Abstract
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. 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 10years post-operation (mean 13.9years, range 13.3-14.4). Subsidence of the stem was measured and compared to prior measurements taken at 6months and 1, 2, and 6years. None of the 13 patients have been revised. The migration at 6months, 1year, 2years, and 6years has been previously recorded. At mean 14-year follow-up, the cohort mean subsidence of the cementless stem was 0.70mm (range - 0.06 to 3.61mm). For each stem followed up at 6months and 14years, the mean subsidence over this period was 0.05mm (range - 0.14 to 0.57mm). There is no significant difference in mean subsidence at 6months and 14years (p = 0.43). The long-term pattern of the subsidence of the Corail femoral stem has not previously been described. Subsidence occurs within the first 6months, after which there is persistent stabilisation of the implant to 14years. This study provides a description of a long-term acceptable migration pattern to which new hydroxyapatite-coated cementless prostheses may be compared. II.
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