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Journal of Orthopaedics and Traumatology

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Open Access 01-12-2018 | Original article

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

Authors: Michael Worlicek, Markus Weber, Michael Wörner, Timo Schwarz, Florian Zeman, Joachim Grifka, Tobias Renkawitz, Benjamin Craiovan

Published in: Journal of Orthopaedics and Traumatology | Issue 1/2018

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.

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Title: 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
Authors: Michael Worlicek
Markus Weber
Michael Wörner
Timo Schwarz
Florian Zeman
Joachim Grifka
Tobias Renkawitz
Benjamin Craiovan
Publication date: 01-12-2018
Publisher: Springer International Publishing
Published in: Journal of Orthopaedics and Traumatology / Issue 1/2018
Print ISSN: 1590-9921
Electronic ISSN: 1590-9999
DOI: https://doi.org/10.1186/s10195-018-0513-z

At a glance: The STEP trials

Springer Medicine

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

Abstract

Background

Materials and methods

Results

Conclusion

Level of evidence

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusion

Level of evidence

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