Early migration patterns of calcium phosphate versus hydroxyapatite-coated stem in uncemented total hip arthroplasty: a prospective randomized clinical trial using radiostereometric analysis

Abstract Background and purpose The design and coating of uncemented joint implants impact bone ingrowth and thereby the stability of the implant. This prospective randomized clinical trial aimed to compare early migration of two uncemented, similarly shaped femoral stems with either calcium phospha...

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Main Authors: Emelie S. Kristoffersson, Daniel Wästerlund, Anette Nyberg, Sead Crnalic, Kjell G. Nilsson, Volker Otten
Format: Article
Language:English
Published: BMC 2025-08-01
Series:Arthroplasty
Subjects:
Online Access:https://doi.org/10.1186/s42836-025-00324-z
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author Emelie S. Kristoffersson
Daniel Wästerlund
Anette Nyberg
Sead Crnalic
Kjell G. Nilsson
Volker Otten
author_facet Emelie S. Kristoffersson
Daniel Wästerlund
Anette Nyberg
Sead Crnalic
Kjell G. Nilsson
Volker Otten
author_sort Emelie S. Kristoffersson
collection DOAJ
description Abstract Background and purpose The design and coating of uncemented joint implants impact bone ingrowth and thereby the stability of the implant. This prospective randomized clinical trial aimed to compare early migration of two uncemented, similarly shaped femoral stems with either calcium phosphate or hydroxyapatite coating. Patients and methods 93 patients (102 hips) were randomized to either an intervention calcium phosphate or a conventional hydroxyapatite-coated stem. Migration measurements were performed postoperatively, and at 6 weeks, 3, 12 months, and 2 and 5 years after operation, and analyzed with radiostereometric analysis. Results There were no significant differences in migration between the two stems from postoperative to 5-year follow-up. With 6 weeks follow-up as baseline, the calcium phosphate coated stem showed a tendency towards migrating less with a maximum total point motion up to 2 years of 0.84 mm (0.68 to 1.00 95% CI) compared to the hydroxyapatite-coated stem which migrated 1.25 mm (0.99 to 1.52 95% CI) (P = 0.010). Conclusions Our data show that the calcium phosphate-coated stem is a safe implant in terms of ingrowth stability, and with migration patterns comparable to a hydroxyapatite-coated stem.
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series Arthroplasty
spelling doaj-art-72499fc1b1ce4d2aad27d0668ae9b7ea2025-08-20T03:45:45ZengBMCArthroplasty2524-79482025-08-017111010.1186/s42836-025-00324-zEarly migration patterns of calcium phosphate versus hydroxyapatite-coated stem in uncemented total hip arthroplasty: a prospective randomized clinical trial using radiostereometric analysisEmelie S. Kristoffersson0Daniel Wästerlund1Anette Nyberg2Sead Crnalic3Kjell G. Nilsson4Volker Otten5Department of Diagnostics and Intervention, Orthopedics, Umeå UniversityDepartment of Diagnostics and Intervention, Orthopedics, Umeå UniversityDepartment of Nursing, Umeå UniversityDepartment of Diagnostics and Intervention, Orthopedics, Umeå UniversityDepartment of Diagnostics and Intervention, Orthopedics, Umeå UniversityDepartment of Diagnostics and Intervention, Orthopedics, Umeå UniversityAbstract Background and purpose The design and coating of uncemented joint implants impact bone ingrowth and thereby the stability of the implant. This prospective randomized clinical trial aimed to compare early migration of two uncemented, similarly shaped femoral stems with either calcium phosphate or hydroxyapatite coating. Patients and methods 93 patients (102 hips) were randomized to either an intervention calcium phosphate or a conventional hydroxyapatite-coated stem. Migration measurements were performed postoperatively, and at 6 weeks, 3, 12 months, and 2 and 5 years after operation, and analyzed with radiostereometric analysis. Results There were no significant differences in migration between the two stems from postoperative to 5-year follow-up. With 6 weeks follow-up as baseline, the calcium phosphate coated stem showed a tendency towards migrating less with a maximum total point motion up to 2 years of 0.84 mm (0.68 to 1.00 95% CI) compared to the hydroxyapatite-coated stem which migrated 1.25 mm (0.99 to 1.52 95% CI) (P = 0.010). Conclusions Our data show that the calcium phosphate-coated stem is a safe implant in terms of ingrowth stability, and with migration patterns comparable to a hydroxyapatite-coated stem.https://doi.org/10.1186/s42836-025-00324-zStem stabilityEarly migrationCalcium phosphate-coatingRadiostereometric analysis
spellingShingle Emelie S. Kristoffersson
Daniel Wästerlund
Anette Nyberg
Sead Crnalic
Kjell G. Nilsson
Volker Otten
Early migration patterns of calcium phosphate versus hydroxyapatite-coated stem in uncemented total hip arthroplasty: a prospective randomized clinical trial using radiostereometric analysis
Arthroplasty
Stem stability
Early migration
Calcium phosphate-coating
Radiostereometric analysis
title Early migration patterns of calcium phosphate versus hydroxyapatite-coated stem in uncemented total hip arthroplasty: a prospective randomized clinical trial using radiostereometric analysis
title_full Early migration patterns of calcium phosphate versus hydroxyapatite-coated stem in uncemented total hip arthroplasty: a prospective randomized clinical trial using radiostereometric analysis
title_fullStr Early migration patterns of calcium phosphate versus hydroxyapatite-coated stem in uncemented total hip arthroplasty: a prospective randomized clinical trial using radiostereometric analysis
title_full_unstemmed Early migration patterns of calcium phosphate versus hydroxyapatite-coated stem in uncemented total hip arthroplasty: a prospective randomized clinical trial using radiostereometric analysis
title_short Early migration patterns of calcium phosphate versus hydroxyapatite-coated stem in uncemented total hip arthroplasty: a prospective randomized clinical trial using radiostereometric analysis
title_sort early migration patterns of calcium phosphate versus hydroxyapatite coated stem in uncemented total hip arthroplasty a prospective randomized clinical trial using radiostereometric analysis
topic Stem stability
Early migration
Calcium phosphate-coating
Radiostereometric analysis
url https://doi.org/10.1186/s42836-025-00324-z
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