Hydroxyapatite-coated total knee replacement: clinical experience at 10 to 15 years

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Medical Engineering

Background:

• Total knee replacement (TKR) is a common procedure for end-stage knee osteoarthritis.
• Achieving durable and stable fixation of implants to bone is crucial for long-term TKR success.
• Hydroxyapatite (HA) coatings are utilized to enhance bone integration with orthopedic implants.

Purpose of the Study:

• To evaluate the clinical and radiological outcomes of primary total knee replacements with hydroxyapatite coating.
• To assess the long-term survival and failure rates of HA-coated TKR implants.
• To investigate the bone-implant interface characteristics over time.

Main Methods:

• Retrospective analysis of 146 primary total knee replacements with HA coating.
• Clinical and radiological assessment of 74 knees in 68 patients at a mean follow-up of 11.2 years.
• Evaluation of failure rates and survival analysis using mechanical failure as the endpoint.

Main Results:

• A global failure rate of 1.37% was observed.
• The survival rate, considering mechanical failure, was 98.14%.
• Radiological assessment revealed intimate bone-HA coating contact and progressive filling of interface gaps over time.

Conclusions:

• Hydroxyapatite coating demonstrates reliable fixation in primary total knee replacement.
• HA coating promotes favorable bone integration and long-term implant stability.
• Results compare favorably to cemented and porous-coated TKR systems.