Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Maier, M.
Survival analysis of 998 Corail® stems implanted at the Department of Orthopaedic Surgery,Medical University of Graz, from 2005 to 2012
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2016. pp.
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Leithner Andreas
- Maurer-Ertl Werner
- Altmetrics:
- Abstract:
- Background: The first implantation of the Corail® hip system was performed in 1986 by the French “ATRO-Groupe”. Till 2012, more than 1.000.000 Corail® implants have been sold worldwide since introduction. Meanwhile, this hydroxyapatite (HA) coated stem is established worldwide by excellent long-term results. The aim of this retrospective study was the clinical evaluation and site analysis for the HA coated Corail® stem, which was in use since 2005 at the Department of Orthopaedic Surgery, Medical University of Graz. Patients and methods: From January 2005 to December 2012, 891 patients, 408 men and 483 women, were identified and included in this study. Within this collective, 998 Corail® stems were implanted. The average age of patients at the time of surgery was 63 years (range, 18-91 years). The mean postoperative radiological follow-up of all patients together was 45 months (range, 3-128 months). Three months postoperatively, 807 patients were available for clinical and radiological follow-up, whereas the number of participants was decreasing during the time of follow-up (e.g. 724 patients after 6 months and 668 patients after one year). The assessment of the radiographs included leg length differences, sign of stress shielding, lysis, heterotopic ossification according to the classification of Brooker, bone resorption rated in Gruen zones and the implant position. An implant survival for aseptic loosening as well as any reason for revision as endpoint was done using the Kaplan-Meier method. Results: In 75% of the cases a standard Corail® stem was implanted, followed by the Corail® high offset stem (21%) and the coxa vara stem (4%). The Corail® stem was combined with a Pinnacle® cup in 93%. The most common bearing used was ceramic-on-ceramic (n=873, 88%) with the head size 36 mm (75%). Heterotopic ossification was observed in 52 patients (5.2%) and clinically irrelevant radiographic loosening lines in 166 patients. Five out of 912 Corail® stems implanted, had to be revised due to aseptic loosening (= revision rate: 0.5%). According to the method of Kaplan-Meier, the survival of the implant was 99% at 5 years and 97.6% after 10 years. Eleven other stem revisions had to be made due to periprosthetic fractures (=1.1%). Conclusion: The results of our study showed excellent clinical results and minimal risk for aseptic loosening of the Corail® stem compared with international registry data. The number of early periprosthetic fractures was stated to be part of a kind of learning curve and was eliminated by adapting the implantation technique. In different register data such as Australia, New Zealand, Denmark and England, an implant survival for the Corail® stem was reported from 97% to 99% after a follow-up up to15 years.