Sealing effect of hydroxyapatite coating - A 12-month study in canines

This study addresses the clinical problems regarding access of wear debris to the bone-implant interface and the possible dissemination of polyethylen e (PE) particles to distant organs. We inserted two implants into each knee of 7 dogs allowing access of joint fluid to the bone-implant interface wit h a 0.75 mm initial gap around the implant. Hydroxyapatite (HA)-coated and non-coated (Ti) titanium alloy implants were randomly allocated to each dis tal femoral condyle. PE particles were repeatedly injected into the right k nee joint 3 weeks after surgery for a period of 49 weeks, while only vehicl e was injected into the left knee joint. We found huge amounts of RE particles mainly in the bone-implant interface around Ti implants. Infiltration of mononuclear inflammatory cells was pres ent around 3 of 7 Ti implants in relation to PE particles. HA implants had approximately 70% bone ongrowth. In contrast, no bone ongrowth was seen on any Ti implants, all being surrounded by a fibrous membrane. The number of RE particles was evaluated semi quantitatively. More PE particles were foun d around Ti implants than with HA implants (p < 0.002). Specimens from iliac lymph nodes, liver, spleen and lung mere examined and showed dissemination of PE particles only in regional lymph nodes.