Madhvani Kiran R, Hampton Matthew, Garneti Naren
Trauma & Orthopaedics, Rotherham District General Hospital, Rotherham, GBR.
Cureus. 2023 Sep 26;15(9):e45982. doi: 10.7759/cureus.45982. eCollection 2023 Sep.
The Corail femoral stem has excellent long-term survivorship in total hip arthroplasty (THA). However, there remains a paucity of information on the specific performance of the high offset collarless stem in relation to subsidence, loosening, offset, and failure rates.
Retrospective data were collected on all consecutive high offset collarless Corail stems implanted at a single centre in the UK. Data included patient demographics, femoral Dorr classification, radiographic analysis for radiolucent lines, and stem subsidence. The postoperative femoral offset was measured against the native offset of the contralateral hip. Any early failures, re-operations, or requirements for revision surgery were recorded.
We identified 162 stems for inclusion in the study. Ninety-five patients were male. The mean age was 60.5 (40 to 78) years, and the mean BMI was 29.8 (21 to 50) kg/m. The mean length of follow-up was 84.5 (12-130) months. Subsidence was recorded on 113 (69.7%) stems. The mean amount of total stem subsidence in the whole cohort was 1.62mm (0 to 3.9mm). There was no correlation between the amount of subsidence and the preoperative Dorr classification, age, sex, BMI, or indication for surgery. Radiolucent lines were exclusively seen in stems paired with a large-diameter 36-mm femoral head. The high offset stem accurately reproduced native femoral offset; the mean difference in offset was -1.21mm (-24mm to +21mm). There were no early failures, re-operations, or revision surgeries.
The use of a high offset stem can accurately reproduce native femoral offset when chosen for THA. The high offset collarless Corail stem does not result in early failures in THA, and we support its use.
Corail股骨柄在全髋关节置换术（THA）中具有出色的长期生存率。然而，关于高偏心距无领柄在下沉、松动、偏心距和失败率方面的具体性能，仍缺乏相关信息。
收集了在英国一个中心连续植入的所有高偏心距无领Corail柄的回顾性数据。数据包括患者人口统计学信息、股骨Dorr分类、用于检测透亮线的影像学分析以及柄的下沉情况。术后股骨偏心距是相对于对侧髋关节的原始偏心距进行测量的。记录任何早期失败、再次手术或翻修手术的需求。
我们确定了162个柄纳入研究。95例患者为男性。平均年龄为60.5岁（40至78岁），平均体重指数为29.8（21至50）kg/m²。平均随访时间为84.5个月（12至130个月）。113个（69.7%）柄记录有下沉。整个队列中柄的总下沉平均量为1.62mm（0至3.9mm）。下沉量与术前Dorr分类、年龄、性别、体重指数或手术指征之间无相关性。仅在与36mm大直径股骨头配对的柄中观察到透亮线。高偏心距柄准确再现了股骨原始偏心距；偏心距的平均差异为-1.21mm（-24mm至+21mm）。没有早期失败、再次手术或翻修手术。
在全髋关节置换术中选择使用高偏心距柄时，可以准确再现股骨原始偏心距。高偏心距无领Corail柄在全髋关节置换术中不会导致早期失败，我们支持其使用。
