Similar clinical results and early subsidence between the Collum Femoris Preserving and the Corail stem: a randomized radiostereometric study of 77 hips with 2 years’ follow-up

Abstract

Background and purpose — Femoral neck preserving hip replacement has been suggested to improve clinical results and facilitate late revision. We compared the 2-year outcome and radiostereometric pattern of femoral head migration between the Collum Femoris Preserving (CFP) stem and the Corail stem.

Patients and methods — 83 patients were randomized to either a CFP stem or a Corail stem. All patients received the same cup. At 2 years clinical outcomes were assessed using validated scoring systems and plain radiographs. 2-year migration was determined using radiostereometric analysis.

Results — At 2 years the clinical outcomes (Oxford Hip Score, Harris Hip Score, SF-36, EQ5D-VAS, satisfaction VAS, and pain VAS) were similar between the 2 groups. The radiographic measurements showed that the femoral neck was resected around 1 cm more proximally with use of CFP stems (p < 0.001). The proximal–distal and medial–lateral migration of the femoral head center was similar. The Corail stem showed increased posterior displacement after 1 year, but no difference was found between the absolute translations in the anterior–posterior direction (p = 0.2). 2 CFP stems were revised due to loosening within the first 2 years. None of the Corail stems was revised.

Interpretation — In the 2-year perspective clinical outcomes suggested no obvious advantages with use of the CFP stem. The magnitude of the early stem migration was similar, but the pattern of migration differed. The early revisions in the CFP are a cause of concern.

Trial registration: ClinicalTrials.gov identifier: NCT02983526.

LJK: Collection of clinical data, RSA measurements, statistical analysis, writing manuscript. GP: Data collection, follow-up, study design, review of manuscript. MM: Follow up, review of manuscript. JK: Study design, review of manuscript, statistical and methodological aspects.

The authors would like to thank Bita Shareghi for her help on the RSA measurements.

Acta thanks Lene Bergendal Solberg and Marc J Nieuwenhuijse for help with peer review of this study.