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The Journal of Bone and Joint Surgery (American) 85:1682-1688 (2003)
© 2003 The Journal of Bone and Joint Surgery, Inc.

Scientific Article

Comparison of Porous-Coated Titanium Femoral Stems with and without Hydroxyapatite Coating

Young-Hoo Kim, MD, Jun-Shik Kim, MD, Seung-Hwan Oh, MD and Ju-Moon Kim, MD

Investigation performed at The Joint Replacement Center of Korea, Seoul, Korea

Young-Hoo Kim, MD
Jun-Shik Kim, MD
Seung-Hwan Oh, MD
Ju-Moon Kim, MD
The Joint Replacement Center of Korea, 627-3, JaYang1-Dong, KwangJin-Gu, Seoul 143-191, Korea. E-mail address for Y.-H. Kim: younghookim{at}netsgo.com

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. One or more of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity (DePuy Johnson and Johnson International, Leeds, United Kingdom). No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Background: The purpose of this prospective, randomized study was to evaluate the clinical and radiographic results associated with proximally porous-coated titanium stems that were identical in geometry but differed with regard to proximal surface treatment (with or without hydroxyapatite coating).

Methods: A prospective, randomized study was performed to evaluate fifty patients (100 hips) who had undergone sequential bilateral primary total hip replacement. A proximally porous-coated titanium stem with hydroxyapatite coating was implanted on one side and a proximally porous-coated titanium stem without hydroxyapatite coating was implanted on the other side during the same operative setting in all fifty patients. A cementless acetabular component made of titanium was used in all hips. There were thirty-six men and fourteen women; the mean age at the time of the operation was 45.3 years. The mean duration of follow-up was 6.6 years. Clinical and radiographic evaluations were performed preoperatively; at six weeks; at three, six, and twelve months; and yearly thereafter.

Results: The Harris hip scores in the hydroxyapatite-coated group (mean, 94 points) and non-hydroxyapatite-coated group (mean, 92 points) were similar at the final follow-up examination. The prevalence of transient pain in the thigh was 4% in each group. No acetabular or femoral component demonstrated aseptic loosening. Bone-remodeling patterns, including calcar atrophy, were similar in the two groups. No acetabular or femoral osteolysis was seen.

Conclusions: At a mean of 6.6 years postoperatively, the clinical and radiographic results associated with proximally porous-coated femoral prostheses with identical geometries that differed only with regard to the presence or absence of hydroxyapatite coating were similar.

Level of Evidence: Therapeutic study, Level I-1b (randomized controlled trial [no significant difference but narrow confidence intervals]). See Instructions to Authors for a complete description of levels of evidence.


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