Plate fixation with hydroxyapatite-coated screws: A comparative loaded study

Antonio Moroni, Cesare Faldini, Sandro Giannini, Burkhard Wippermann

Research output: Contribution to journalArticlepeer-review


The authors evaluated whether AO/ASIF screws coated with hydroxyapatite are better fixed than standard screws in a highly loaded plate fixation animal study. Twelve sheep were divided into two groups. The medial tibial middiaphysis was exposed and a 5-mm long bone cylinder was removed. The tibiae were fixed with six-hole dynamic compression plates. Six sheep received standard AO/ASIF stainless steel cortical screws (Group A), and six sheep received AO/ASIF stainless steel cortical screws coated with hydroxyapatite (Group B). Three months after surgery, the sheep were euthanized. The mean screw insertion torque was 4800 ± 768 N/mm in Group A and 4847 ± 450 N/mm in Group B. The mean screw extraction torque was 530 ± 374 N/mm in Group A and 3733 ± 849 N/mm in Group B. Extraction torque of Group A was significantly lower compared with the corresponding insertion torque. In Group B, there were no differences between extraction and insertion torque. Morphologic analyses showed marked fibrous tissue encapsulation in Group A and bone to screw direct contact in Group B. The results confirm that hydroxyapatite-coated AO/ASIF screws prevent deterioration of screw anchorage, even under highly loaded conditions. By using hydroxyapatite-coated screws, complications resulting from inadequate fixation could be avoided.

Original languageEnglish
Pages (from-to)262-267
Number of pages6
JournalClinical Orthopaedics and Related Research
Issue number408
Publication statusPublished - Mar 1 2003

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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