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Hydroxyapatite and hip arthroplasty: Lessons learned from 34 years of clinical experience

Published in N°013 - September / October 2021
Article viewed 20 times

Hydroxyapatite and hip arthroplasty: Lessons learned from 34 years of clinical experience

By Jean-Alain Epinette in category SYNTHESIS
Clinique Medico Chirurgicale 200 Rue D’Auvergne, 62700 Bruay-la-buissiere / [email protected]

Once described as ‘the third way’ between cemented implants and simple roughened surfaces, hydroxyapatite has built up an impressive clinical reputation over the past three decades compared to so-called ‘biological’ methods of fixation but is now facing competition from newer rough...

Introduction

Once described as ‘the third way’ between cemented implants and simple roughened surfaces, hydroxyapatite has built up an impressive clinical reputation over the past three decades compared to so-called ‘biological’ methods of fixation but is now facing competition from newer rough and even ‘ultra-rough’ surfaces thanks to particularly promising advances in additive manufacturing processes involving 3D printing.

Having now passed the 30-year-mark of clinical experience with these hydroxyapatite (HA) coatings for hip replacements, we felt the need to conduct a comprehensive review of this method of fixation based on experimental, histological and paraclinical data gathered from what is already a long track record, addressing the usual arguments and controversies often discussed during our scientific meetings and conferences. This article tackles the fundamental issue of whether clinical outcomes are long lasting, using a series of 273 primary implants with a clinical follow-up of 20–34 years in young and active subjects aged 50 or under. The final chapter discusses the future of bioactive coatings in the form of new so-called ‘ultra-porous’ materials and their potential role for fixing hip implants in the future.

1. The benefits of hydroxyapatite

Calcium...

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