TY - JOUR

T1 - Higher early proximal migration of hemispherical cups with electrochemically applied hydroxyapatite (BoneMaster) on a porous surface compared with porous surface alone

T2 - a randomized RSA study with 53 patients

AU - Jørgensen, Peter Bo

AU - Daugaard, Henrik

AU - Jakobsen, Stig Storgaard

AU - Lamm, Martin

AU - Søballe, Kjeld

AU - Stilling, Maiken

N1 - Publisher Copyright: © 2019, © 2019 The Author(s). Published by Taylor & Francis on behalf of the Nordic Orthopedic Federation. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.

PY - 2020/1/2

Y1 - 2020/1/2

N2 - Background and purpose — BoneMaster (BM) is an electrochemically deposited hydroxyapatite (HA) implant-coating, which is evenly distributed, thin, and quickly resorbed. It is designed to stimulate osseointegration and early implant stability and alleviate longer-term HA-induced third-body polyethylene wear. This study evaluates early cup migration and functional outcomes of cementless porous-coated hemispherical cups with or without BM. Patients and methods — In a patient-blinded, randomized, controlled trial 53 patients at mean 64 years (55–75) with coxarthritis were operated with an Exceed cup (Zimmer Biomet) and Bi-Metric stem (Zimmer Biomet) with porous and BM coating (PBM) or with porous coating alone (P). Follow-ups were performed postoperatively and at 3, 6, 12, and 24 months. Effect measures were cup migration measured with RSA and PROMs. Results — At 6-month follow-up, proximal cup migration in the PBM group (0.09 mm, 95% CI 0.02–0.20) was higher than in the P group (0.25 mm, CI 0.15–0.35). At 1- and 2-year follow-up, cup migration in all 6 degrees of freedom was similar between groups (p > 0.2). From before surgery to 2-year follow-up, Oxford Hip Score (OHS) increased by 17 points (CI 14–20). Hip disability and Osteoarthritis Outcome Score (HOOS) increased in all sub-scores, but was more pronounced for PBM cups compared with P cups in the Symptoms sub-score (p = 0.04). Interpretation — Contrary to expectations, PBM cups had higher early migration than P cups. At 2-year follow-up, migration was similar between groups. There seems to be no early benefit of BM coating on acetabular cups.

AB - Background and purpose — BoneMaster (BM) is an electrochemically deposited hydroxyapatite (HA) implant-coating, which is evenly distributed, thin, and quickly resorbed. It is designed to stimulate osseointegration and early implant stability and alleviate longer-term HA-induced third-body polyethylene wear. This study evaluates early cup migration and functional outcomes of cementless porous-coated hemispherical cups with or without BM. Patients and methods — In a patient-blinded, randomized, controlled trial 53 patients at mean 64 years (55–75) with coxarthritis were operated with an Exceed cup (Zimmer Biomet) and Bi-Metric stem (Zimmer Biomet) with porous and BM coating (PBM) or with porous coating alone (P). Follow-ups were performed postoperatively and at 3, 6, 12, and 24 months. Effect measures were cup migration measured with RSA and PROMs. Results — At 6-month follow-up, proximal cup migration in the PBM group (0.09 mm, 95% CI 0.02–0.20) was higher than in the P group (0.25 mm, CI 0.15–0.35). At 1- and 2-year follow-up, cup migration in all 6 degrees of freedom was similar between groups (p > 0.2). From before surgery to 2-year follow-up, Oxford Hip Score (OHS) increased by 17 points (CI 14–20). Hip disability and Osteoarthritis Outcome Score (HOOS) increased in all sub-scores, but was more pronounced for PBM cups compared with P cups in the Symptoms sub-score (p = 0.04). Interpretation — Contrary to expectations, PBM cups had higher early migration than P cups. At 2-year follow-up, migration was similar between groups. There seems to be no early benefit of BM coating on acetabular cups.

UR - http://www.scopus.com/inward/record.url?scp=85074969373&partnerID=8YFLogxK

U2 - 10.1080/17453674.2019.1687860

DO - 10.1080/17453674.2019.1687860

M3 - Journal article

C2 - 31698977

AN - SCOPUS:85074969373

VL - 91

SP - 26

EP - 32

JO - Acta Orthopaedica

JF - Acta Orthopaedica

SN - 1745-3674

IS - 1

ER -