Radiographic Analysis of Bone Remodeling around Hydroxyapatite Coated Femoral Stems

Abstract

The study presented in the current paper was designed to investigate periprosthetic bone remodeling associated with two cementless HA coated stem models, ABG-II (Stryker) and Corail (DePuy), randomly implanted in 40 active patients at Colentina Clinical Hospital,Romania. Anteroposterior with neutral rotation and Lequesne profile radiographs of both hips were taken and several data were recorded: acetabular angle, rotation center of the hip, rotation center height with respect to the greater trochanter tip, femoral cortical thickness, cortico-medullary index at three areas (lesser trochanter (LT), 8 and 12 mm distal to LT), and osteoporosis severity according to the Singh index. The presence of osteolytic lesions in the proximal femur was assessed according to the scale proposed by Goetz in the radiographs obtained at the end of the follow-up (1 to 5 years). The radiological results showed that all stems were stable, and no evolutive radiolucent lines have been observed. We also have noticed minimal remodelling changes in 7 hips (36.61%), with minor cancellous bone densification mainly in zones 2 and 6, without cortical hypertrophy or osteoporosis. A decreased bone density in zones 1 and 7, secondary to stress-shielding, has been evident in 5 hips. Stem subsidence has been similar to that reported in literature with other hydroxyapatite coated designs.