Fourth-Generation Ceramic-On-Ceramic THA With Anatomic and Tapered Femoral Stems: 11-Year Follow-Up.

Area of Science:

• Orthopedic surgery
• Biomaterials science
• Clinical outcomes research

Background:

• Ceramic-on-Ceramic (CoC) total hip arthroplasty (THA) offers excellent outcomes.
• Long-term data comparing anatomic (Corail) and tapered (Ribbed) femoral stems in CoC THA is limited.
• Understanding stem-specific differences in survival and complications is crucial for clinical decision-making.

Purpose of the Study:

• To compare the 11-year clinical outcomes and survival rates of anatomic (Corail) and tapered (Ribbed) femoral stems in CoC THA.
• To evaluate differences in functional scores, articular noises, and postoperative pain between the two stem types.
• To provide long-term evidence for stem selection in CoC THA.

Main Methods:

• Retrospective cohort study of 1438 patients undergoing CoC THA between 2009-2011.
• Follow-up of 591 hips with Corail stems and 334 hips with Ribbed stems at 11 years.
• Outcomes assessed using modified Harris Hip Score (mHHS), WOMAC, and questionnaires for articular noises and thigh pain.

Main Results:

• Both Corail and Ribbed stems demonstrated high survival rates (>98.8%) at 11 years.
• Significant improvements in mHHS were observed for both stems (p<0.001).
• Corail stems had higher rates of squeaking (22.7% vs 6.9%) but lower rates of thigh pain (4% vs 17.4%) compared to Ribbed stems.

Conclusions:

• CoC THA with both Corail and Ribbed stems provides excellent long-term clinical outcomes and survival.
• The Corail stem is associated with a lower incidence of postoperative thigh pain but a higher incidence of squeaking.
• Stem choice may influence specific complications like thigh pain and noise, despite similar overall survival.