Fifteen Years of Clinical Experience with Hydroxyapatite Coatings in Joint Arthroplasty

This book presents an up-to-date summary of studies with hydroxyapatite-coated implants and describes the "state of the art" of hydroxyapatite coatings in orthopaedics as this stands at the close of 2002. The book covers issues from fundamental research to the clinical results obtained with HA-coated hip and knee replacements in patient populations. With host response data of about fifteen years available now in the hip, and twelve years follow-up available in the knee, the time was right to ask various investigators worldwide to report the current clinical results with their hydroxyapatite-coated implants of choice, and then to collect these manuscripts into a single volume. From around the world, some ninety scientists - surgeons, biophysicists, histologists, and bioengineers - contributed their results to this volume. The 50 or so papers printed in the book were organized into the following sections. Section I introduces the development and role of calcium phosphates from prehistory to present. Section II discusses basic science, such as histology and experimental works. Section III focuses on bioactive coatings, and clinical works, Section IV on clinical experiences in primary hips at a minimum of ten years, and Section V on hip revision surgery. Section VI presents clinical experience with HA knees at a minimum of 10 years, and Section VII presents a clinical overview, discussing outcomes in hydroxyapatite-coated arthroplasty and addressing frequently asked questions relating to hydroxyapatite and HA-coated implants. This compilation of results will surely help to answer the question of whether the favorable results achieved in the short term with this method of biologic fixation of total joint implants has withstood the test of time. The goal of the current book was mainly to determine if the use of hydroxyapatite coatings for the fixation of orthopaedic implants to bone, so fascinating to us in the late 1980s, has been proven by the survivorship and satisfaction of those patients receiving hip and knee implants of the various designs described herein. May this Monograph be of value to orthopaedic surgeons who are interested in joint replacement. We trust it will allow them to form their own educated opinion about the utility of hydroxyapatite coatings for implant fixation.