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Abstract
Background and purpose Hydroxyapatite (HA) coating is believed to improve bone-implant ingrowth and long-term survival of prostheses. Recent studies, however, have challenged this view. Furthermore, HA particles may produce third-body wear and initiate aseptic loosening of implants. We report the performance of HA- and porous-coated acetabular cups in a prospective randomized trial.
Methods This was an 8-year follow-up study of our previously published prospective randomized study to compare clinical outcomes, survival, periprosthetic bone mineral density, migration, and wear rates of HA- and porous-coated acetabular cups. Dual X-ray absorptiometry (DXA) and Ein Bild Roentgen Analyse (EBRA) measurements were used. 100 patients who underwent unilateral cementless total hip arthroplasty were randomized to either porous-coated cups or HA-coated cups. Patients were examined preoperatively and at 3, 6, and 9 months, and also 1, 3, and 8 years after surgery. 81 patients were available for 8-year follow-up, 40 with porous-coated cups and 41 with HA-coated cups.
Results Age, sex, bone mineral density, and clinical results (Harris hip score) were similar in the 2 groups. The survival, wear, and migration patterns of the cups were also similar in both groups. The results of periprosthetic bone mineral density scans in region of interest 2 was in favor of the porous-coated cups, but there were no differences between the 2 groups in all the remaining regions of interest.
Interpretation HA coating had no statistically significant effect on clinical results, survival, wear, or migration at the 8-year follow-up.
KV, KS, PTN, and MBL designed the study. KV and MBL gathered the data. KV reviewed all the patients, MBL did the EBRA analysis, and KV and MBL performed all the statistical analyses and interpretation of data. All the authors were involved in writing of the manuscript.
We thank nurse Ulla Hornum for her great help in managing patient contacts and outpatient clinic visits, and statistician Maria Rodrigo Domingo for statistical analysis and consultations. The previous study (Laursen et al. Citation2007) was supported by Zimmer Scandinavia, which produced Trilogy Calcicoat prostheses.
No competing interests declared.