In the last years the number of hip arthroplasties is constantly increased, and an incessant growing demand is expected for the next decades. Considering the increased life expectancy for elderly patients and a larger extension of surgical indications in younger adults, the need for an appropriate implant choice is now emphasized. Long-term survival implants which can satisfy current patients high physical demands are required. Thus, in order to avoid high revision rates of cemented implants described for young and active patients, orthopaedic surgeons' attention has been focusing on materials used for primary (mechanical) and secondary stability (osteo-integration of components) through the concept of "biological fixation". The process of bonding ostheogenesis in prosthesis using biological fixation could enable a stability which resembles permanent physiological union after fractures in healty cancellous bone. Hydroxyapatite coating on femoral component of uncemented total hip arthroplasty was proposed on the basis of its biocompatibility and osteoconductive properties. The aim of this work was to analyze clinical and functional long-term outcomes in patients receiving hip replacementwith biological fixation.
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