Clinical and Radiologic Outcomes of a Fully Hydroxyapatite-Coated Femoral Revision Stem: Excessive Stress Shielding Incidence and its Consequences

I. Sanli, J.J.C. Arts, Jan Geurts*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Stress shielding remains a concern in total hip arthroplasty. The consequences of stress shielding in hydroxyapatite-coated femoral component revisions were evaluated in a prospective cohort study. A total of 106 patients operated on by revision total hip arthroplasty were identified. Sixty-three patients were eligible for clinical and radiologic assessment of osseointegration, bone remodeling, and stress shielding. Five patients showed evidence of excessive stress shielding. One patient experienced a periprosthetic fracture. No adverse events occurred in the remaining patients with a low rate of thigh pain and reliable osseointegration. This is the only available study concerning mid- to long-term consequences of excessive stress shielding in hydroxyapatite-coated revision stems. We advocate surgeons using these stems to remain vigilant and be aware of possible stress shielding side effects.
Original languageEnglish
Pages (from-to)209-214
JournalJournal of Arthroplasty
Issue number1
Publication statusPublished - Jan 2016


  • femoral
  • stem
  • revision
  • hydroxyapatite
  • stress-shielding

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