Tissue reactions around a hydroxyapatite-coated hip prosthesis: Case report of a retrieved specimen |
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| Institution: | 1. Indian Institute of Technology (IIT), Kharagpur, India;2. Washington State University, Pullman, WA, United States;1. School of Mechanical Engineering and Automation, Northeastern University, Shenyang 110819, People''s Republic of China;2. School of Mechanical Engineering, Xinjiang Institute of Engineering, Urumchi 830023, People''s Republic of China;3. School of Materials Science and Engineering, Shenyang Ligong University, Shenyang 110159, People''s Republic of China;4. School of Mechanical Engineering, Henan University of Technology, Zhengzhou 450001, People''s Republic of China;1. Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden;2. Department of Oncology and Pathology, Division of Clinical Cancer Epidemiology, Karolinska Institutet, Stockholm, Sweden;3. Department of Urology, Skåne University Hospital, Lund University, Lund, Sweden;4. Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden;5. Department of Molecular Medicine and Surgery, Section of Urology, Karolinska Institutet, Stockholm, Sweden;6. Faculty of Nursing, University of Iceland, Reykjavik, Iceland;7. Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden;8. UroClinic, Stockholm, Sweden;9. Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden |
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| Abstract: | Bone reactions were studied around a titanium, hydroxyapatite (HA)-coated Osteonics (Allendale, NJ) bipolar hip prosthesis, which was revised for severe midthigh pain 4 years after implantation. Inspection of the retrieved prosthesis using a dissecting microscope revealed scarce remnants of a coating-like material on the surface of the prosthesis; however, histology of this layer and histology of the bony side of the bone—HA interface failed to reveal any remnants of an HA coating. The interface was covered predominantly by trabecular bone, which closely followed the contour of the prosthesis, and was partly woven nonmineralized bone. At locations where mineralized bone faced the prosthesis, many small dark titanium wear particles were found. Similar particles were found in macrophages in the intertrabecular medullary space. Polyethylene wear particles were specifically located in macrophages in a soft tissue interface at more distal levels along the stem of the prosthesis. Although the observations presented in this case cannot be generalized, it clearly shows that the HA coating layer had completely disappeared after 4 years. More detailed retrieval studies and longer clinical follow-up studies are needed before a final evaluation of the behavior of HA coatings and long-term fixation of HA-coated prostheses can be made. |
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