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Journal of Bone and Joint Surgery - British Volume, Vol 84-B, Issue 3, 387-391.
doi: 10.1302/0301-620X.84B3.12388  
Copyright © 2002 by British Editorial Society of Bone and Joint Surgery
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Hydroxyapatite coating improves fixation of pedicle screws

A CLINICAL STUDY

B. Sandén, MD, PhD1; C. Olerud, MD, PhD1; M. Petrén-Mallmin, MD, PhD2; and S. Larsson, MD, PhD1

1 Department of Orthopaedic Surgery
2 Department of Radiology, Uppsala University Hospital, SE-751 85 Uppsala, Sweden.

Correspondence should be sent to Dr B. Sandén.

We investigated the effects of hydroxyapatite (HA) coating on the purchase of pedicle screws. A total of 23 consecutive patients undergoing lumbar fusion was randomly assigned to one of three treatment groups. The first received uncoated stainless-steel screws, the second screws which were partly coated with HA, and the third screws which were fully coated. The insertion torque was recorded. After 11 to 16 months, 21 screws had been extracted. The extraction torque was recorded. Radiographs were taken to assess fusion and to detect loosening of the screws.

At removal, the extraction torques exceeded the upper limit of the torque wrench (600 Ncm) for many HA-coated screws. The calculated mean extraction torque was 29 ± 36 Ncm for the uncoated group, 447 ± 114 Ncm for the partly-coated group and 574 ± 52 Ncm for the fully-coated group. There were significant differences between all three groups (p < 0.001). There were more radiolucent zones surrounding the uncoated screws than the HA-coated screws (p < 0.001). HA coating of pedicle screws resulted in improved fixation with reduced risk of loosening of the screws.




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J. A. N. Shepperd and H. Apthorp
A contemporary snapshot of the use of hydroxyapatite coating in orthopaedic surgery
J Bone Joint Surg Br, August 1, 2005; 87-B(8): 1046 - 1049.
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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General