Does hydroxyapatite coating have no advantage over porous coating in primary total hip arthroplasty? A meta-analysis

Journal of Orthopaedic Surgery and Research

Shi-Gui Yan¹  Zhong-li Shi¹  Bin Hu¹  Ming-Min Shi¹  An Liu¹  Tiao Lin¹  Yun-Lin Chen¹ 

[1] Department of Orthopaedic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, No.88 Jiefang Road, Hangzhou 310009, P.R. China

关键词: Total hip arthroplasty;    Survival;    Harris hip score;    Porous;    Hydroxyapatite;   

Others  :  1133013
DOI  :  10.1186/s13018-015-0161-4

 received in 2014-07-07, accepted in 2015-01-08,  发布年份 2015

【 摘 要 】

There are some arguments between the use of hydroxyapatite and porous coating. Some studies have shown that there is no difference between these two coatings in total hip arthroplasty (THA), while several other studies have shown that hydroxyapatite has advantages over the porous one. We have collected the studies in Pubmed, MEDLINE, EMBASE, and the Cochrane library from the earliest possible years to present, with the search strategy of “(HA OR hydroxyapatite) AND ((total hip arthroplasty) OR (total hip replacement)) AND (RCT* OR randomiz* OR control* OR compar* OR trial*)”. The randomized controlled trials and comparative observation trials that evaluated the clinical and radiographic effects between hydroxyapatite coating and porous coating were included. Our main outcome measurements were Harris hip score (HHS) and survival, while the secondary outcome measurements were osteolysis, radiolucent lines, and polyethylene wear. Twelve RCTs and 9 comparative observation trials were included. Hydroxyapatite coating could improve the HHS (p < 0.01), reduce the incidence of thigh pain (p = 0.01), and reduce the incidence of femoral osteolysis (p = 0.01), but hydroxyapatite coating had no advantages on survival (p = 0.32), polyethylene wear (p = 0.08), and radiolucent lines (p = 0.78). Hydroxyapatite coating has shown to have an advantage over porous coating. The HHS and survival was duration-dependent—if given the sufficient duration of follow-up, hydroxyapatite coating would be better than porous coating for the survival. The properties of hydroxyapatite and the implant design had influence on thigh pain incidence, femoral osteolysis, and polyethylene wear. Thickness of 50 to 80 μm and purity larger than 90% increased the thigh pain incidence. Anatomic design had less polyethylene wear.

【 授权许可】

   
2015 Chen et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

Figure 5.

Figure 6.

Figure 7.

Figure 8.

