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International Orthopaedics

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17-11-2022 | Hip-TEP | Original Paper

Effect of femoral stem surface coating on clinical and radiographic outcomes of cementless primary total hip arthroplasty: a patient-matched retrospective study

Authors: Maria-Roxana Viamont-Guerra, Sonia Ramos-Pascual, Mo Saffarini, José Sales, Frederic Laude

Published in: International Orthopaedics | Issue 1/2023

Abstract

Purpose

This study aims to determine whether changing the stem coating grants superior outcomes at a minimum follow-up of five years.

Methods

Retrospective review of a consecutive series of primary total hip arthroplasties (THAs) operated by direct anterior approach between 01/01/2013 and 31/12/2014. Two stems were compared, which were identical except for their surface coating; “the Original stem” was fully coated with hydroxyapatite (HA), while “the ProxCoat stem” was proximally coated with plasma-sprayed titanium and HA. Matching was performed. Clinical assessment included modified Harris hip score (mHHS), Oxford hip score (OHS), and forgotten joint score (FJS). Radiographic assessment evaluated alignment, subsidence, pedestal formation, heterotopic ossification, radiolucent lines ≥ 2 mm, spot welds, cortical hypertrophy, and osteolysis.

Results

232 hips received the Original stem and 167 the ProxCoat stem, from which respectively five hips (2.2%) and no hips (0%) underwent revision. Matching identified two groups of 91 patients, with comparable patient demographics. At > five years follow-up, there were no differences in OHS (16 ± 6 vs 15 ± 5; p = 0.075) nor FJS (81 ± 26 vs 84 ± 22; p = 0.521), but there were differences in mHHS (89 ± 15 vs 92 ± 12; p = 0.042). There were no differences in alignment, subsidence, pedestal formation, heterotopic ossification, cortical hypertrophy, and osteolysis. There were differences in prevalence of proximal radiolucent lines (12% vs 0%; p < 0.001) and distal spot welds (24% vs 54%; p < 0.001).

Conclusion

At a minimum follow-up of five years, this study on matched patients undergoing primary THA found that ProxCoat stems results in significantly fewer radiolucent lines, more spot welds, and less revisions than Original stems, thus suggesting better bone ingrowth.

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Title: Effect of femoral stem surface coating on clinical and radiographic outcomes of cementless primary total hip arthroplasty: a patient-matched retrospective study
Authors: Maria-Roxana Viamont-Guerra
Sonia Ramos-Pascual
Mo Saffarini
José Sales
Frederic Laude
Publication date: 17-11-2022
Publisher: Springer Berlin Heidelberg
Keywords: Hip-TEP
Hip-TEP
Published in: International Orthopaedics / Issue 1/2023
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-022-05629-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Effect of femoral stem surface coating on clinical and radiographic outcomes of cementless primary total hip arthroplasty: a patient-matched retrospective study

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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