Subsidence and perioperative periprosthetic fractures using collarless hydroxyapatite-coated stem for displaced femoral neck fractures according to Dorr type

Abstract

Background: Hydroxyapatite (HA)-coated stem has been introduced to decrease complications and eventually achieve quicker implant ingrowth and long-term stability. The aim of this study was to determine subsidence rate and incidence of perioperative periprosthetic fracture (PPF) of uncemented collarless Corail stem for displaced femoral neck fractures according to Dorr type. Methods: A retrospective review of plain radiographs and clinical data was carried out to identify consecutive patients who underwent uncemented hip hemiarthroplasty using collarless HA-coated Corail stem between March 2010 and August 2014. The risk of subsidence and PPF according to Dorr type was evaluated. Results: Dorr types A, B, and C were found in 66 (median age 74, 29.7%), 107 (median age 77, 48.2%), and 49 (median age 80, 22.1%) cases, respectively. Subsidence of stem occurred in eight (3.6%) cases. Dorr type had significant relationship ( p < 0.05) with subsidence. Type C canals had higher rates of subsidence. PPFs occurred in 11 (5.0%) cases without showing significant difference among Dorr types not significant (n.s.). Female gender was not influential on subsidence (n.s.) and PPF (n.s.). Conclusion: Dorr type C had higher risk of subsidence when using uncemented collarless HA-coated stem. Dorr canal type had no bearing on risk of PPFs. Women did not have significantly higher risk of both subsidence and PPFs compared to men. A collarless fully HA-coated Corail stem had 3.6% of radiological subsidence and 5.0% of PPF risk.