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Published on: September 16, 2020
Randomised controlled trial comparing early migration of two collarless polished cemented stems using
R W McCalden1, K D Charron, X Yuan
1London Health Sciences Centre, University of Western Ontario, 339 Windermere Road, London, Ontario, Canada N6A 5A5. richard.mccalden@lhsc.on.ca
Summary
The newer CPCS femoral stem showed less subsidence but more rotation than the Exeter stem in early clinical results. Both designs demonstrate comparable migration, suggesting long-term success for the CPCS stem.
Area of Science:
- Orthopedic surgery
- Biomedical engineering
- Medical device design
Background:
- The Exeter stem is a well-established collarless, tapered, polished cemented femoral stem.
- The CPCS stem is a newer design with a slight lateral to medial taper, otherwise similar to the Exeter stem.
Purpose of the Study:
- To compare the early clinical results and micromovement of the CPCS femoral stem against the Exeter stem.
- To evaluate the safety and efficacy of the CPCS stem design.
Main Methods:
- A single-blinded randomized controlled trial involving 34 patients.
- 17 patients received a radiostereometric CPCS stem, and 17 received a radiostereometric Exeter stem.
- Outcome measures and migration patterns (subsidence, rotation) were assessed pre- and post-operatively and at two years.
Main Results:
- No significant differences in overall early clinical results or most migration patterns were observed between the CPCS and Exeter stems.
- The CPCS stem exhibited significantly less subsidence (0.77 mm) compared to the Exeter stem (1.25 mm) at two years (p=0.032).
- The CPCS stem showed significantly greater internal rotation (1.61 degrees) than the Exeter stem (0.59 degrees) (p=0.048).
Conclusions:
- The CPCS femoral stem demonstrates comparable early migration patterns to the Exeter stem, suggesting potential for long-term success.
- Subtle design differences between the stems may account for variations in subsidence and rotation.
- The CPCS stem is a viable alternative to the Exeter stem, with promising early safety and efficacy data.
