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. 2015:2015:386461.
doi: 10.1155/2015/386461. Epub 2015 Feb 23.

Cementless hydroxyapatite coated hip prostheses

Antonio Herrera  1 , Jesús Mateo  2 , Jorge Gil-Albarova  2 , Antonio Lobo-Escolar  3 , Elena Ibarz  4 , Sergio Gabarre  4 , Yolanda Más  4 , Luis Gracia  4
Affiliations

Cementless hydroxyapatite coated hip prostheses

Antonio Herrera et al. Biomed Res Int. 2015.

Abstract

More than twenty years ago, hydroxyapatite (HA), calcium phosphate ceramics, was introduced as a coating for cementless hip prostheses. The choice of this ceramic is due to its composition being similar to organic apatite bone crystals. This ceramic is biocompatible, bioactive, and osteoconductive. These qualities facilitate the primary stability and osseointegration of implants. Our surgical experience includes the implantation of more than 4,000 cementless hydroxyapatite coated hip prostheses since 1990. The models implanted are coated with HA in the acetabulum and in the metaphyseal area of the stem. The results corresponding to survival and stability of implants were very satisfactory in the long-term. From our experience, HA-coated hip implants are a reliable alternative which can achieve long term survival, provided that certain requirements are met: good design selection, sound choice of bearing surfaces based on patient life expectancy, meticulous surgical technique, and indications based on adequate bone quality.

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Figures

Figure 1
Figure 1
(a) ABG-I stem and acetabular cups; (b) ABG-II stem and acetabular cup.
Figure 2
Figure 2
X-ray image of patient with follow-up at 12 y. Osteolysis in acetabulum produced by excessive polyethylene wear.
Figure 3
Figure 3
Computed tomography of the same case in Figure 2. Osteolysis in acetabulum.
Figure 4
Figure 4
X-ray control of patient in Figures 2 and 3, after 4 y follow-up, after changing polyethylene and fulfilling with bone graft the acetabulum osteolysis. No change of original implant.
Figure 5
Figure 5
Same case as in Figures 2, 3, and 4. X-ray control image in 2013, after 8 y. follow-up of second surgery with original implant since 1993.
Figure 6
Figure 6
Evolution of bone mass density for ABG I (blue) and ABG II (red), corresponding to five-year follow-up, in the Gruen zones.
Figure 7
Figure 7
X-ray image of patient with follow-up at 12 y. Excessive polyethylene wear. Osteolysis in metaphyseal of femur.
Figure 8
Figure 8
Same case as in Figure 7, after changing polyethylene and fulfilling with bone graft and femoral mesh. No change of original implant. Control at 20 y. of primary surgery.
Figure 9
Figure 9
Maximum and minimum principal stress flow in the models with prosthesis (from a FE simulation).
Figure 10
Figure 10
X-ray image of oversized stem in right femur with cancellous bone densification in support area (zone A) and bone resorption (zone B).
See this image and copyright information in PMC

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