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Journal of Bone and Joint Surgery - British Volume, Vol 85-B, Issue 3,
366-370.
doi: 10.1302/0301-620X.85B3.13054 Copyright © 2003 by British Editorial Society of Bone and Joint Surgery A femoral component with proximal HA coatingAN ANALYSIS OF SURVIVAL AND FIXATION AT UP TO TEN YEARSJ. A. Skinner, FRCS (Orth), Senior Lecturer and Honorary Consultant Orthopaedic SurgeonRoyal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK. P. O. Kroon, MD, Consultant Orthopaedic Surgeon Alingsas Hospital, Alingsas, Sweden. S. Todo, MD, Research Fellow Department of Orthopaedic Surgery, Osaka City University Medical School, Abeno-Ku, Asdahinachi, 1-4-3 Osaka, 545-8585, Japan. G. Scott, FRCS, Consultant Orthopaedic Surgeon The Royal London Hospital, Whitechapel Road, London E1 4DG, UK. Correspondence should be sent to Mr J. A. Skinner. We describe the survival at ten years of 100 femoral components of the Freeman hip prosthesis. It is proximally hydroxyapatite (HA)-coated and was fixed without cement. Radiological assessment identified radiolucent lines (RLLs) and lytic lesions and was used to measure migration. The criterion of failure was revision or impending revision for aseptic femoral loosening. No femoral components were revised or are awaiting revision for aseptic loosening, giving 100% survival at ten years (95% confidence interval, 95.7 to 100), although 59 were at risk at ten years. Two components were revised for fracture of a ceramic head with damage to the trunnion. Although well fixed in each, for survival analysis we evaluated the hip as if the patient had died. Twelve acetabular components were revised and at each operation the femoral component was found to be well fixed, was not disturbed and remained in the survival analysis. Three patients were lost to follow-up, and 12 died with well-functioning prostheses. Radiologically, all except one of the components appeared to be well fixed with no RLLs and no lytic lesions at the latest follow-up. The mean vertical migration was 0.4 mm at one year, 0.8 mm at two years and 1.4 mm at ten years. One component had migrated 7.6 mm at ten years (2.1 mm in year 1) and developed RLLs in Gruen zones I and II. The symptoms, however, were only minor and revision was not indicated. Our study has shown that proximal HA coating gives effective fixation for a femoral component. This article has been cited by other articles:
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