【 参考文献 】

• [1]Prieto-Alhambra D, Javaid MK, Judge A, Maskell J, Kiran A, de Vries F, et al.: Fracture risk before and after total hip replacement in patients with osteoarthritis: potential benefits of bisphosphonate use. Arthritis Rheum. 2011, 63:992-1001.
• [2]Manley MT, D’Antonio JA, Capello WN, Edidin AA: Osteolysis: a disease of access to fixation interfaces. Clin Orthop. 2002, 405:129-37.
• [3]Kim YH, Park JW, Patel C, Kim DY: Polyethylene wear and osteolysis after cementless total hip arthroplasty with alumina-on-highly cross-linked polyethylene bearings in patients younger than thirty years of age. J Bone Joint Surg Am 2013, 95(12):1088-93.
• [4]Søballe K, Toksvig-Larsen S, Gelineck J, Fruensgaard S, Hansen ES, Ryd L, et al.: Migration of hydroxyapatite coated femoral prostheses. A Roentgen Stereophotogrammetric study. J Bone Joint Surg Br. 1993, 75(5):681-7.
• [5]D’Angelo F, Molina M, Riva G, Zatti G, Cherubino P: Failure of dual radius hydroxyapatite-coated acetabular cups. J Orthop Surg Res. 2008, 3:35. BioMed Central Full Text
• [6]Bloebaum RD, Beeks D, Dorr LD, Savory CG, DuPont JA, Hofmann AA: Complications with hydroxyapatite particulate separation in total hip arthroplasty. Clin Orthop. 1994, 298:19-26.
• [7]Geesink RGT, Hoefnagels NHM: Six year results of hydroxyapatite-coated total hip replacement. J Bone Joint Surg Br 1995, 77(4):534-47.
• [8]Park YS, Lee JY, Yun SH, Jung MW, Oh I: Comparison of hydroxyapatite- and porous-coated stems in total hip replacement. Acta Orthop Scand 2003, 74(3):259-63.
• [9]Parvizi J, Sharkey PF, Hozack WJ, Orzoco F, Bissett GA, Rothman RH: Prospective matched-pair analysis of hydroxyapatite-coated and uncoated femoral stems in total hip arthroplasty. A concise follow-up of a previous report. J Bone Joint Surg Am. 2004, 86-A(4):783-6.
• [10]Rothman RH, Hozack WJ, Ranawat A, Moriarty L: Hydroxyapatite-coated femoral stems. A matched-pair analysis of coated and uncoated implants. J Bone Joint Surg Am. 1996, 78(3):319-24.
• [11]Sharp RJ, O’Leary ST, Falworth M, Cole A, Jones J, Marshall RW: Analysis of the results of the C-Fit uncemented total hip arthroplasty in young patients with hydroxyapatite or porous coating of components. J Arthroplasty 2000, 15(5):627-34.
• [12]Lombardi AV Jr, Berend KR, Mallory TH: Hydroxyapatite-coated titanium porous plasma spray tapered stem: experience at 15 to 18 years. Clin Orthop Relat Res. 2006, 453:81.
• [13]Rasquinha VJ, Ranawat CS, Mauriello AJ Jr: Hydroxyapatite: catalyst or conjuror? J Arthroplasty. 2002, 17(Suppl 1):113-7.
• [14]Santori FS, Ghera S, Moriconi A, Montemurro G: Results of the anatomic cementless prosthesis with different types of hydroxyapatite coating. Orthopedics 2001, 24(12):1147-50.
• [15]Ciccotti MG, Rothman RH, Hozack WJ, Moriarty L: Clinical and roentgenographic evaluation of hydroxyapatite-augmented and nonaugmented porous total hip arthroplasty. J Arthroplasty 1994, 9(6):631-9.
• [16]Dorr LD, Wan Z, Song M, Ranawat A: Bilateral total hip arthroplasty comparing hydroxyapatite coating to porous-coated fixation. J Arthroplasty 1998, 13(7):729-36.
• [17]Gandhi R, Davey JR, Mahomed NN: Hydroxyapatite coated femoral stems in primary total hip arthroplasty: a meta-analysis. J Arthroplasty 2009, 24(1):38-42.
• [18]Goosen JH, Kums AJ, Kollen BJ, Verheyen CC: Porous-coated femoral components with or without hydroxyapatite in primary uncemented total hip arthroplasty: a systematic review of randomized controlled trials. Arch Orthop Trauma Surg 2009, 129(9):1165-9.
• [19]Furlan AD, Pennick V, Bombardier C, van Tulder M: Updated method guidelines for systematic reviews in the Cochrane Back Review Group. Spine. 2009, 34:1929-41.
• [20]Higgins JPT, Green S: Cochrane Collaboration. Cochrane handbook for systematic reviews of interventions. Wiley-Blackwell, Chichester, England and Hoboken NJ; 2008.
• [21]Rorabeck C: Tapered hydroxyapatite-coated press-fit stems: any added value? J Arthroplasty 2006, 21(4 Suppl 1):85-8.
• [22]Tanzer M, Kantor S, Rosenthall L, Bobyn JD: Femoral remodeling after porous-coated total hip arthroplasty with and without hydroxyapatite-tricalcium phosphate coating: a prospective randomized trial. J Arthroplasty 2001, 16(5):552-8.
• [23]Kim YH, Kim JS, Oh SH, Kim JM: Comparison of porous-coated titanium femoral stems with and without hydroxyapatite coating. J Bone Joint Surg Am 2003, 85-A(9):1682-8.
