVIEW OF A PROSPECTIVE RANDOMISED TRIAL COMPARING PARTIAL AND FULLY COATED STEMS

R Hussein
A Smith
J Shepperd
H Apthorp
A Butler-Manuel

HYDROXY-APATITE TOTAL HIP REPLACEMENT: 4–5 YEAR REVIEW OF A PROSPECTIVE RANDOMISED TRIAL COMPARING PARTIAL AND FULLY COATED STEMS

Hussein R, Smith A, Shepperd J, Apthorp H, Butler-Manuel A. HYDROXY-APATITE TOTAL HIP REPLACEMENT: 4–5 YEAR REVIEW OF A PROSPECTIVE RANDOMISED TRIAL COMPARING PARTIAL AND FULLY COATED STEMS. Orthop Procs. 2003;85-B(SUPP_I):62-63. doi:10.1302/0301-620X.85BSUPP_I.0850062e

Hussein, R, et al. “HYDROXY-APATITE TOTAL HIP REPLACEMENT: 4–5 YEAR REVIEW OF A PROSPECTIVE RANDOMISED TRIAL COMPARING PARTIAL AND FULLY COATED STEMS.” Orthopaedic Proceedings, vol. 85-B, no. SUPP_I, 2003, pp. 62-63., https://doi.org/10.1302/0301-620X.85BSUPP_I.0850062e

Hussein, R., Smith, A., Shepperd, J., Apthorp, H., & Butler-Manuel, A. (2003). HYDROXY-APATITE TOTAL HIP REPLACEMENT: 4–5 YEAR REVIEW OF A PROSPECTIVE RANDOMISED TRIAL COMPARING PARTIAL AND FULLY COATED STEMS. Orthopaedic Proceedings, 85-B(SUPP_I), 62-63. https://doi.org/10.1302/0301-620X.85BSUPP_I.0850062e

Hussein, R., Smith, A., Shepperd, J., Apthorp, H. and Butler-Manuel, A. (2003) “HYDROXY-APATITE TOTAL HIP REPLACEMENT: 4–5 YEAR REVIEW OF A PROSPECTIVE RANDOMISED TRIAL COMPARING PARTIAL AND FULLY COATED STEMS.” Orthopaedic Proceedings, 85-B(SUPP_I), pp. 62-63. Available at: https://doi.org/10.1302/0301-620X.85BSUPP_I.0850062e

Hussein, R, A Smith, J Shepperd, H Apthorp, and A Butler-Manuel. “HYDROXY-APATITE TOTAL HIP REPLACEMENT: 4–5 YEAR REVIEW OF A PROSPECTIVE RANDOMISED TRIAL COMPARING PARTIAL AND FULLY COATED STEMS.” Orthopaedic Proceedings 85-B, no. SUPP_I (2003): 62-63. https://doi.org/10.1302/0301-620X.85BSUPP_I.0850062e

Hussein R, Smith A, Shepperd J, Apthorp H, Butler-Manuel A. HYDROXY-APATITE TOTAL HIP REPLACEMENT: 4–5 YEAR REVIEW OF A PROSPECTIVE RANDOMISED TRIAL COMPARING PARTIAL AND FULLY COATED STEMS. Orthop Procs. 2003 Jan 1;85-B(SUPP_I):62-63. https://doi.org/10.1302/0301-620X.85BSUPP_I.0850062e

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Abstract

Aim of the study: To determine the optimum hydroxy-apatite-coating pattern of the femoral component in cementless hip arthroplasty.

Methods: Between January 1996 and May 1997, the first 65 patients (73 hips) of a single center prospective trial were randomised to receive a proximally coated Osteonics or a fully coated JRI Furlong stem. 30 Osteonics and 43 JRI stems were implanted. Clinical assessment was carried out using the modified Merle D’Aubigne and Postel (MDP) scoring system and the visual analogue scale (VAS). Radiological evaluation included measurement of subsidence, bone resorbtion, pedestal formation and implant-bone interface assessment. All live patients were reviewed. The average follow up was 50.3 months in the JRI group and 51.8 months in the Osteonics group.

Results: There were eight intra-operative femoral and one medial acetabullar wall fractures in the JRI group. In the Osteonics group there was one intra operative femoral fracture. There was one cup revision in both groups for aseptic loosening and one excision arthroplasty in the JRI group for sepsis. Clinical evaluation revealed a mean MDP of 16.3 (8–18) and a mean VAS of 0.55 (0–7) for the JRI group. The mean MDP for the Osteonics group was 16.31 (8–18) and the mean VAS 0.62 (0–4). Radiological evaluation revealed resorbtion in zone 7A in 16 of the JRI hips and 5 of the Osteonics. There was a reactive line around the distal part of the Osteonics stem in 17 patients, which was not correlated with symptoms. Subsidence rates were limited and comparable.

Conclusion: Both hips performed well. There was no difference in revision rate for loosening (p> 0.84). Clinical evaluation showed no significant difference in outcome between the prostheses (p> 0.83 for MDP & VAS). Radiology revealed different patterns, which did not represent a clinical importance at this stage.

These abstracts were prepared by Mr Peter Kay. Correspondence should be addressed to him at The Hip Centre, Wrightington Hospital, Appley Bridge, Wigan, Lancashire WN6 9EP.