Hydroxyapatite-coated tapered cementless femoral components in total hip arthroplasty

Tapered cementless femoral fixation provides a reliable option for routine primary total hip arthroplasty (THA). The use of hydroxyapatite (HA)-coated stems is increasing as a result of mounting evidence that HA may improve the reliability of bone osseointegration and improve overall THA outcomes. These trends are based on a growing body of literature that supports both the theoretical and clinical rationale of this approach. There is solid clinical evidence that the combination of tapered geometry with an HA coating increases the likelihood of reliable femoral fixation. A comprehensive review of this literature evaluating the clinical use of cementless femoral components that use an HA coating is presented, and reveals that HA-coated stems have significantly improved proximal femoral fixation with less stress shielding and superior osseous remodeling. Although these advantages have not been shown to significantly increase long-term durability, there is sufficient data to support the routine use of HA-coated, tapered cementless femoral stems in THA.