Owain Critchley1,2, Stuart Callary3,4, Graham Mercer5, David Campbell6, Christopher Wilson7,8. 1. Department of Orthopaedics and Trauma Surgery, Flinders University, Adelaide, SA, Australia. 2. Department of Orthopaedics and Trauma, Flinders Medical Centre, Flinders Drive, Bedford Park, Adelaide, SA, 5042, Australia. 3. Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, SA, Australia. 4. Centre for Orthopaedic and Trauma Research, University of Adelaide, Adelaide, SA, Australia. 5. Department of Orthopaedics, Repatriation General Hospital, Adelaide, SA, Australia. 6. Wakefield Orthopaedic Clinic, 270 Wakefield Street, Adelaide, SA, Australia. 7. Department of Orthopaedics and Trauma Surgery, Flinders University, Adelaide, SA, Australia. chriswilson42@hotmail.com. 8. Department of Orthopaedics and Trauma, Flinders Medical Centre, Flinders Drive, Bedford Park, Adelaide, SA, 5042, Australia. chriswilson42@hotmail.com.
Abstract
BACKGROUND: The magnitude and pattern of acceptable long-term migration of cementless femoral stems are not well understood. The Corail hydroxyapatite-coated cementless stem is a clinically successful and commonly used femoral stem with a long-term migration pattern not previously described in the literature. The aim of this study was to assess the long-term migration of the Corail hydroxyapatite-coated cementless stem using radiostereometric analysis (RSA) at 14-year follow-up, thereby establishing a benchmark acceptable long-term migration pattern for hydroxyapatite-coated cementless prostheses. MATERIALS AND METHODS: A prospective cohort of 29 patients (30 hips) undergoing primary total hip arthroplasty for primary hip osteoarthritis were enrolled into a study to characterise the migration of the Corail cementless stem. A total of 13 patients (4 males, 9 females) with mean age 82 (range 68-92) underwent repeat RSA radiographs at minimum 10 years post-operation (mean 13.9 years, range 13.3-14.4). Subsidence of the stem was measured and compared to prior measurements taken at 6 months and 1, 2, and 6 years. RESULTS: None of the 13 patients have been revised. The migration at 6 months, 1 year, 2 years, and 6 years has been previously recorded. At mean 14-year follow-up, the cohort mean subsidence of the cementless stem was 0.70 mm (range - 0.06 to 3.61 mm). For each stem followed up at 6 months and 14 years, the mean subsidence over this period was 0.05 mm (range - 0.14 to 0.57 mm). There is no significant difference in mean subsidence at 6 months and 14 years (p = 0.43). CONCLUSIONS: The long-term pattern of the subsidence of the Corail femoral stem has not previously been described. Subsidence occurs within the first 6 months, after which there is persistent stabilisation of the implant to 14 years. This study provides a description of a long-term acceptable migration pattern to which new hydroxyapatite-coated cementless prostheses may be compared. LEVEL OF EVIDENCE: II.
BACKGROUND: The magnitude and pattern of acceptable long-term migration of cementless femoral stems are not well understood. The Corailhydroxyapatite-coated cementless stem is a clinically successful and commonly used femoral stem with a long-term migration pattern not previously described in the literature. The aim of this study was to assess the long-term migration of the Corailhydroxyapatite-coated cementless stem using radiostereometric analysis (RSA) at 14-year follow-up, thereby establishing a benchmark acceptable long-term migration pattern for hydroxyapatite-coated cementless prostheses. MATERIALS AND METHODS: A prospective cohort of 29 patients (30 hips) undergoing primary total hip arthroplasty for primary hip osteoarthritis were enrolled into a study to characterise the migration of the Corail cementless stem. A total of 13 patients (4 males, 9 females) with mean age 82 (range 68-92) underwent repeat RSA radiographs at minimum 10 years post-operation (mean 13.9 years, range 13.3-14.4). Subsidence of the stem was measured and compared to prior measurements taken at 6 months and 1, 2, and 6 years. RESULTS: None of the 13 patients have been revised. The migration at 6 months, 1 year, 2 years, and 6 years has been previously recorded. At mean 14-year follow-up, the cohort mean subsidence of the cementless stem was 0.70 mm (range - 0.06 to 3.61 mm). For each stem followed up at 6 months and 14 years, the mean subsidence over this period was 0.05 mm (range - 0.14 to 0.57 mm). There is no significant difference in mean subsidence at 6 months and 14 years (p = 0.43). CONCLUSIONS: The long-term pattern of the subsidence of the Corail femoral stem has not previously been described. Subsidence occurs within the first 6 months, after which there is persistent stabilisation of the implant to 14 years. This study provides a description of a long-term acceptable migration pattern to which new hydroxyapatite-coated cementless prostheses may be compared. LEVEL OF EVIDENCE: II.
Entities:
Keywords:
Radiostereometric analysis; Stabilisation; Subsidence; Total hip arthroplasty
Authors: Ramakanth R Yakkanti; Dylan N Greif; Dennis J Vanden Berge; Raymond P Robinson Journal: Arch Orthop Trauma Surg Date: 2022-03-03 Impact factor: 3.067
Authors: Paul Van Der Voort; Martijn L D Klein Nulent; Edward R Valstar; Bart L Kaptein; Marta Fiocco; Rob G H H Nelissen Journal: Acta Orthop Date: 2020-11-04 Impact factor: 3.717