The Final Implant Position of a Commonly Used Collarless Straight Tapered Stem Design (Corail) Does Not Correlate with Femoral Neck Resection Height in Cement-free Total Hip Arthroplasty: a Retrospective Computed Tomography Analysis

Overview

Journal J Orthop Traumatol

Specialties Emergency Medicine
Orthopedics

Date 2018 Nov 15

PMID 30426269

Citations 5

Authors

Michael Worlicek

Markus Weber

Michael Worner

Timo Schwarz

Florian Zeman

Joachim Grifka

Tobias Renkawitz

Benjamin Craiovan

Affiliations

Soon will be listed here.

Abstract

Background: In total hip arthroplasty, inadequate femoral component positioning can be associated with instability, impingement and component wear and subsequently with patient dissatisfaction. In this study, we investigated the influence of femoral neck resection height on the final three-dimensional position of a collarless straight tapered stem (Corail). We asked two questions-(1) is neck resection height correlated with version, tilt, and varus/valgus alignment of the femoral component, and (2) dependent on the resection height of the femoral neck, which area of the stem comes into contact with the femoral cortical bone?

Materials And Methods: Three-dimensional computed tomography scans of 40 patients who underwent minimally invasive, cementless total hip arthroplasty were analyzed retrospectively. We analyzed the relationship between femoral neck resection height and three-dimensional alignment of the femoral implant, as well as the contact points of the implant with the femoral cortical bone. This investigation was approved by the local Ethics Commission (No.10-121-0263) and is a secondary analysis of a larger project (DRKS00000739, German Clinical Trials Register May-02-2011).

Results: Mean femoral neck resection height was 10.4 mm (± 4.8) (range 0-20.1 mm). Mean stem version was 8.7° (± 7.4) (range - 2° to 27.9°). Most patients had a varus alignment of the implant. The mean varus/valgus alignment was 1.5° (± 1.8). All 40 patients (100%) had anterior tilt of the implant with a mean tilt of 2.2° (± 1.6). Femoral neck resection height did not correlate with stem version, varus/valgus alignment, or tilt. Independent from femoral neck resection height, in most patients the implant had contact with the ventral and ventromedial cortical bone in the upper third (77.5%) and the middle third (52.5%). In the lower third, the majority of the implants had contact with the lateral and dorsolateral cortical bone (92.5%).

Conclusion: Femoral neck resection height ranging between 0 and 20.1 mm does not correlate with the final position of a collarless straight tapered stem design (Corail).

Level Of Evidence: Level 3.

Citing Articles

A New Method to Predict Postoperative Stem Anteversion in Total Hip Arthroplasty for Developmental Dysplasia of the Hip.

Hu Y, Sun Z, Zhang J, Yan M, Mao Y, Li H Orthop Surg. 2024; 16(5):1101-1108.

PMID: 38509013 PMC: 11062849. DOI: 10.1111/os.14037.

A comprehensive analysis on contributing factors for varus or valgus malposition of femoral stems in uncemented total hip arthroplasty via DAA.

Teh H, Abounouh M, Haibock P, Selvaratnam V, Ganapathy S, Graichen H J Orthop. 2024; 50:42-48.

PMID: 38162260 PMC: 10755486. DOI: 10.1016/j.jor.2023.11.068.

[Comparison of filling ratio, alignment, and stability between ABG short-stem and Corail long-stem in total hip arthroplasty for Dorr type C femur].

Bao X, Li M, Wu L, Jiang S, Shen B Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023; 37(6):641-646.

PMID: 37331936 PMC: 10277249. DOI: 10.7507/1002-1892.202303123.

The direct anterior approach provokes varus stem alignment when using a collarless straight tapered stem.

Haversath M, Lichetzki M, Serong S, Busch A, Landgraeber S, Jager M Arch Orthop Trauma Surg. 2020; 141(6):891-897.

PMID: 32474699 DOI: 10.1007/s00402-020-03457-9.

The 'critical trochanter angle': a predictor for stem alignment in total hip arthroplasty.

Haversath M, Busch A, Jager M, Tassemeier T, Brandenburger D, Serong S J Orthop Surg Res. 2019; 14(1):165.

PMID: 31146787 PMC: 6542108. DOI: 10.1186/s13018-019-1206-x.

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