• [24]Kim YH, Kim JS, Joo JH, Park JW: Is hydroxyapatite coating necessary to improve survivorship of porous-coated titanium femoral stem? J Arthroplasty 2012, 27(4):559-63.
• [25]Jaffe WL, Scott DF: Rationale and clinical application of hydroxyapatite coatings in pressfit total hip arthroplasty. Semin Arthroplasty 1993, 4(3):159-66.
• [26]Geesink RG: Osteoconductive coatings for total joint arthroplasty. Clin Orthop Relat Res. 2002, 395:53-65.
• [27]Egger M, Davey Smith G, Schneider M, Minder C: Bias in meta-analysis detected by a simple, graphical test. BMJ 1997, 315(7109):629-34.
• [28]Camazzola D, Hammond T, Gandhi R, Davey JR: A randomized trial of hydroxyapatite-coated femoral stems in total hip arthroplasty: a 13-year follow-up. J Arthroplasty 2009, 24(1):33-7.
• [29]Yoon KS, Kim HJ, Lee JH, Kang SB, Seong NH, Koo KH: A randomized clinical trial of cementless femoral stems with and without hydroxyapatite tricalcium-phosphate coating. An 8- to 12-year follow-up study. J Arthroplasty 2007, 22(4):504-8.
• [30]Yee AJ, Kreder HK, Bookman I, Davey JR: A randomized trial of hydroxyapatite coated prosthesis in total hip arthroplasty. Clin Orthop Relat Res. 1999, 366:120-32.
• [31]Tanzer M, Gollish J, Leighton R, Orrell K, Giacchino A, Welsh P, et al.: The effect of adjuvant calcium phosphate coating on a porous-coated femoral stem. Clin Orthop Relat Res. 2004, 424:153-60.
• [32]Incavo SJ, Schnelder R, Elting J: The effect of surface coating of femoral prostheses implanted without cement: a 2- to 4-year follow-up study. Am J Orthop (Belle Mead, NJ) 1998, 27(5):355-61.
• [33]Lee JM, Lee CW: Comparison of hydroxyapatite-coated and non-hydroxyapatite-coated noncemented total hip arthroplasty in same patients. J Arthroplasty 2007, 22(7):1019-23.
• [34]Hamadouche M, Witvoet J, Porcher R, Meunier A, Sedel L, Nizard R: Hydroxyapatite-coated versus grit-blasted femoral stems, a prospective, randomised study using EBRA-FCA. J Bone Joint Surg Br 2001, 83(7):979-87.
• [35]Ranawat CS, Rasquinha VJ, Meftah M, Ranawat AS: The hydroxyapatite-tapered stem: any added value? Semin Arthroplasty. 2011, 22:75-8.
• [36]McPherson EJ, Dorr LD, Gruen TA, Saberi MT: Hydroxyapatite-coated proximal ingrowth femoral stems. A matched pair control study. Clin Orthop Relat Res 1995, 315:223-30.
• [37]Sanchez-Sotelo J, Lewallen DG, Harmsen WS, Harrington J, Cabanela ME: Comparison of wear and osteolysis in hip replacement using two different coatings of the femoral stem. Int Orthop 2004, 28(4):206-10.
• [38]Paulsen A, Pedersen AB, Johnsen SP, Riis A, Lucht U, Overgaard S: Effect of hydroxyapatite coating on risk of revision after primary total hip arthroplasty in younger patients: findings from the Danish Hip Arthroplasty Registry. Acta orthop 2007, 78(5):622-8.
• [39]Sano K, Ito K, Yamamoto K: Changes of bone mineral density after cementless total hip arthroplasty with two different stems. Int Orthop 2008, 32(2):167-72.
• [40]Brown TE, Larson B, Shen F, Moskal JT: Thigh pain after cementless total hip arthroplasty: evaluation and management. J Am Acad Orthop Surg 2002, 10(6):385-92.
• [41]Hernández CP, Nájera SO, Mesa RF, Pajares LM, Hernández HM: Hydroxyapatite-coated stems with metaphyseal and diaphyseal press-fit. Eleven-year follow-up results. Acta Orthop Belg. 2002, 68(1):24-32.
• [42]Joshi MG, Advani SG, Miller F, Santare MH: Analysis of a femoral hip prosthesis designed to reduce stress shielding. J Biomech 2000, 33(12):1655-62.
• [43]Dopico-González C, New AM, Browne M: Probabilistic finite element analysis of the uncemented hip replacement–effect of femur characteristics and implant design geometry. J Biomech 2010, 43(3):512-20.
• [44]Ando M, Imura S, Omori H, Okumura Y, Bo A, Baba H: Nonlinear three-dimensional finite element analysis of newly designed cementless total hip stems. Artif Organs 1999, 23(4):339-46.
• [45]Herrera A, Mateo J, Lobo-Escolar A, Panisello JJ, Ibarz E, Gracia L: Long-term outcomes of a new model of anatomical hydroxyapatite-coated hip prosthesis. J Arthroplasty 2013, 28(7):1160-6.
• [46]Cao CF, Zhou JJ, Pang JH, Chen XQ: A five-year clinical and radiographic follow-up of bipolar hip arthroplasty with insertion of a porous-coated anatomic femoral component without cement. Orthop Surg 2011, 3(2):88-94.
• [47]Coathup MJ, Blunn GW, Flynn N, Williams C, Thomas NP: A comparison of bone remodelling around hydroxyapatite-coated, porous-coated and grit-blasted hip replacements retrieved at post-mortem. J Bone Joint Surg Br 2001, 83(1):118-23.