Hydroxyapatite-coated acetabular components -: Histological and histomorphometric analysis of six cups retrieved at autopsy between three and seven years after successful implantation

被引:56
作者
Tonino, A [1 ]
Oosterbos, C [1 ]
Rahmy, A [1 ]
Thèrin, M [1 ]
Doyle, C [1 ]
机构
[1] De Wever Hosp, Dept Orthopaed, NL-6401 CX Heerlen, Netherlands
关键词
D O I
10.2106/00004623-200106000-00002
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: Important questions remain regarding the use of hydroxyapatite-coated acetabular components in total hip arthroplasty. What is the relation of resorption of the hydroxyapatite coating to enduring fixation? Will unresorbed or dislodged hydroxyapatite particles cause adverse tissue reactions? Retrieval studies of clinically well-functioning acetabular components should help to answer these questions. Methods: We examined six clinically successful hydroxyapatite-coated cementless acetabular components that were retrieved at autopsy between 3.3 and 6.6 years after implantation. Ail components were of the same design. The prostheses and the surrounding bone were prepared for qualitative histological and quantitative histomorphometric analysis. The percentage of bone growth onto the implant, the relative bone area around the implant, the extent of residual hydroxyapatite coating, and the coating thickness were measured. Results: All of the cups showed bone ongrowth, with a mean bone-implant contact land standard deviation) of 36.5% +/- 13.5%. The contact area was the same in all three zones delineated by DeLee and Charnley. The extent and thickness of the hydroxyapatite layer were much reduced in the specimens from older patients and in those associated with a longer duration of implantation. Degradation of the hydroxyapatite coating by osteoclasts was observed. We did not observe loose hydroxyapatite granules far from the coating, nor did we note any adverse tissue reaction: to these granules. In contrast, polyethylene debris was noted in approximately half of the empty Conclusions: Cell-mediated hydroxyapatite resorption seems to be the main reason for loss of hydroxyapatite coating. The area of bone ongrowth was within a certain range (20% to 50%) of the measured surfaces, and it was independent of the amount of hydroxyapatite residue. The hydroxyapatite coating showed a slow rate of resorption with time, without any adverse tissue reactions.
引用
收藏
页码:817 / 825
页数:9
相关论文
共 36 条
[31]   HYDROXYAPATITE COATING ENHANCES FIXATION OF POROUS COATED IMPLANTS - A COMPARISON IN DOGS BETWEEN PRESS FIT AND NONINTERFERENCE FIT [J].
SOBALLE, K ;
HANSEN, ES ;
BROCKSTEDTRASMUSSEN, H ;
PEDERSEN, CM ;
BUNGER, C .
ACTA ORTHOPAEDICA SCANDINAVICA, 1990, 61 (04) :299-306
[32]   HISTOLOGY OF POROUS-COATED ACETABULAR COMPONENTS - 25 CEMENTLESS CUPS RETRIEVED AFTER ARTHROPLASTY [J].
SUMNER, DR ;
JASTY, M ;
JACOBS, JJ ;
URBAN, RM ;
BRAGDON, CR ;
HARRIS, WH ;
GALANTE, JO .
ACTA ORTHOPAEDICA SCANDINAVICA, 1993, 64 (06) :619-626
[33]   The hydroxyapatite-ABG hip system - 5-to 7-year results from an international multicentre study [J].
Tonino, AJ ;
Rahmy, AIA .
JOURNAL OF ARTHROPLASTY, 2000, 15 (03) :274-282
[34]   Hydroxyapatite-coated femoral stems -: Histology and histomorphometry around five components retrieved at post mortem [J].
Tonino, AJ ;
Thèrin, M ;
Doyle, C .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 1999, 81B (01) :148-154
[35]   THE SHEAR-STRENGTH AND THE FAILURE MODE OF PLASMA-SPRAYED HYDROXYAPATITE COATING TO BONE - THE EFFECT OF COATING THICKNESS [J].
WANG, BC ;
LEE, TM ;
CHANG, E ;
YANG, CY .
JOURNAL OF BIOMEDICAL MATERIALS RESEARCH, 1993, 27 (10) :1315-1327
[36]   Mechanical and histological evaluations of cobalt-chromium alloy and hydroxyapatite plasma-sprayed coatings in bone [J].
Yang, CY ;
Wang, BC ;
Chang, WJ ;
Chang, E ;
Wu, JD .
JOURNAL OF MATERIALS SCIENCE-MATERIALS IN MEDICINE, 1996, 7 (03) :167-174