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Related Experiment Videos

HA-coated screws decrease the incidence of fixation failure in osteoporotic trochanteric fractures.

Antonio Moroni1, Cesare Faldini, Francesco Pegreffi

  • 1Department of Orthopaedic Surgery, Bologna University, Rizzoli Orthopaedic Institute, Via G.C. Pupilli 1, 40136 Bologna, Italy. a.moroni@ior.it

Clinical Orthopaedics and Related Research
|August 5, 2004
PubMed
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Hydroxyapatite (HA)-coated screws for dynamic hip screw fixation in elderly patients with trochanteric fractures and osteoporosis showed improved outcomes. This method reduced lag screw cutout and improved hip function scores compared to standard screws.

Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science
  • Geriatric Medicine

Background:

  • Trochanteric fractures are common in elderly patients with osteoporosis.
  • Standard dynamic hip screw fixation can lead to complications like screw cutout.
  • Osteoporotic bone presents challenges for implant fixation.

Purpose of the Study:

  • To evaluate the efficacy of hydroxyapatite (HA)-coated screws in dynamic hip screw fixation for trochanteric fractures.
  • To compare outcomes between HA-coated screws and standard AO/ASIF screws in osteoporotic bone.

Main Methods:

  • A randomized controlled trial involving 120 elderly patients with AO, A1, or A2 trochanteric fractures.
  • Patients were assigned to receive dynamic hip screws with either standard AO/ASIF screws (Group A) or HA-coated AO/ASIF screws (Group B).

Related Experiment Videos

  • Outcomes assessed included lag screw cutout, femoral neck shaft angle, and Harris hip score at 6 months.

    • Main Results:

    • Lag screw cutout occurred in 4 patients in Group A, with no instances in Group B.
    • Femoral neck shaft angle remained more stable in Group B (133 +/- 7 degrees) compared to Group A (127 +/- 12 degrees) at 6 months.
    • The Harris hip score was significantly higher in Group B (71 +/- 18) than in Group A (60 +/- 25) at 6 months.

    Conclusions:

    • HA-coated lag screws provide superior fixation in dynamic hip screw procedures for osteoporotic trochanteric fractures.
    • This leads to reduced complications and improved functional outcomes in elderly patients.
    • Hydroxyapatite coating is recommended for enhanced screw fixation in challenging bone conditions.