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Long-term migration characteristics of the Corail hydroxyapatite-coated femoral stem: a 14-year radiostereometric analysis follow-up study

  • Hip Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

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.

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Acknowledgements

The authors would like to thank the principal radiographer, Doyle Smith, for his contribution to obtaining RSA radiographs for all the patients.

Funding

The institution (in 2003) of one or more of the authors (DC, GM) received funding from DePuy Synthes in the initial stages of project implementation in 2003.

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Authors and Affiliations

  1. Department of Orthopaedics and Trauma Surgery, Flinders University, Adelaide, SA, Australia

    Owain Critchley & Christopher Wilson

  2. Department of Orthopaedics and Trauma, Flinders Medical Centre, Flinders Drive, Bedford Park, Adelaide, SA, 5042, Australia

    Owain Critchley & Christopher Wilson

  3. Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, SA, Australia

    Stuart Callary

  4. Centre for Orthopaedic and Trauma Research, University of Adelaide, Adelaide, SA, Australia

    Stuart Callary

  5. Department of Orthopaedics, Repatriation General Hospital, Adelaide, SA, Australia

    Graham Mercer

  6. Wakefield Orthopaedic Clinic, 270 Wakefield Street, Adelaide, SA, Australia

    David Campbell

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  1. Owain Critchley
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  2. Stuart Callary
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  3. Graham Mercer
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  4. David Campbell
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Correspondence to Christopher Wilson.

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Each author certifies that he or she has no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Southern Adelaide Human Research Ethics Committee [SAC HREC EC00188; application number OFR # 003.15–HREC/14/SAC/553]) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Critchley, O., Callary, S., Mercer, G. et al. Long-term migration characteristics of the Corail hydroxyapatite-coated femoral stem: a 14-year radiostereometric analysis follow-up study. Arch Orthop Trauma Surg 140, 121–127 (2020). https://doi.org/10.1007/s00402-019-03291-8

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