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

Abstract

BackgroundControversy 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. MethodsDatabases 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). ResultsSeven 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. ConclusionsThis meta-analysis demonstrates that the use of HA-coated femoral stems in primary THA has no clinical or radiological benefits.