André Ferreira1, Thierry Aslanian2, Thibaud Dalin3, Jean Picaud4. 1. Clinique du Parc-Lyon, 155 ter boulevard de Stalingrad, 69006, Lyon, France. a.ferreira@cliniqueduparclyon.com. 2. Groupe Lépine, Genay, France. 3. Anatomy Laboratory, Université Claude Bernard Lyon 1, Lyon, France. 4. Clinique Saint-Jean, Cagnes sur Mer, France.
Abstract
PURPOSE: Using a ceramic-ceramic bearings, cementless total hip arthroplasty (THA) has provided good clinical results. To ensure longevity a good quality fixation of the implants is mandatory. Different surface treatments had been used, with inconsistent results. We hypothesized that a "bilayer coating" applied to both THA components using validated technology will provide a long-lasting and reliable bone fixation. METHODS: We studied the survival and bone integration of a continuous, single-surgeon, retrospective series of 126 THA cases (116 patients) with an average follow-up of 12.2 years (minimum 10 years). The THA consisted of cementless implants with a bilayer coating of titanium and hydroxyapatite and used a ceramic-ceramic bearing. RESULTS: With surgical revision for any cause (except infection) as the end point, THA survival was 95.1 % at 13 years. Stem (98.8 %) and cup (98.6 %) survival was similar at 13 years. Bone integration was confirmed in 100 % of implants (Engh-Massin score of 17.42 and ARA score of 5.94). There were no instances of loosening. Revisions were performed because of instability (1.6 %), prosthetic impingement or material-related issues. CONCLUSION: A bilayer titanium and hydroxyapatite coating provides strong, fast, reliable osseo integration, without deterioration at the interface or release of damaging particles. The good clinical outcomes expected of ceramic bearings were achieved, as were equally reliable stem and cup fixation.
PURPOSE: Using a ceramic-ceramic bearings, cementless total hip arthroplasty (THA) has provided good clinical results. To ensure longevity a good quality fixation of the implants is mandatory. Different surface treatments had been used, with inconsistent results. We hypothesized that a "bilayer coating" applied to both THA components using validated technology will provide a long-lasting and reliable bone fixation. METHODS: We studied the survival and bone integration of a continuous, single-surgeon, retrospective series of 126 THA cases (116 patients) with an average follow-up of 12.2 years (minimum 10 years). The THA consisted of cementless implants with a bilayer coating of titanium and hydroxyapatite and used a ceramic-ceramic bearing. RESULTS: With surgical revision for any cause (except infection) as the end point, THA survival was 95.1 % at 13 years. Stem (98.8 %) and cup (98.6 %) survival was similar at 13 years. Bone integration was confirmed in 100 % of implants (Engh-Massin score of 17.42 and ARA score of 5.94). There were no instances of loosening. Revisions were performed because of instability (1.6 %), prosthetic impingement or material-related issues. CONCLUSION: A bilayer titanium and hydroxyapatite coating provides strong, fast, reliable osseo integration, without deterioration at the interface or release of damaging particles. The good clinical outcomes expected of ceramic bearings were achieved, as were equally reliable stem and cup fixation.
Entities:
Keywords:
Bilayer coating; Bone integration; Cementless fixation; Ceramic bearing; THA
Authors: Leigh Townsend; Richard L Williams; Olachi Anuforom; Matthew R Berwick; Fenella Halstead; Erik Hughes; Artemis Stamboulis; Beryl Oppenheim; Julie Gough; Liam Grover; Robert A H Scott; Mark Webber; Anna F A Peacock; Antonio Belli; Ann Logan; Felicity de Cogan Journal: J R Soc Interface Date: 2017-01 Impact factor: 4.118