Hydroxyapatite coated hip implant integrating with bone.

Is Hydroxyapatite the Secret to Longer-Lasting Hip Replacements? A 10-Year Study

Beau Callahan in Health & Wellness November 2025 • 4 min read.

"Discover how hydroxyapatite coatings can significantly improve the longevity and success of total hip replacements, even with technical imperfections."

For individuals grappling with debilitating hip pain, total hip replacement (THR) offers a beacon of hope, restoring mobility and improving quality of life. The success of THR hinges on the implant's ability to integrate seamlessly with the surrounding bone, ensuring long-term stability and function. Hydroxyapatite (HA) coatings have emerged as a promising solution to enhance this integration.

Hydroxyapatite is a naturally occurring mineral that forms the primary component of bone. Applying an HA coating to hip implants mimics the natural bone structure, encouraging direct bone growth onto the implant surface. This process, known as osseointegration, leads to a stronger, more stable bond between the implant and the bone, potentially extending the lifespan of the hip replacement.

In 2010, a team of researchers published a compelling 10-year study assessing the long-term outcomes of total hip replacements using a fully hydroxyapatite-coated stem and socket. This study offers valuable insights into the effectiveness of HA coatings in promoting implant fixation, reducing complications, and improving overall patient outcomes. Let's delve into the findings of this study and explore the potential benefits of HA-coated hip implants for those considering THR.

Decoding the 10-Year HA Hip Replacement Study: Key Findings

Hydroxyapatite coated hip implant integrating with bone.

The study meticulously assessed 254 consecutive primary total hip replacements using the Furlong JRI system, which features a fully hydroxyapatite (HA)-coated stem and socket. Patients underwent a minimum follow-up of 10 years, with researchers tracking their Harris hip scores (HHS) – a comprehensive measure of hip function and pain – as well as radiographic evidence of implant stability and bone integration.

The results were compelling, demonstrating significant improvements in patient outcomes and implant longevity. Key findings from the study include:

Significant Pain Reduction: The average Harris hip score increased substantially, with a marked reduction in thigh pain reported by patients.
Exceptional Implant Stability: All stems met stability criteria after 10 years, with no revisions required due to aseptic loosening – a common cause of hip replacement failure.
Low Revision Rate: Only a small percentage of cups (1.2%) required revision for aseptic loosening, highlighting the effectiveness of HA coatings in promoting secure cup fixation.
Tolerance to Technical Imperfections: The study found that even with some technical implantation defects, such as varus or valgus placement of the femoral stem, the implants demonstrated good stability and did not show radiologic progression of loosening.

These findings strongly suggest that the JRI Furlong system, with its full HA coating, offers a reliable solution for primary THR, providing excellent clinical and radiologic results over the long term. The study's findings underscore the potential of HA coatings to enhance implant fixation, minimize the risk of loosening, and improve the overall success rate of hip replacement surgery.

The Future of Hip Replacements: Are HA Coatings the Answer?

This 10-year study adds to the growing body of evidence supporting the use of hydroxyapatite coatings in total hip replacement. The ability of HA to promote osseointegration, enhance implant stability, and reduce the risk of loosening makes it a valuable tool for improving the long-term outcomes of THR. As research continues and new technologies emerge, HA coatings may become an increasingly integral component of hip replacement surgery, offering patients a greater chance of lasting pain relief and restored mobility.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1177/11207000100200s714, Alternate LINK

Title: Fully Hydroxyapatite-Coated Total Hip Replacement: Ten-Year Results

Subject: Orthopedics and Sports Medicine

Journal: HIP International

Publisher: SAGE Publications

Authors: Màrius Valera Pertegàs, Pedro Vergara-Valladolid, Xavier Crusi-Sererols, Rogelio Sancho-Navarro

Published: 2010-04-01

Everything You Need To Know

What is hydroxyapatite, and why is it used in hip replacements?

Hydroxyapatite is a naturally occurring mineral that is the primary component of bone. It is used as a coating on hip implants to mimic natural bone structure. This encourages direct bone growth onto the implant surface, a process called osseointegration. Osseointegration creates a stronger, more stable bond between the implant and the bone, which can potentially extend the lifespan of the hip replacement. The benefits of osseointegration include enhanced implant stability, reduced pain, and long-term success in total hip replacement surgeries.

What were the main findings of the 10-year study on hip replacements using hydroxyapatite coatings?

The 10-year study on total hip replacements using the Furlong JRI system, which features a fully hydroxyapatite-coated stem and socket, revealed several key findings. Patients experienced significant pain reduction, as indicated by improved Harris hip scores. All stems met stability criteria after 10 years, with no revisions required due to aseptic loosening. The study also showed a low revision rate for cups due to aseptic loosening (1.2%), highlighting the effectiveness of hydroxyapatite coatings in promoting secure cup fixation. Importantly, the implants demonstrated good stability even with some technical implantation defects, such as varus or valgus placement of the femoral stem. These results suggest that the JRI Furlong system, with its full hydroxyapatite coating, offers a reliable solution for primary total hip replacement.

What is aseptic loosening, and how does hydroxyapatite help prevent it in hip replacements?

Aseptic loosening is a common cause of hip replacement failure where the implant becomes loose without infection. Hydroxyapatite (HA) coatings help prevent this by promoting osseointegration. Osseointegration is the direct bone growth onto the implant surface, creating a strong and stable bond between the implant and the bone. The 10-year study found that using HA-coated implants significantly reduced the incidence of aseptic loosening, leading to lower revision rates and improved long-term stability. HA coatings enhances implant fixation and minimizes the risk of loosening, improving the overall success rate of hip replacement surgery.

How do Harris hip scores relate to the success of hip replacement surgery, and what did the study reveal about these scores?

Harris hip scores (HHS) are a comprehensive measure of hip function and pain. They are used to evaluate the success of hip replacement surgery. The 10-year study revealed that patients who received total hip replacements with hydroxyapatite-coated stems and sockets experienced a substantial increase in their average Harris hip scores. This increase indicates a significant reduction in pain and an improvement in overall hip function. The improvement in HHS scores, combined with radiographic evidence of implant stability and bone integration, demonstrates the positive impact of HA coatings on patient outcomes.

Does using hydroxyapatite coatings in hip replacements eliminate the need for precise surgical technique, and what are the implications?

While the 10-year study found that hydroxyapatite-coated implants demonstrated good stability even with some technical implantation defects (such as varus or valgus placement of the femoral stem), it does not imply that precise surgical technique is no longer important. Instead, it suggests that HA coatings can provide a buffer against minor imperfections in implantation, potentially improving outcomes in cases where perfect alignment is not achieved. However, optimal surgical technique remains crucial for maximizing the benefits of HA coatings and ensuring the best possible long-term results. This tolerance to technical imperfections is a significant advantage. It can lead to more consistent outcomes across different surgeons and patient anatomies.