Early migration characteristics of a hydroxyapatite-coated femoral stem: an RSA study

Abstract

Measurement of early stem subsidence can be used to predict the likelihood of long-term femoral component loosening and clinical failure. Data that examines the early migration pattern of clinically proven stems will provide clinicians with useful baseline data with which to compare new stem designs. This study was performed to evaluate the early migration pattern of a hydroxyapatite-coated press-fit femoral component that has been in use for over ten years. We enrolled 30 patients who underwent THA for osteoarthritis. The median age was 70 years (range, 55-80 years). Patients were clinically assessed using the Harris hip score. Radiostereometric analysis was used to evaluate stem migration at three to four days, six months, one year and two years. We observed a mean subsidence of 0.73 mm at six months, 0.62 mm at one year and 0.58 mm at two years and a mean retroversion of 1.82° at six months, 1.90° at one year and 1.59° at two years. This data suggests that subsidence is confined to the first six months after which there was no further subsidence. The results from this study can be compared with those from novel cementless stem designs to help predict the long-term outcome one may expect from new cementless stem designs.

Figures

Fig. 1

A postoperative radiograph showing the markers inserted into the femur (a) and attached to the stem (b)

Fig. 2

Mean stem subsidence (mm) after 6, 12 and 24 months. The ranges show the standard error of the mean

Fig. 3

Graph showing stem subsidence (mm) for individual patients after 6, 12 and 24 months

Fig. 4

Mean stem rotation (degrees) after 6, 12 and 24 months. The ranges show the standard error of the mean

Fig. 5

Graph showing stem rotation (degrees) for individual patients after 6, 12 and 24 months