HA-coated screws decrease the incidence of fixation failure in osteoporotic trochanteric fractures

This study was done to determine if elderly patients with trochanteric fractures and with osteoporosis could benefit from treatment with a dynamic hip screw fixed with HA-coated AO/ASIF screws. One hundred twenty patients with AO, A1, or A2 trochanteric fractures were selected. Patients were divided into two groups and randomized to receive a 135°-four-hole dynamic hip screw fixed with either standard lag and cortical AO/ASIF screws (Group A), or HA-coated lag and cortical AO/ASIF screws (Group B). Lag screw cut-out occurred in four patients in Group A, but not in any patients in Group B. In Group A, the femoral neck shaft angle was 134° ± 5° postoperatively and 127° ± 12° at 6 months. In Group B, the femoral neck shaft angle was 134° ± 7° postoperatively and 133° ± 7° at 6 months. The Harris hip score at 6 months was 60 ± 25 in Group A and 71 ± 18 in Group B. The superior results of Group B can be attributed to the increased screw fixation provided by the HA-coated screws. We recommend lag screws coated with HA for dynamic hip screw fixation, especially in osteoporotic bone.