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. 2020 Jan 6;6(1):99-103.
doi: 10.1016/j.artd.2019.11.009. eCollection 2020 Mar.

Observed effect of femoral component undersizing and a collarless design in the development of radiolucent lines in cementless total hip arthroplasty

Paul Magill  1 , Janet Hill  1 , Seamus O'Brien  1 , Michael Stevenson  2 , Alain Machenaud  3 , David Beverland  1
Affiliations

Observed effect of femoral component undersizing and a collarless design in the development of radiolucent lines in cementless total hip arthroplasty

Paul Magill et al. Arthroplast Today. .

Abstract

Background: The objective of this study was to determine the prevalence of radiolucent lines (RLLs) around the femoral component in a cohort of patients who underwent well-functioning cementless total hip arthroplasty (THA).

Methods: A cohort of unrevised Corail (DePuy Synthes, Raynham, MA) femoral components (n = 636) were analyzed at a median follow-up of 6.0 years (interquartile range: 5.2-6.8) with the Oxford Hip Score (OHS) and radiographs. Two independent observers assessed the radiographs for the presence of RLLs.

Results: The overall prevalence of RLLs in zone 7 was 13% (83/636). Patients with RLLs in zone 7 had an average OHS of 40.3 (15-48), and those who did not have RLLs in zone 7 had an average OHS of 38 (6-48), P = .07. Both groups had an average pain score of 1.6 out of 5, P = .5. The prevalence of RLLs in zone 7 was much less in the collared femoral components (2.6% prevalence) than in the collarless components (23.6% prevalence), but there was heterogeneity between these 2 groups preventing comparison. Logistic regression analysis of only the collarless components identified undersizing as the only predictive (odds ratio = 2.6) factor for RLL development in zone 7.

Conclusions: Undersizing the Corail stem is strongly predictive of developing RLLs in zone 7. Preoperative templating for the appropriate size is critical. We observed more RLLs in zone 7 with the collarless design Corail, but a comparison study with the same bearing couple is needed to investigate this further.

Keywords: Cementless; Collar; Corail; Hip; Templating; Uncemented.

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Figures

Figure 1
Figure 1
Plain radiograph comparison of a KS collarless (a and b) and KA collared (c) corail cementless femoral component, both at ten years after implantation, and both in patients with no pain. Note in 1a and 1b the radiolucent lines in Gruen zones 1,7,8 and 14.
Figure 2
Figure 2
Implant choices and operative technique changes during the catchment period of the study. Only reviewed stems (n = 636) included. NXLPE, non cross-linked polyethylene; XLPE, cross-linked polyethylene; CoC, ceramic on ceramic; CoM, ceramic on metal; MoM, metal on metal..
See this image and copyright information in PMC

References

    1. NJR editorial board . 2019. NJR 16th Annual Report.www.reports.njrcentre.org.uk
    1. Vidalain J.P. The Corail system in primary THA: results, lessons and comments from the series performed by the ARTRO Group (12-year experience) Eur J Orthop Surg Traumatol. 1999;9:87.
    1. Vidalain J.P. HA coating. Ten-year experience with the CORAIL system in primary THA. The Artro Group. Acta Orthop Belg. 1997;63(Suppl 1):93. - PubMed
    1. Vidalain J.P. Twenty-year results of the cementless Corail stem. Int Orthop. 2011;35:189. - PMC - PubMed
    1. 2019. Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR). Hip, Knee & Shoulder Arthroplasty: 2019 Annual Report. Adelaide: AOA.www.aoanjrr.sahmri.com

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