No difference in outcome or migration but greater loss of bone mineral density with the Collum Femoris Preserving stem compared with the Corail stem: a randomized controlled trial with five-year follow-up

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Rilby, KarinGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för ortopedi,Institute of Clinical Sciences, Department of Orthopaedics (författare)

No difference in outcome or migration but greater loss of bone mineral density with the Collum Femoris Preserving stem compared with the Corail stem: a randomized controlled trial with five-year follow-up

Artikel/kapitelEngelska2022

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2022

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LIBRIS-ID:oai:gup.ub.gu.se/319882
https://gup.ub.gu.se/publication/319882URI
https://doi.org/10.1302/0301-620x.104b5.Bjj-2021-1539.R1DOI

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Aims The aim of this study was to compare the mid-term patient-reported outcome, bone remodelling, and migration of a short stem (Collum Femoris Preserving; CFP) with a conventional uncemented stem (Corail). Methods Of 81 patients who were initially enrolled, 71 were available at five years' follow-up. The outcomes at two years have previously been reported. The primary outcome measure was the clinical result assessed using the Oxford Hip Score (OHS). Secondary outcomes were the migration of the stem, measured using radiostereometric analysis (RSA), change of bone mineral density (BMD) around the stem, the development of radiolucent lines, and additional patient-reported outcome measures (PROMs). Results There were no statistically significant differences between the groups regarding PROMs (median OHS (CFP 45 (interquartile range (IQR) 35 to 48); Corail 45 (IQR 40 to 48); p = 0.568). RSA showed stable stems in both groups, with little or no further subsidence between two and five years. Resorption of the femoral neck was evident in nine patients in the CFP group and in none of the 15 Corail stems with a collar that could be studied. Dual X-ray absorbiometry showed a significantly higher loss of BMD in the proximal Gruen zones in the CFP group (mean changes in BMD: Gruen zone 1, CFP -9.5 (95% confidence interval (CI) -14.8 to -4.2), Corail 1.0 (95% CI 3.4 to 5.4); Gruen zone 7, CFP -23.0 (95% CI -29.4 to -16.6), Corail -7.2 (95% CI -15.9 to 1.4). Two CFP stems were revised before two years' follow-up due to loosening, and one Corail stem was revised after two years due to chronic infection. Conclusion The CFP stem has a similar clinical outcome and subsidence pattern when compared with the Corail stem. More pronounced proximal stress-shielding was seen with the CFP stem, suggesting diaphyseal fixation, and questioning its femoral neck-sparing properties in the long term.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Ortopedi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Orthopaedics hsv//eng
total hip-arthroplasty
prospective cohort
primary stability
oxford
hip
cfp stem
replacement
pattern
rsa
radiostereometry
arthritis
Orthopedics
Surgery

Biuppslag (personer, institutioner, konferenser, titlar ...)

Naucler, E. (författare)
Mohaddes, Maziar,1974Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för ortopedi,Institute of Clinical Sciences, Department of Orthopaedics(Swepub:gu)xmoham (författare)
Kärrholm, Johan,1951Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för ortopedi,Institute of Clinical Sciences, Department of Orthopaedics(Swepub:gu)xkarjo (författare)
Göteborgs universitetInstitutionen för kliniska vetenskaper, Avdelningen för ortopedi (creator_code:org_t)

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Ingår i:Bone & Joint Journal104B:5, s. 581-5882049-4394

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Av författaren/redakt...: Rilby, Karin; Naucler, E.; Mohaddes, Maziar ...; Kärrholm, Johan, ...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Ortopedi

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Av lärosätet: Göteborgs universitet

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