Abstract
Introduction
The Corail stem is a fully HA coated tapered implant that has demonstrated long-term success. On the NJR it has become one of the most commonly used implants in the UK. The aim of our study was to document our experience of the revision of this implant together highlighting some important technical considerations.
Patients/Materials & Methods
A retrospective review of a consecutive case series of revision procedures where the Corail stem was extracted. We considered time since implantation, collared or uncollared design, indication for revision, Paprosky classification of femoral deficiency, endo-femoral reconstruction or extended approach/osteotomy, subsequent reconstruction either further primary type implant (cemented or cementless) or revision femoral implant.
Results
49 patients required extraction of Corial Stem as part of revision THA. Mean time to extraction 5.2 years (range 1.1 to 10.5 years). Indication for revision in 27 cases ARMD, 7 aseptic loosening, 7 PJI, 6 Peri-prosthetic fractures and 2 instability. The only cases that utilised an extended approach were those performed for peri-prosthetic fracture (5 B2 & 1 Type C fractures) all of which were reconstructed with a Modular Taper Fluted Stem. Of the remaining 43 cases revised for other reasons femoral bone stock was Paprosky Grade 2 in 21 cases, grade 3A in 22 cases. Stems were extracted with implant specific extraction device via endo-feomral route and subsequent reconstruction utilised a primary type femoral implant in 34% of cases.
Discussion
All stems, apart from those revised for peri-prosthetic fracture were reconstructed via endo-femoral route. Safe implant extraction is key in this approach and the success of this method in our series emphasizes the major importance of the implant specific extraction instrumentation.
Conclusion
As a result of safe implant extraction over 1/3rd of patients were able to have a primary implant inserted at the time of revision surgery.
