16 Year Review of Hydroxyapatite Ceramic Coated Hip Implants - A Clinical and Histological Evaluation
Traditionally implants for hip arthroplasty are secured with bone cement. Problems have been encountered with cement fixation with loosening and osteolysis attributed to the reaction to particulate cement material and also polyethylene debris from wear. Cementing techniques have been improved and the Swedish Hip Register  demonstrates that the revision rates have been reduced with improved cementing techniques. However, uncemented hip arthroplasty is now having a revival. In particular, bioactive materials are being used and this paper presents the results of a consecutive series of hip arthroplasties carried out over a total period of just 16 years. All the patients are included, including primary and revision hip arthroplasty. Patients are assessed using the Harris Hip Score . 13% of the hips scored less than 80 on the Harris Hip Score but only 9.4% scored poor pain scores. These represent the results of poor hip arthroplasty, of which an even smaller percentage are related to failed HA hip arthroplasty.
Panjian Li, Kai Zhang and Clifford W. Colwell, Jr.
J. M. Buchanan "16 Year Review of Hydroxyapatite Ceramic Coated Hip Implants - A Clinical and Histological Evaluation ", Key Engineering Materials, Vols. 284-286, pp. 1049-1052, 2005