The JRI cemented total hip replacement consisted of an acetabulum with a gamma irradiated UHMW polyethylene cup encased in a titanium metal shell, a 32 mm titanium head, and forged titanium alloy stem. This long-term study of 208 fully HA-coated Corail stems showed highly satisfactory osseo-integration and fixation in 97.6% after a mean of 17.0 years follow-up. Other radiographic features are discussed in depth. Diaphyseal stress shielding and cortical thickening were observed in three stems (1.4%). Combined metaphyseal and diaphyseal osseo-integration and bone remodeling were visible in one hundred stems (48%). Trabecular orientation and micro-anatomy suggested proximal load-transfer patterns in all except three cases (98.6%). Five stems (2.4%) required or are awaiting revision surgery. No stem altered in varus or valgus alignment more than two degrees and mean subsidence was 0.1 mm (range: 0 to 2) after a mean of 17.0 years. One stem (0.5%) was revised due to infection. Three stems (1.4%) showed metaphyseal periprosthetic osteolysis in two of seven Gruen zones associated with eccentric polyethylene wear awaiting metaphyseal bone grafting and cup liner exchange. Radiographic signs of aseptic stem loosening were visible in two cases (1%). The radiographs were digitized and examined with contrast enhancing software (DICOM Anonymizer 1.1.2) for analysis of the trabecular architecture. Radiographic evaluation focused on periprosthetic osteolysis, bone remodeling, osseous integration, subsidence, metaphyseal or diaphyseal load transfer, and femoral stress shielding. Total hip replacements in this study were performed by three members of the surgeon design team (Artro Group) in France between 19. We present a prospective study focused on radiographic long-term outcomes and bone remodeling at a mean of 17.0 years (range: 15 to 20) in 208 cementless fully HA-coated femoral stems (Corail®, DePuy, Johnson & The possible reasons for this difference are discussed. The periprosthetic and perioperative fracture rates for the two stems were found to be significantly different at three years into the study and the trial was stopped. The number of perioperative fractures in the Furlong group was 13(6.8%)and in the Anca sample 22 (15.3%). The surgery was undertaken by one surgeon, in one centre, in matched patients and using the same well-tried CSF acetabular cup and bearings.ģ35 patients had been entered into the trial, 228 females and 126 males.ġ91 patients had the JRI furlong hip implanted (57%) and 146 are in the Anca sample (43%). Patients were then randomised for one of the two stems. There were no restrictions for selection to the sample. The only variable was the stem shape.Īll patients placed on the senior authors’ waiting list for primary THR were asked if they would enter the trial. The same acetabular component was used in both samples. The paper discusses the merits and disadvantages of these two stems. We compared the original JRI Furlong stem with the Wright Anca fit stem which is more anatomical in design. We conducted an ethically approved, randomized and prospective trial to compare two radically different designs of fully hydroxyapatite(HA) coated femoral stems. The optimum design for the femoral component for cementless Total Hip Replacement is not known.
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