Analysis of retrieved hydroxyapatite-coated hip prostheses

Hydroxyapatite (HAp) coatings are used extensively on orthopaedic devices to improve the adhesion of bone to the prosthesis. This approach increases the integrity and longevity of the implanted prosthesis. Four HAp-coated hip components recovered from patients during revision surgery were investigated for bone attachment and coating modification after storage in ethanol or formaldehyde. Orthopedic components displayed preferable bone attachment on microtextured areas and little bone on smoother areas. The coating microstructure differed between three coatings that remained on the prosthesis surface, ranging from completely crystalline coatings made by vacuum plasma spraying to less crystalline coatings manufactured by air plasma spraying. Coating failure for the lower crystallinity coatings was observed by a crack at the interface that was possibly caused by the dissolution of an amorphous phase. While higher crystallinity coatings degraded by coating delamination, the lower crystallinity coating produced loose particulate on the outer coating surface. Coating morphology as observed by scanning electron microscopy (SEM) displayed lamellae fracture, chemical dissolution, osteoclastic resorption, and precipitation in agreement with previously identified in-vitro events. The coating longevity appeared to be extended in those areas subject to lower levels of stress and more bone coverage.