Primary ArthroplastyClinical and Radiographic Outcomes at 25-30 Years of a Hip Stem Fully Coated With Hydroxylapatite
Section snippets
Materials and Methods
The records of all 347 consecutive THAs performed between 1986 and 1990 by one surgeon (AM) using the CORAIL stem (DePuy, Leeds, UK) were reviewed. The series comprised 320 patients aged 63.3 ± 11.3 years (median 65 years; range 20-89 years) at the index operation, with body mass index of 25.8 ± 4.0 kg/m2 (median 25.5 kg/m2; range 16.4-41.3 kg/m2). Their gender distribution was balanced, with 167 men (181 hips) aged 62.0 ± 11.2 years (median 63 years; range 20-87 years) and 153 women (166 hips)
Results
From the original 320 patients (347 hips), aged 63.3 ± 11.3 years (median 65 years; range 20-89 years) at the index operation, only 80 patients (86 hips) were confirmed to be presently living with the original stem in place (Fig. 1), now aged 83.0 ± 8.4 years (median 84 years; range 57-101 years). It is worth noting that for this series, the cumulative risk of mortality was greater than the cumulative risk of revision. The remaining cohort comprised 40 men (43 hips) and 40 women (43 hips),
Discussion
The aim of the present study was to report the long-term outcomes and survival of the CORAIL hip stem. By virtue of their advanced age at index operation (63.3 ± 11.3 years; range 20-89 years), and because of the long follow-up period (26.8 ± 1.2 years; range 25-30 years), many patients had died (64.6%) and some were lost to follow-up (6.5%). The 80 remaining patients represent a quarter of the initial cohort (25%), some of whom have impaired function and mobility due to pathologies unrelated
Conclusion
The present study is the first to report outcomes and survival of an HA-coated hip stem beyond 25 years of follow-up. The KM survival considering stem revision as end point, is 93.7%, which compares favorably with long-term survival of the Charnley cemented stem, and with shorter-term arthroplasty registry studies. The fully HA-coated stem achieved its intended purpose of total osteointegration in the long-term, although the proximolateral region remains susceptible to radiolucencies.
Acknowledgments
The authors would like to thank Sonia Dubreuil, Hugo Bothorel, and Luca Nover for their support in data management and manuscript preparation.
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Thirty-Year Minimum Follow-Up Outcome of a Straight Cementless Rectangular Stem
2024, Journal of ArthroplastySurvival and Clinical Outcomes at 30 to 35 Years Following Primary Total Hip Arthroplasty With a Cementless Femoral Stem Fully Coated With Hydroxyapatite
2023, Journal of ArthroplastyCitation Excerpt :Considering revision of the stem for aseptic loosening as endpoint, the revision incidence at 35 years was 3.1% (95%CI, 6.6–15.0) using KM, while it was 2.1% (95%CI, 1.0–4.3) using CIF (See Figure 3). Since the prior publication at 25 to 30 years [27], there were 2 additional cases recorded that required only cup revision, this brought the total to 57 cases of cup revision without stem revision. The majority of acetabular cups were revised for wear of the polyethylene insert which often led to component loosening.
Funding sources: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to https://doi.org/10.1016/j.arth.2017.09.040.