Hydroxyapatite-coated femoral stems in primary total hip arthroplasty: a meta-analysis of randomized controlled trials

Abstract

Background: Controversy exists over the use of hydroxyapatite (HA)-coated femoral stems in primary total hip arthroplasty (THA). We conducted a meta-analysis of randomized controlled trials (RCT) to compare the clinical and radiologic outcomes of primary THA using HA-coated versus non-HA-coated femoral stems.

Methods: Databases including MEDLINE, EMBASE and the Cochrane Library were searched to find relevant RCTs comparing HA-coated versus non-HA-coated femoral stems in primary THA. Data analyses were performed using RevMan 5.0 (The Cochrane Collaboration).

Results: Seven studies (792 hips) met the inclusion criteria. The pooled weighted mean difference (WMD) for the postoperative Harris hip score was 3.04 (95% CI: -4.47 to 10.54, P = 0.43). The cumulative risk ratios (RR) for the presence of endosteal condensation and radioactive lines were 1.02 (95% CI: 0.93 to 1.12, P = 0.64) and 1.01 (95% CI: 0.90 to 1.14, P = 0.81), respectively.

Conclusions: This meta-analysis demonstrates that the use of HA-coated femoral stems in primary THA has no clinical or radiological benefits.